Almost everyone has an experience of the most pain they have ever felt. It becomes a part of our narrative. Some people will even try to measure immeasurable pain, declaring for example, that kidney stones hurt more than childbirth.
(As someone who has recently given birth, I am just grateful that I have not have had to make such a comparison.)
Sometimes we may think that someone is wimping out when they declare that pain is stopping them in their tracks. Before I developed a healthy dose of compassion, I used to scoff when people took days off work for menstruation or headaches.
Even though pain is so hard to measure, doctors will often use the McGill pain questionnaire developed in the 1970s by two scientists. This questionnaire categorizes the pain into three categories: sensory, affective and evaluative. There is then a “grid of suffering,” which is a clinical tool where the patient will rate the intensity of feeling. It is then used as a benchmark to see if a treatment plan is able to bring the patient’s pain down measurably. (1)
However, one person’s 10 might be another person’s 5. Why is this so? Why do people experience pain differently?
I know that for myself, my view towards pain shifted when I got older and when I experienced different types of pain. What used to be an 8 would now be downgraded to a 6.
Is this just pain experience? Or is there something else at play?
Turns out that some people really are more sensitive to pain than others, according to research from Wake Forest University Baptist Medical Center. In other words, MRI proved that pain is both not in your head and precisely in your head. Parts of the brain that are important in pain were incredibly active in people who declared a stimulus to be intensely painful. (2)
They also found that when pain is delivered, it is processed by the spinal cord in the same manner, no matter whether the person was the most sensitive or the least sensitive. It is when the brain gets involved that the experience becomes processed entirely differently from one person to the next.
These genetic differences can be a great factor in how we interpret pain. We also need to consider factors like age, sex, ethnicity, personality, mood, stress and cognitive processes, according to Robert B. Fillingim, who spoke at the American Pain Society conference. (3) (Women actually feel more pain than men because of more nerve receptors.)
In other words, a heck of a lot more than what is included on a clinical intake form.
The paradigm shift in the pain field right now, according to Irene Tracey, head of the University of Oxford’s Nuffield Department of Clinical Neurosciences, is the way that chronic pain is viewed. “Now we think of chronic pain as a shift to another place, with different mechanisms, such as changes in genetic expression, chemical release, neurophysiology and wiring,” she says. (1)
Most scientists and doctors are a far way from really, truly understanding pain – especially as it relates to an individual. This is one of those times when “to thy own self be true” rings true.
You know your body. You know your pain. You are your own best advocate.