Pain Management of Amazon Indigenous Peoples: A Community-Based Study

Abstract

Purpose Indigenous peoples are vulnerable populations that live in remote areas of the Amazon forest with limited access to health-care services. Underreporting and undertreatment of pain is a common event in the general population but little is known about these issues in indigenous peoples. The aim of this study was to investigate the characteristics and cultural aspects of pain management in five ethnicities of the Brazilian Amazon. Materials and Methods Cross-sectional study carried out with adult indigenous individuals from five ethnicities of the Brazilian Amazon over two scientific expeditions (June–July/2017 and February–March/2019). Pain assessment included etiology, intensity, duration, aggravating and alleviating factors, body location, impact of pain on activities of daily living, and treatment. Results Ninety indigenous individuals with a mean age of 41.42 ± 19.59 years (range 19‒98 years) and median age of 37 years participated in the study. Sixty-four individuals (71.1%) reported experiencing pain at the time of interview with intermittent musculoskeletal pain of strong intensity being the more prevalent (back pain: 45.3%, joint pain: 43.7%) followed by headache (26.5%). The main alleviating factors reported were traditional indigenous medicine (21.0%) and rest (30.0%), and physical exertion was the main aggravating factor (69.0%). Most study participants reported that pain affected their mood, activities of daily living, and sleep and that they used both traditional indigenous medicine (78.0%) and conventional medicine (81.0%) for pain relief. Conclusion Musculoskeletal pain is prevalent among indigenous individuals, affects their quality of life, and is partly attributed to their lifestyle. Cultural aspects mediating the pain experience were observed. Traditional indigenous medicine for pain relief remains partially preserved among the ethnic groups investigated. The findings of this study can help improve the delivery care to these vulnerable populations.

“Two Cultures in Favor of a Dying Patient”: Experiences of Health Care Professionals Providing Snakebite Care to Indigenous Peoples in the Brazilian Amazon

“…Two independent studies on other indigenous health issues in the Brazilian Amazon indicated indigenous acceptability of biomedicine and support this finding. In the Vale do Rio Javari, about 80% of indigenous people reported utilizing both indigenous and biomedicine to treat chronic pain [ 20 ]. In the Alto Solimões, almost all indigenous people were amenable to point-of-care screening for syphilis and HIV, and 87% of those who tested positive received biomedical treatment [ 21 ].…”