Medical science has long suspected a link between a person’s tolerance for pain and his or her perception of pain intensity. Most of us have talked about our own pain tolerance, giving credence to the idea that a link exists. Now, a study recently published in the Pain journal gives us insight into what might be going on.
The study was conducted at the University of Manchester (UK) by a group of researchers looking into the placebo effect for managing chronic pain. They studied 237 patients in three categories:
- Osteoarthritis patients (60)
- Fibromyalgia patients (79)
- Healthy patients (98).
All three categories were combined before the entire group was divided into placebo and control groups. Two series of tests were run in separate sessions two weeks apart.
What the Survey Revealed
Participants were given a cream to apply to the forearm. Placebo group members were told that the cream may or may not be a topical anesthetic. Control group members were told that the cream was completely benign.
All of the participants were subjected to laser pain stimuli. They were asked to measure the intensity of the pain they experienced at three points during the test: before the cream was applied, during application of the cream, and after application.
Researchers discovered that the placebo group reported a significant reduction in pain after applying the cream, regardless of which of the three initial groups they belonged to. Furthermore, the expectancy of pain and pain relief differed among placebo and control groups.
In simple English, the test proved that people have an innate ability to control their perceptions of pain based on their expectations of it. The researchers noticed no measurable difference in this regard when comparing the healthy patients with those suffering from osteoarthritis and fibromyalgia.
Tolerance and Perception
The results of the survey can be extrapolated to understand the link between pain tolerance and perception. If you are a person with a high tolerance for pain, you might not be bothered by things like Novocain injections at the dentist’s office. The injections still hurt to some degree, but you are able to control your response to them. It would seem that your ability to control your response results in a reduced perception in pain severity.
Chronic pain is something the doctors at Lone Star Pain Medicine in Weatherford, TX frequently treat. They say that it is common for patients to perceive pain differently. One patient may be very sensitive to pain while another more easily tolerates it.
Could it be that individual perceptions are in some way related to expectations? In other words, if you expect something to be extremely painful, is it more likely that you will perceive it as such? That is what the placebo study seems to indicate.
Placebo patients who assumed they were receiving a topical anesthetic had the expectation that they would feel less pain after the cream was applied. That lower expectancy appears to have led to a reduced perception of pain during the actual test.
New Pain Treatments
More research is necessary to confirm what the University of Manchester researchers discovered. But if their results bear out in future research, they could lead to new ways to treat everything from osteoarthritis to fibromyalgia and simple back pain. It could be that chronic pain is better managed simply by managing a patient’s expectations of pain management.
It just goes to show that the brain is an important player in pain management. And if we can change how the brain perceives pain, treating it should be a lot easier.
