Understanding Pain Tolerance

Why is pain such an individual experience?  If two people both have arthritis in their fingers, shouldn’t they feel a similar amount of pain?  The answer has to do with a person’s pain threshold and pain tolerance—both of which are shaped by biology, past experiences, and emotions.

Pain threshold is the point at which a person begins to feel pain.

Pain tolerance is the maximum level of pain that a person can bear.

Our bodies have a  “pain gate.”  In general, chronic pain makes that gate too sensitive so that it flies open—and stays open—even when the body is not in “danger.”  Because of this, people with chronic pain tend to have a LOW pain threshold.

However, because they deal with pain on an every day basis, many people with chronic pain have a HIGH pain tolerance.  They have developed ways to cope with the pain, often because they feel they have no choice.

But the experience of pain involves more than neurological signals.  Our psychological and emotional responses to pain begin in childhood.  Think about this: two toddlers fall and bump their knees.  The first child’s mother gives her son’s knee a little kiss and says, “Oh, you’re all better now,” and the child runs off to play some more. The other mother  picks up her son and says in a terrified voice, “Oh no!  Are you bleeding?  You poor baby, that must hurt so badly.”  The second child begins to cry loudly and clings to his mother.  It’s not that one mother is right and the other wrong.  It’s that the boys received two very different messages about pain—and those messages might affect their pain tolerance and coping skills as they get older.

Researchers have found other factors that seem to influence how a person responds to pain.  These include:

• Gender.  Women tend to be more sensitive to pain, but the ability to tolerate pain seems to be equal between men and women.
• Genetics.  For example, scientists have discovered that people with red hair have a lower pain threshold than other people.
• Fitness.  People who are fit, athletic, and at a healthy weight seem to tolerate pain better than people with poor fitness.
• Emotions. When people are in pain, emotions like despair, fear, and anxiety can make them more sensitive and less tolerant to pain.  And because depression and chronic pain often go hand-in-hand (see side bar), pain management physicians often treat both the physical and the emotional aspects of being in pain.