When Asians experience pain, there can be a lot of emotions that come with it.

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Fear. Anger. Embarrassment. Shame.

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And the initial gut reaction? To shove these emotions down, out of the way, into a box, never to see the light of day.

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Here’s a personal example. Seventeen-year-old me was competing hard during a high school tennis match. It was hot, and let’s just say I wasn’t always the best at hydrating (I tried, ok?). So, naturally, I started having very painful muscle cramps. First, it was my calves, then my forearms, followed by my hands and fingers. Long story short, I was on the brink of having a complete body cramp. But I’m not the kind of person who would throw in the towel. I didn’t want to embarrass myself by giving up, and my team needed this win. I refused to forfeit. I ended up losing anyway.

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The question you might be asking now though is, “Why?” Why would I not call for a medical timeout? Or to forfeit the match for my own safety and health? Well, I felt the same way many Asians may feel but are reluctant to admit. I saw pain as a weakness, and if it didn’t incapacitate me, I was fine. Right?

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For instance, a study by Kim et al. (2008) states that “Asian Americans were more concerned that seeking support would cause them to lose face, disrupt group harmony, and receive criticism from others.”  Another study by Liao et al. (2016) supports this by noting that “Asian… participants were less likely to express their pain symptoms to others, and if they did, they experienced regret and embarrassment as a consequence.” Dr. Cindy Tiu, an osteopathic physician who specializes in interventional pain, has also noticed some of these themes in her own practice. “Asians make up a very very small minority of patients I see in the pain clinic. I do believe that that has to do with Asians not wanting to complain or seek out help for pain,” says Tiu. She notes that the older generation tends to downplay their pain, only to have their children drag them into the clinic knowing that their parents really need help. This could be due to the mindset that parents must be strong in order to provide for their families, even if it means suffering in silence. Other studies, such as written by Clark et al. (2023), have also noted other broad themes that come into play such as difficult communication with health professionals, concerns about taking pain medications, resilience and privacy, cultural implications as well as the difficulties of managing pain at home.  

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Though this theme of pain and how it’s expressed may not be limited to just the Asian community, it does raise the question of how we, as future healthcare providers, can support our future patients who face these barriers. How do we create a space where someone can feel safe enough to admit that they’re in pain and to ask for help? And my only answer to this is to keep talking about it with empathy and understanding.

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I hope that this article can open the door for vulnerable conversations that our population tends to shy away from. There’s no need to shove our emotions and gut reactions into a box. Suffering in silence doesn’t need to be the norm anymore. The pain that people experience deserves to be brought to light, to be healed and cared for. And I hope that we, as the future generation of healthcare, can be the ones to create a new norm: a culture that says it’s ok to say “I’m hurting,” that it’s ok to ask for help. It’s ok to not be ok.

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References

Clarke, G., Crooks, J., Bennett, M.I. et al. Experiences of pain and pain management in advanced disease and serious illness for people from South Asian communities in Leeds and Bradford: a qualitative interview study. BMC Palliat Care 22, 90 (2023). https://doi.org/10.1186/s12904-023-01208-2

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Kim HS, Sherman DK, Taylor SE. Culture and social support. Am Psychol 2008;63:518-26.

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Liao, L., et al. (2016). Cultural differences in pain experience among four ethnic groups: A qualitative pilot study. Journal of Behavioral Health, 5(2), 77.

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