What's Your Pain Tolerance?

Discussion in 'Fibromyalgia Main Forum' started by JLH, Mar 17, 2010.

  1. JLH

    JLH New Member

    What's Your Pain Tolerance?

    Everyone struggles with pain at some point, but how you tolerate pain can be up to you.

    Why is back pain or a knee injury annoying to one person and sheer agony to another? Turns out, an individual's tolerance to pain is as unique as the person, and is shaped by some surprising biological factors, as well as some psychological factors that we can actually try to control.

    Feeling Pain

    There are two steps to feeling pain. First, is the biological step, for example, the pricking of skin or a headache coming on. These sensations signal the brain that the body is experiencing trouble. The second step is the brain's perception of the pain -- do we shrug off these sensations and continue our activities or do we stop everything and focus on what hurts?

    "Pain is both a biochemical and neurological transmission of an unpleasant sensation and an emotional experience," Doris Cope, MD, an anesthesiologist who leads the Pain Medicine Program at the University of Pittsburgh Medical Center, tells WebMD. "Chronic pain actually changes the way the spinal cord, nerves, and brain process unpleasant stimuli causing hypersensitization, but the brain and emotions can moderate or intensify the pain." Past experiences and trauma, Cope says, influence a person's sensitivity to pain.

    Managing pain and people's perceptions to their symptoms is a big challenge in a country where more than 76 million people report having pain lasting more than 24 hours, according to the American Pain Foundation. Persistent pain was reported by:

    * 30% of adults aged 45 to 64
    * 25% of adults aged 20 to 44
    * 21% of adults aged 65 and older

    More women than men report pain (27.1 % compared with 24.4%), although whether women actually tolerate pain better than men remains up for scientific debate.

    Pain Rising

    Pain produces a significant emotional, physical, and economical toll in the U.S. Chronic pain results in health care expenses and lost income and lost productivity estimated to cost $100 billion every year.

    Pain may be on the rise in the U.S. because age and excessive weight contribute to pain and discomfort. Americans are living longer into old age, and two-thirds of the population is either overweight or obese.

    The most common type of chronic pain in the U.S. is back pain; the most common acute pain being musculoskeletal pain from sports injuries, says Martin Grabois, MD, professor and chair of the department of physical medicine and rehabilitation at Baylor College of Medicine in Houston.

    What Drives Your Pain Tolerance?

    Pain tolerance is influenced by people's emotions, bodies, and lifestyles. Here are several factors that Grabois says can affect pain tolerance:

    * Depression and anxiety can make a person more sensitive to pain.
    * Athletes can withstand more pain than people who don't exercise.
    * People who smoke or are obese report more pain.

    Biological factors -- including genetics, injuries such as spinal cord damage, and chronic diseases such as diabetes that cause nerve damage -- also shape how we interpret pain.

    Your Sensitive Side

    Some surprising biological factors may also play a role in pain tolerance. For example, recent research shows that one side of your body may experience pain differently than the other side.

    A study published in the December 2009 issue of Neuroscience Letters showed that right-handed study participants could tolerate more pain in their right hands than in their left hands. This study also showed that women were more sensitive to pain than men; but women and men were equal in their ability tolerate pain intensity.

    A dominant hand -- your right hand, if you're right-handed, for example -- may interpret pain more quickly and accurately than the non-dominant hand, which may explain why the dominant side can endure longer. Hand dominance may also be linked to the side of your brain that interprets the pain, the researchers note.

    Redheads More Sensitive to Pain?

    Another surprising factor is that hair color may reflect pain tolerance. In 2009, researchers reported in the Journal of the American Dental Association showed that redheads were more sensitive to pain and may need more anesthesia for dental procedures.

    Why redheads in particular? Redheads, the researchers say, tend to have a mutation in a gene called melanocortin-1 receptor (MC1R), which is what helps make their hair red. MC1R belongs to a group of receptors that include pain receptors in the brain. The researchers suggest that a mutation in this particular gene appears to influence sensitivity to pain.

    "We have different receptors for pain in our body, and those receptors respond differently, whether you're taking aspirin or acetaminophen," Stelian Serban, MD, director of acute and chronic inpatient pain service and an assistant professor of anesthesiology at The Mount Sinai Medical Center in New York, tells WebMD.

    Getting Better at Handling Pain

    A person's biological makeup can affect whether he or she develops resistance to pain medicines, which means a treatment that once worked no longer eases the pain. This can be a "vicious circle" to break, Serban says. "You use more treatment and become more tolerant and you become less active and have more pain."

    We can't change our genetic receptors, and not even changing your hair color or which hand you write with can rewire your sensitivity to pain. However, there are coping mechanisms that can influence the brain's perceptions of pain.

    Researchers have focused on trying to alter the psychological interpretations of pain by retraining the mind. "You can change the perception [of pain] on the brain," Grabois says. "You haven't changed the perception on the nerves."

    Alternative remedies, such as relaxation techniques like biofeedback, teach people how to divert their mind from zeroing in on the pain.

    People can empower themselves by learning relaxation techniques, such as breathing practices during natural childbirth, Cope says. When it comes to pain, mind over matter can work. "Meditation, distraction, and a positive attitude are things people can do themselves to lessen pain," she says.

    By Katrina Woznicki
    WebMD Feature
    Reviewed by Louise Chang, MD
  2. gapsych

    gapsych New Member

    My BIL is an oncologist, and deals with a lot of patients who are in horrific pain. While he believes relaxation techniques, positive attitude can help and has such things as aquariums, soft music, comfortable chairs during chemotherapy, he also believes that often the amount of pain his patients are experiencing whether during chemotherapy or not, may be a reflection of how sick they are.

    I had my second child w/o medications but it was a fast and furious labor. But, what if a woman has factors they are not in her control such as a prolonged labor, the infant facing the wrong way or other medical complications. Would we say these women have lower pain thresholds? Would we say these woman do not know how to empower themselves,they should just breath the right way and stop being so emotional?

    How many women needing medication for child birth have been made to feel that they have somehow failed?

    If someone were using an electric drill on your skull, would breathing techniques really help?

    I am not dismissing relaxation techniques, distraction, positive attitude as factors that may help the perception of pain.

    I meditate, practice relaxation techniques, but I dare anyone to say that the pain I go through is only a reflection of my will power, character or attitude.

    Just my two cents worth!!! I will now fall off my soapbox :>)!!

    [This Message was Edited on 03/17/2010]
  3. shari1677

    shari1677 New Member

    Before I was diagnosed with FM, I had several surgeries to include gallbladder, 2 C-sections and a breast reduction. With each, I took pain pills for less than 2 days and was back to work.

    I have had FM for I think 5 years now, maybe 4. I have been taking narcotics almost the whole time.

    I believe this is worse than surgery - at least for me!
  4. loto

    loto Member

    I didn't know a study was done about redheads being more sensitive to pain.
    Being a redhead, this is very interesting to me.

    Thanks for posting!

  5. Pebbles730

    Pebbles730 New Member

    When I just had CFS, which was about 10 yrs before I developed the Fibro, I had pain and aches sure. But I was able to go about my normal daily life, with no medications. I didn't go to therapy and I did my own home treatment. When my body hurt, I slept, and tried to eliminate stress.
    Back in those days before fibro, I had gotten 5 tattoos over the years. And I know now, that there is no way that I could handle that pain again. My pain levels are so much more increased since this Fibro has gotten a hold of me. I mean, it hurts for my husband to hug me sometimes. I was a ballet dancer for 15 years. I used to spend three hours a night ballet and tap dancing twice a week. I used to sit on a hard wooden floor to exercise for and hour and a half before classes started. Now I cannot even sit on a hard surface for more than 5 minutes before I am in terrible pain. So, how do you account for that?
    I'm sorry but it really irritates me when people are so busy telling you to stop taking the medications that you need to function in life. I am not depressed, I'm happier than I have ever been in my life! I am not obese, I do not smoke, etc etc. So there go those explainations. When I got the CFS no one knew about that either. Everyone thought I was just lazy. My doctor says that I am a high functioning CFS/ Fibro patient. I hold down a full time job, clean, cook and take care of my 3 dogs. I'm thankful that I can do those things. But without my medication I would not be able to do any of those things. There are many Fibro / CFS patients that have it much much worse than me. People who cannot get out of bed or do anything. Are they depressed? Probably, but that is because all they want is help to be able to get back to somewhat normal. And then there are people and doctors telling them to go do some exercise and meditate and that will solve anything. Maybe the first step in helping us feel better is to stop making people feel guilty for doing what they need to do to function. Once I gave up the guilt, that relieved alot of my stress.
    Sorry for rant, just sometimes things like this get my goat!!
    [This Message was Edited on 03/18/2010]
  6. AuntTammie

    AuntTammie New Member

    keep in mind when thinking about this stuff that pain threshold and pain tolerance are two different things (threshold is the point at which we perceive something as painful and for most of us that has been greatly diminished; pain tolerance is how much pain we can put up with and since most of us are always in pain, we actually tend to have HIGHER levels of tolerance)

    ETA: for exp, using the 0 - 10 scale for how painful somethign feels (10 being agonizing, 0 being no pain), for someone with Fibro light touch might feel like a 3 (and for a normal person it would be a zero) - that's threshold

    however, we might constantly feel like we are experiencing widespread pain at an 8 and we are so used to it we can still function, whereas a normal person encountering a pain level of 8 would completely out of commission - that's tolerance[This Message was Edited on 03/18/2010]
  7. Svette_Palme

    Svette_Palme New Member

    A little known Fibro research team Dr. Light [husband and wife] have discovered the sensory neurons that monitors muscle status. When the situation demands it, that sensory system sends out the signals that trigger the brain to produce pain.

    Simply, they found that there are more of those neurons and they are more active in Fibro patients!! I think this is stunning research.

    No wonder we feel more pain. BTW - "pain is allways and only in the brain"
  8. HeavenlyRN

    HeavenlyRN New Member

    .....that I didn't read the first post entirely because it is difficult for me to read so long on the computer.

    However, I will say this. As a nursing student, we were always taught that "the pain is what the patient says it is."

    After having been a nurse for almost 20 years, I have always kept that first and foremost in my mind when treating someone. And, as the past 4 years as a Hospice nurse in long term care settings, I have often had to "convince" the patient's primary nurse that, yes, the patient could very well be having pain - even if they don't "look" like they're in pain. Or, I often heard, "oh he always moans like that." I would say then........"well, maybe he's "always" been in pain and it's just not being treated properly." I used to (I'm on disability myself right now) get a lot of dirty looks when I would say that!

    But, it was my job to keep the patient comfortable. And I'm proud to say I did my job!! :)
  9. gapsych

    gapsych New Member

    JHL, This is an interesting topic.

    Heavenly RN, Thank you for the compassionate work you have done as a hospice nurse.

    The world needs more people like you!!

    BTW, years ago someone told me that redheads have a higher incidence of ADD. Now, of course this could be an urban legend or come from the fact that people always have thought red heads as being temperamental.

    Several generations back a lot of my relatives had red hair but from the stories I have heard they were very "stoic", people of few words, LOL!!

    My hair, until I had to start dying it was a very light brown with red undertones. I have to be careful when I have it dyed as the red will tend to make the color look brassy.

    I am going to look this one up but if someone finds out before me, please post it.

    Pain tolerance vs. pain threshold. makes sense I have always thought my pain tolerance is high. Before and after the FMS.

    As for men, have them go through labor and see how they feel, LOL!!!

    Take care.

    [This Message was Edited on 03/19/2010]
  10. HeavenlyRN

    HeavenlyRN New Member

    ...thank you for the kind words! I appreciate it.

    Re: people with red hair being people of few words - and I'm going to hijack the topic of this thread for a minute.......my 31 year old son has red hair. He hasn't stopped talking since he learned how to say his first word!!! My exhusband once said, "And to think we wanted him to learn how to talk!" (PS....I love my son very much!!!)

    Oh - and regarding childbirth.....I agree with you! However, when I had my incredibly severe, awful, horrible, take-your-breath-away back pain back in December - I reached a new threshold. Childbirth was NOTHING compared to that! Of course, I'm sure my mind is a little fuzzy on the childbirth thing because my youngest child is 27!!

    Oh well, it sure FELT worse than childbirth!
    [This Message was Edited on 03/19/2010]
  11. lgp

    lgp Well-Known Member

    Pain is, in my opinion, a very subjective matter.

    I gave birth to twins (7lbs 5oz and 6lbs 3oz respectively) without any drugs or epidural--natural all the way. The same with my third child who came in at 9lbs 13 oz. While neither birth was a walk in the park, the pain was surprisingly greater with the singleton, but I think the fact that she was posterior and my water had broken some 18 hours earlier had something to do with it. But the pain was pretty bad, however fleeting.

    That being said, nothing but nothing could compare to the pain of the attack of acute diverticulitis that landed me in the hospital for four days last December. That made childbirth feeli like stubbing my toe. It is even difficult to put into words, that's how bad the pain was. At the ER the triage nurse asked me to classify the pain from 1-10 and I told her 11....several shots of morphine and then dilautin made it a bit manageable...it was the first time I ever actually cried tears from pain. And my threshold is pretty high, considering I deal with FM every day and have opted out of narcotics of any kind to treat it. The good news is I had my follow up colonoscopy last week, and any damage caused by the attack back in December has totally healed.

    Regarding redheads, oddly enough, all the women on my dad's side are redheads. Years ago, my mom told me that when everybody in the family was having babies at the same time, they all used the same doctor. My mom used to chat with him alot, and he told my mom he used to be on his guard when any redheaded patients came through the door, because he had to be extra guarded about their treatments. He felt they were medically fragile. Interestingly, the rehdheads were the only ones in the family to suffer multiple miscarriages.


    [This Message was Edited on 03/20/2010]