is a highly subjective complaint. A minor bump that causes one person to say nothing more than “Ouch!” can be excruciating to another. When you do something that can cause injury, your nerves immediately send a message to your brain indicating danger — and the pain is a sign that you should stop or do something to fix the problem.
The thing is, everyone receives and interprets those signals differently, but no one knows for sure why. Evidence points to several factors for varying pain tolerance, including genetics, and hormonal fluctuations, especially estrogen, which explains why many women are more sensitive to pain immediately before menstruation when estrogen levels decrease. However, there is also evidence that pain itself can make pain feel worse.
The Ongoing Cycle of Pain
The sensation of pain is a function of the central nervous system (CNS). Neurotransmitters send messages to the brain, which then interprets them as painful or pleasant. However, when pain is severe and ongoing, it can actually change how the CNS works. Chronic pain often leads to central sensitization; in other words, your CNS becomes more sensitive to any type of pain, and in some case, over sensitized to the point where any type of contact is painful.
Imagine you bang your foot on a table leg. It hurts, but a few hours later, it feels fine, and there is no evidence of injury. A few days later you bang your foot again — only this time, the pain lasts longer. Because the only measure you have of your pain level is the pain you felt the first time, there is really no way to determine whether the pain is actually worse than it was the first time, or if it’s just an increased perception of pain.
In most people, this increased sensitization is mild, and is memory based; in other words, when we have a memory of pain to compare the current ailment to, we can find out whether it is more intense or not. Someone who has nothing to compare pain to might not believe that the pain is as intense as it “should be,” while someone else who has experienced more pain believes that the pain is more intense than normal. For others, the increased sensitivity to pain is debilitating, possibly explaining why some people live with chronic pain despite medical intervention. In these cases, it’s not necessarily the condition itself that is causing pain, but the fact that the CNS has become over sensitized to the “danger” signals that the neurotransmitters send to the brain, effectively turning everything into a potential source of danger.
One of the problems with treating patients who have sensitized nervous systems is that the treatments themselves — including physical therapy and massage — can often trigger the warning signals that lead to increased pain.
Not to mention, many treatments focus on the actual physical causes of pain, the problems inside the muscles, bones, and joints, and do not address the neurological issues associated with pain — in other words, they don’t assess how the patient perceives pain and the psychological aspects of pain.
That’s why someone who has a low tolerance to pain, who is experiencing chronic pain, or both, needs to work with a pain diagnostic and treatment center that looks at the whole patient, and addresses not only the physical manifestations of pain, but also the underlying causes of pain and the psychological aspects of the condition. Evidence shows that certain treatments can actually reduce both the pain and the sensation of pain, including:
? Behavioral modification therapy. Developing skills and strategies to remain positive and focused even when in pain has been proven to help the brain “rewire” itself to increase tolerance. Staying positive increases the production of the brain chemical serotonin, which helps dull the sensation of pain.
? Working through the pain. Many athletes improve their pain tolerance by simply training through the pain. The more they train, the more accustomed to the pain they become, and the more they can handle. While you should never do anything that would cause more damage, stretching, walking, or low-impact exercise can help reduce the pain, both short and long-term.
? Breathing exercises. Learning to control your breath, in conjunction with visualization and positive self-talk, can reduce pain and increase tolerance.
Above all, the most important thing to do when you’re experiencing pain, especially if it hurts more than usual or more than you think it should, is to get help. There could be a serious underlying medical issue, and treatment will reduce or eliminate the pain. Remember, the longer you’re in pain, the worse it can get, so seek help and live a pain-free life.