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What's Your Pain Tolerance?

Everyone struggles with pain at some point, but how you tolerate pain can be up to you.
By Katrina Woznicki
WebMD Feature

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.

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