likely to have shoulder, elbow and foot joint pain; women have finger, hip, ankle and

wrist joint pain (Davis, Ettinger, Newhaus & Hauck, 1987). Although specific affected

joint patterns have been identified as following a gender pattern, gender differences do

not contribute to risk factors for the development of osteoarthritis (Davis, et al.

1987;Keefe, et al. 2000; Lawrence, et al. 1998).

Race, Pain and Osteoarthritis

 Differences in cultural response to pain have been studied using two methods, non-

experimental using observational methods, and laboratory experimental using painful

stimuli and measuring the response. Zatzick and Dimsdale (1990) were unable to

correlate cultural variations in pain response in their meta-analysis of pain stimuli and of

pain response. They concluded, "there is no evidence suggesting that the

neurophysiology detection of pain varies across cultural boundaries" (p.554). However,

Bates, Edwards, and Anderson (1993) using observational methods to evaluate the

differences in reported chronic pain intensity among seven diverse ethnic groups, found

significant correlations. Additionally, they investigated specific sociodemographic,

medical, and psychological variables that may predict an intra-ethnic group variation in

pain intensity. Bates, et al. (1993) found that pain intensity did not vary among various

ethnic groups because of differences in neurophysiology but was a result of the

biocultural model of pain perception.

 European whites have a greater incidence of osteoarthritis than Jamaicans, Blacks,

South African Blacks, Chinese, and Indians (Felson, 1988). Rates for American Indians

are intermediate. There is speculation that individuals of European white descent have a

genetic developmental defect in both the knee and hip joints that facilitates the