This is going to hurt

 Our response to pain differs enormously from one person to the next. Why is this the case – and more to the point, can we do anything about it? 

Have you ever wondered why some Premier League footballers spend more time rolling around on the ground than others? According to recent research, the answer is not as simple as you might think. The first thing to understand is that our ability to tolerate pain is as unique to us individually as the shape of our noses. Defined as much by psychological factors as biological ones, emerging data has begun to explain why we all react differently to pain.

When we cut ourselves, a sensation is sent to the brain signalling that we are experiencing trouble. The injury is a biological fact. And yet the way we react to this biochemical and the neurological signal varies hugely from one person to the next. According to Doctor Doris Cope who leads the Pain Medicine Program at the University of Pittsburgh, “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."

This insight is not insignificant. In the UK, chronic pain now affects more than one third of the adult population, translating to just under 28 million people. Understanding how and why we respond to pain differently is now a critical concern for our overburdened National Health System.

pain

Depression and anxiety appear to make us more susceptible to pain. And while smokers and the obese report more pain, athletes (professional footballers not withstanding) can tolerate more of it than any other group.  

Perhaps less surprising is that our tolerance of pain, or ‘pain threshold’ is directly influenced by our past experiences, especially traumatic ones. In fact, much of the way we respond to pain as adults is defined by the way we were socialised to react to pain as children. Something to consider the next time you see a footballer take a dramatic dive.

Imagine a child bumps into a kitchen chair and takes a tumble. He picks himself up and carries on despite his grazed knee, happily gabbling to himself without tears or complaints against the cynical chair that brought him down. Observe now that same child falling while his mother is watching and you may spot a decision being made faster than a referee can raise a red card. A decision that is influenced directly by his mother’s reaction. If she screams and rushes to his side he will learn to ‘act out’ in order to secure her attention and capitalise on his pain in future. But if she coolly checks to see that he is not hurt before returning to her Sunday papers, he will not.  

There is a lot in life we cannot change. Our genetic receptors and early socialisation may be factors that are beyond our control. And yet, we can still take steps to influence the way our brains perceive pain. Long before prescription painkillers became available it was common for patients to undergo ‘mesmerism’ prior to a major operation. Hypnotism has come a long way since the Victorian era but its continued use underpins the importance of the mind-body connection in regulating our response to pain. 

victorian mesmerism

Cognitive behavioural therapy (CBT), distraction techniques, mindfulness or hypnosis are all effective ways to become more tolerant of pain, while regular exercise releases natural painkillers known as endorphins.  

Pain as a signal of actual bodily harm remains an indisputable fact. Sometimes it is the only way we can tell that our body is in trouble. Life hurts –  we just have to find ways to soften the blow. 

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