Substantial literature suggests that diverse biological, psychological, and sociocultural
mechanisms account for differences by race and ethnicity in the experience, epidemiology,
and management of pain. Many studies have examined differences between Whites and
minority populations, but American Indians (AIs), Alaska Natives (ANs), and Aboriginal
peoples of Canada have been neglected both in studies of pain and in efforts to understand
its biopsychosocial and cultural determinants. This article reviews the epidemiology
of pain and identifies factors that may affect clinical assessment and treatment in
these populations. We searched for peer-reviewed articles focused on pain in these
populations, using PubMed, CINAHL, Cochrane, and the University of New Mexico Native
Health Database. We identified 28 articles published 1990 to 2009 in 3 topic areas:
epidemiology of pain, pain assessment and treatment, and healthcare utilization. A
key finding is that AI/ANs have a higher prevalence of pain symptoms and painful conditions
than the U.S. general population. We also found evidence for problems in provider-patient
interactions that affect clinical assessment of pain, as well as indications that
AI/AN patients frequently use alternative modalities to manage pain. Future research
should focus on pain and comorbid conditions and develop conceptual frameworks for
understanding and treating pain in these populations.