Pain threshold - everything you need to know about pain. Unbearable pain: what is the pain scale and is it necessary to endure The Princess and the Pea

All people perceive pain completely differently: for some, a banal vaccination becomes a difficult ordeal, while others can easily withstand any medical manipulation without resorting to pain relief. This is due to the fact that every living organism has a characteristic pain sensitivity threshold.

What is pain threshold

The pain threshold is an indicator of the degree of irritation of the central nervous system, which is accompanied by pain.

The highest level of pain that a living organism can endure in a particular situation is considered its pain tolerance level. At the same time, it is impossible to determine the pain threshold or tolerance level based on the characteristics of the impact that causes pain.

It is generally accepted that the pain threshold of the human body is laid down at the level of genes, so the reaction to identical stimuli will be unique for everyone. One will suffer from unbearable pain, while the other will feel only mild discomfort.

Those who feel pain only with a very strong impact have a high pain threshold. Those with a low threshold are less tolerant of pain and experience discomfort even with minimal impact.

Doctors say that with a weakened immune system, which is caused by a deficiency of B vitamins or overwork of the body, there is a risk of a decrease in the pain threshold.

Studies have shown that women have a much higher pain threshold than men, and its maximum level is observed during labor.

This means that the level of pain tolerance directly depends on the overall hormonal picture, namely on the body’s endocrine system, which secretes estrogen. However, representatives of the fairer sex are more vulnerable psychologically, which is manifested by fear and tears, even with the slightest pain.

Types of pain perception

Doctors distinguish 4 types of pain sensitivity.

The Princess and the Pea

People with this type have a very low pain threshold and a similar range of pain tolerance. They can hardly tolerate even the slightest pain and light physical activity.

As a rule, these are melancholic, vulnerable natures who prefer loneliness. Before any medical procedure, they need to be persuaded for a long time, because they cannot withstand even minor pain. To prevent painful shock, all procedures, and especially surgical interventions, are performed under general anesthesia.

Little Mermaid

They are characterized by a low pain threshold and a large pain tolerance range. They have a hard time withstanding painful effects, but are able to calm down and courageously endure medical manipulations. These are loyal, impressionable people, prone to empathy and compassion.

sleeping Beauty

These are the owners of a high pain threshold and a short tolerance interval. Such characteristics make it possible for the body not to respond to minor pain. But a violent reaction will result from the slightest increase in irritation, because representatives of this type completely lack patience.

They are able to hide strong tension under the guise of absolute calm, which is manifested by emotional outbursts.

Steadfast Tin Soldier

This is the name given to people with a high pain threshold and a large range of pain tolerance. They are able to ignore the manifestations of painful sensations of any strength and endure physical activity without problems. As a rule, such abilities are characterized by successful and self-confident individuals with leadership qualities.

How to determine

An algesimeter is used to determine the level of the pain threshold. The essence of the device’s operation is the impact of certain irritants (high pressure, high temperature and electric current) on delicate areas of the skin, usually the areas between the toes and hands. The force of impact gradually increases, which makes it possible to determine the lowest and highest sensitivity rates; the difference between them is the pain tolerance interval.

How to increase

The level of the pain threshold is determined by the functioning of nociceptors - the “bare” endings of nerve cells distributed throughout the body. Constant exposure to these places forms the body’s protective properties to external irritants.

It has been proven that pain tolerance indicators depend on emotions, the physical state of the body, and sometimes on the time of day. This means that the pain threshold can be controlled.

Several methods will help increase its degree, the main task of which is to produce the hormones of happiness - endorphin and serotonin.

• Eating spicy and bitter foods (mustard, red pepper, horseradish and others) that burn the tongue, causing the body to defend itself and produce endorphins.
• Eating foods that promote the production of serotonin - nuts, bananas, eggs, milk, turkey meat.
• Anger is a psycho-emotional arousal of the body that mobilizes all forces. This is an excellent one-time option for increasing the pain threshold, but regular outbursts of negative emotions, on the contrary, will lead to exhaustion of the body and a decrease in the level of resistance to pain.
• Sex. Endorphins, which dull pain, are produced in large quantities during sexual intimacy.

Pain is a protective reaction of the body, so it is important not to overdo it with increasing the pain threshold, but to maintain its natural level.

It has been proven that cheerful, cheerful people who lead a healthy lifestyle most often have a high pain sensitivity threshold.

Few people like to experience pain. For many, even this word evokes negative emotions, and the feeling itself is real suffering. But each person is individual and feels pain in their own way. People who have a low pain threshold are those who panic at the mere sight of a dentist. Those who have this very high threshold often do not even need anesthesia.

What are the “thresholds” for pain?

The pain threshold is usually understood as the degree of sensitivity of the human body to the effects of any traumatic forces on it. This sensitivity is directly related to the level of irritation of many nerve endings. Depending on how much pain a person experiences, a pain threshold is distinguished between low and high.

How to determine the degree of sensitivity? Everything is very simple: with a high level, people practically do not feel pain from injections, and with a low level, they can even scream. A person with a high threshold can withstand quite strong impacts on his body: sudden changes in temperature, deep cuts or blows. A person with a low level cannot even endure the pain of an ordinary abrasion.

The ability to tolerate pain, according to scientists, is inherent in every person’s genes. However, resistance to physical suffering may also depend on the emotional state. One way or another, knowing your pain type is as important as information about your blood type, weight category, height and other characteristics of our body.

Verification method

How to test your pain threshold and find out how susceptible you are to pain? To measure this indicator, scientists invented a special device - an algesimeter. Using this device, the human body is exposed to a light electrical discharge or high temperature.

Such a check is carried out in the most sensitive place - on the skin near the armpit or between the toes. During the study, the device notes the magnitude of the impact and the limit within which a person does not feel pain at all or calmly endures pain.

Heightened perception

Surely many will agree that it is much better to have a high than a low pain threshold. This heightened perception of even the slightest discomfort can turn the simplest blood sampling procedure into a real test for a person.

Experts believe that all people who are too sensitive to physical pain can be further divided into two groups:

• “touchy”, or low tolerance interval. Such a person is simply not able to endure pain; for him, even a small scratch is a reason for tears and even panic. With such fear of pain, any medical procedures are recommended to be carried out only with complete or at least local anesthesia. Otherwise, there is a risk of not only a nervous breakdown, but also a real painful shock;
• “little mermaid”, or high tolerance interval. These people have very high sensitivity, but if necessary they are ready to endure pain for quite a long time. The best behavioral tactics for a person of this type is the correct psychological attitude and moral preparation some time before he has to experience an unpleasant sensation.

Often people with a high threshold simply cannot believe that a low pain threshold really exists. So, for example, some doctors believe that a patient who panics at the sight of a syringe or a dental chair is faking it. However, just as there are no two identical people, there are no absolutely identical perceptions of pain.

The level of your sensitivity to pain can be controlled to some extent. It has been scientifically proven that under certain circumstances, at certain hours, and also under the influence of various emotions, this parameter can change.

There are several proven methods that can temporarily increase the degree of pain perception:

• increase in serotonin levels. You can influence the level of the “happiness hormone” by including in your diet bananas, hazelnuts, milk, eggs, turkey meat and some other products that help increase its level in the blood;
• psychological trainings. If you develop the skill of managing your emotions, you can learn to drown out pain by independently “inducing” other feelings (anger, excitement, etc.);
• "burning" therapy. Eating foods such as ginger, red pepper, mustard or horseradish has a distracting effect on pain receptors, gradually inhibiting their function;
• release of endorphins. The level of the hormone responsible for the state of euphoria increases during active sports, during the period of falling in love and during creative activity.

It is also believed that a person's pain threshold may vary depending on their age. According to scientific research, people between the ages of 10 and 30 are most sensitive to such sensations. Young children and those who have crossed the 30-year mark feel pain much less, but it is much more difficult for them to endure this feeling.

Pain is always an unpleasant sensation. But its intensity can be different: it depends on what kind of disease has developed and what pain threshold the person has.

So that the doctor can understand exactly how it hurts - unbearably or more or less moderately - so-called pain scales were invented. With their help, you can not only describe your pain at the moment, but also say what has changed with the prescription of treatment.

Visual analogue scale

This is the scale most often used by anesthesiologists and oncologists. It provides an opportunity to assess the intensity of pain - without any prompting.

The visual analogue scale is a 10 cm long line drawn on a blank sheet of paper - without boxes. 0 cm is “no pain”, the rightmost point (10 cm) is “the most unbearable pain, which is about to lead to death.” The line can be either horizontal or vertical.

The patient must place a point where he feels his pain is located. The doctor takes a ruler and looks at what mark the patient’s point is:

• 0-1 cm – pain is extremely mild;
• from 2 to 4 cm – weak;
• from 4 to 6 cm – moderate;
• from 6 to 8 cm – very strong;
• 8-10 points – unbearable.

When assessing pain, the doctor not only looks at this point, but also at the person’s entire behavior. If a person can be distracted by questions, if he calmly walked through the office before leaving, he may be overestimating the degree of pain. Therefore, he can be asked to re-rate his pain - on the same scale. And if this is a woman, then ask to compare it with pain during childbirth (it is estimated at 8 points for each woman). If she says: “What, giving birth was twice as painful,” then you should rate her pain at 4-5 points.

Modified visual analogue scale

The essence of pain assessment is the same as in the previous case. The only difference between this scale is the color marking, against which the line is drawn. The color comes in a gradient: from green, which starts at 0, to 4 cm it is replaced by yellow, and to 8 cm it is replaced by red.

Verbal ranking scale

It is very reminiscent of a visual analogue scale: it is also a 10 cm long line that can be drawn in front of the patient independently. But there is a difference: every 2 cm there is an inscription:

• at 0 cm – no pain;
• 2 cm – mild pain;
• at around 4 cm – moderate pain;
• at 6 cm – strong;
• at 8 cm – very strong;
• at the end point - unbearable pain.

In this case, it is already easier for a person to navigate, and he puts an end to it based on which epithet he most associates his own state with.

The positive aspects of this method of pain assessment are that it can be used to assess both acute and chronic pain syndromes. In addition, the scale can be used in children, starting from primary schoolchildren, as well as people with primary degrees.

Pain scale "in faces" (facial)

This scale can be used to determine the intensity of pain in people with advanced dementia. It consists of 7 drawings of faces with emotions, each of which schematically conveys the strength of the pain syndrome. They are arranged in order of increasing pain.

Why drawings, and why such primitive ones? Because from such drawings the emotion is easier to read and more difficult to misinterpret than from a work of art or photograph.

Before a person points to a face that displays the appropriate degree of pain, he needs to explain the picture. The doctor says: “Look, the first person is not in pain, then people are shown who feel pain - more and more each time. The person on the right is in terrible pain. Show me how much pain you feel." After this, the person points or circles the desired face.

Modified face scale

It consists of 6 faces, each of which depicts an emotion corresponding to the description of pain on a verbal ranking scale. It is also used to assess the intensity of pain in dementia and is also carried out after a short introductory speech.

Scale used for bedridden and speechless patients

Resuscitators use the CPOT scale, which allows them to assess the degree of pain without talking to the patient. They take into account 4 parameters:

1. Arm muscle tension.
2. Facial expression.
3. Attempts to speak or resistance to breathing apparatus.
4. Motor reactions.

Each parameter is scored from 0 to 2 points, after which the points are summed up.

The interpretation is this:

0-2 points – no pain;

3-4 points – mild pain;

5-6 points – moderate pain;

7-8 points – severe pain;

9-10 – very severe pain.

The most comprehensive pain assessment is the McGill questionnaire.

Thanks to this questionnaire (questionnaire), it is possible to evaluate three main systems for the formation and conduction of pain:

1. nerve fibers that directly transmit pain sensations;
2. structures that exist in both the spinal cord and the brain: the reticular formation and the limbic system;
3. sections in the cerebral cortex that are involved in the assessment and final interpretation of pain.

Therefore, the questionnaire is conditionally divided into 4 groups:

• to determine the sensory characteristics of pain;
• to assess which emotional components the pain involves;
• to assess how pain is assessed by the brain;
• a group of words that are aimed at assessing all criteria at once.

Physically, the questionnaire looks like 20 columns, each of which contains from 1 to 5 epithets, arranged in order - in accordance with the intensity of pain. A person needs to circle as many of them as will help him accurately describe his feelings.

The pain index is scored by how many words were used to describe pain for each of the 4 parameters. It is also important which serial numbers were used to evaluate each aspect. And finally, the serial numbers of the selected epithets are summed up and their arithmetic mean is calculated.

What are pain scales for?

Not all doctors use pain scales. They are used mainly by anesthesiologists-resuscitators, therapists and oncologists. Sometimes doctors of other specialties encounter them when it comes to chronic patients.

Depending on how the pain is assessed, an anesthetic will be prescribed:

• For mild pain, use a non-narcotic pain reliever: Ibuprofen, Analgin, Diclofenac, Paracetamol.
• For moderate use, 2 non-narcotic analgesics with slightly different points of application, or a combination of a weak narcotic and a non-narcotic analgesic.
• Severe pain requires the prescription of strong narcotic and non-narcotic analgesics. Often it is necessary to resort to additional methods: blockades of nerve pathways, alcoholization (injection of ethanol) into nerve endings, which cause chronic severe pain.

Any of these drugs has a lot of side effects. Therefore, it is in the patient’s interests to assess his own pain as objectively as possible, and if it changes, to report it to the doctor. Now, if the doctor does not react in any way, then he needs to be changed to another specialist.

Content

The tolerance of traumatic factors is determined by the functioning of the central nervous system. The pain threshold depends on the level of irritability of the nerve endings and the feelings that arise from unpleasant influences. This indicator is transmitted at the genetic level, but it can be changed by finding out what parameters determine it. Although women experience the most excruciating pain for a person during childbirth, men in life have a higher degree of tolerance and adaptation.

What is pain threshold

The degree of perception of traumatic effects on the body is related to the level of excitation of the nervous system. The body's subjective response to severe pain determines its threshold for a person. The ability to endure unpleasant sensations is inherent in genes, so this characteristic is individual for everyone. The strength of pain that a person can withstand is also determined by the source of irritation, emotional mood and hormonal levels. In a state of passion or during childbirth, sensitivity decreases due to the instinct of self-preservation and the influence of the endocrine system.

Low pain threshold

The serious danger is shock. A low threshold of pain sensitivity, together with the lack of ability to tolerate unpleasant sensations, makes any traumatic manipulation unbearable. You should always warn the doctor about your threshold to avoid psychological trauma. If the indicators are low, it is not recommended to pierce your ears, get tattoos, or painful cosmetic procedures with injections without using various methods of anesthesia: special creams that are applied to the skin, sprays.

High pain threshold

With this type of sensitivity it is much easier to endure stressful situations for the body. A high pain threshold does not mean that you can subject yourself to serious trials. It is believed that the degree of susceptibility depends on the person’s psychotype. Those who have no fear of physical influences at all are, as a rule, active, extreme, and have leadership qualities.

Pain threshold in women and men

The degree of perception of feelings depends on gender. The role of a man was determined by evolution - a hunter, a defender, a conqueror, who had to endure suffering and endure blows in fights. The male sex hormone, testosterone, has an analgesic effect. In this regard, men have a constant high threshold of sensitivity.

Women have a more vulnerable nervous system due to a larger number of receptors; there is less testosterone in their blood. In addition, historically, representatives of the fair sex were little exposed to negative stimuli from the outside world. This causes a low pain threshold. A woman’s sensitivity directly depends on the period of the menstrual cycle and changes in the time of day. Thus, in the morning and during menstruation, increased vulnerability is observed.

What does it depend on?

In addition to gender, the pain threshold is influenced by a number of internal and external factors. Knowing them, you can manage your feelings and sensations. If you have to undergo medical or cosmetic procedures that cause discomfort, you can prepare your body for stress. It is important to consider that the pain threshold may change over time and circumstances. What factors influence this:

• experienced nervous shocks, degree of fatigue;
• the presence of inflammatory processes in the body;
• diseases of the nervous system, the degree of its training;
• genetic predisposition;
• saturating the body with useful substances and vitamins;
• individual physiological characteristics;
• the amount of vitamin B necessary for the normal functioning of the nervous system;
• psychological mood, psychosomatic characteristics, emotions.

Pain types

There are four types of people based on their tolerance to unpleasant sensations. The first type has a low sensitivity threshold. Such people acutely perceive minor physical and psychological pain. The second type differs from the first in its wide tolerance range. This means that they take pain seriously, but are able to endure suffering. The third type is characterized by a high degree of tolerance and a short interval: when the unpleasant sensations intensify, they immediately give up. The fourth variety calmly endures pain and has a strong reserve of patience.

The fourth type just needs to be mentally attuned to unpleasant sensations, and medical manipulations will be accepted calmly. It will be possible to avoid painful shock during medical procedures if you determine in advance the type to which the patient belongs and select the appropriate anesthesia (aerosol or injection). In addition, it is important for the fourth type to develop a sense of empathy. Children who relate to him may think that since they are not in pain, then others do not suffer either.

How is human pain measured?

In the middle of the last century, scientists set out to develop an objective scale of unpleasant sensations. As a result of a series of 100 experiments, a quantitative estimate from 0 to 10.5 dollars was created. The name of the unit of measurement comes from the Latin name for pain “dolor”. During labor, a woman experiences sensations of intensity equal to 10.5 dollars. For comparison: during the experiments in which the scale was developed, with pain of 8 dollars, the study participants left a second-degree burn on the forehead from the effects of high temperature.

How to find out your pain threshold

On an outpatient basis, the degree of sensitivity is determined using a special device - an algesimeter. There are 4 types of unpleasant sensations: nociception (a physical sensation in which nerve receptors begin to transmit signals to the brain), pain, suffering. This device makes it possible to detect the onset of the action of the stimulus, as well as the interval between the first stage and the last. The pain type of personality is determined by the reaction to the impact and the stages from nociception to a state close to shock.

Test

The algesimeter records the minimum and maximum pain threshold. During the assessment, heat or electricity is applied to the area between the toes and hands, where the skin is most delicate. The minimum threshold implies the pain that already causes discomfort, and the maximum threshold implies the pain within which it can be tolerated. Based on the results, the therapist draws conclusions about the person’s tolerance.

How to increase your pain threshold

To reduce sensitivity, you can influence those factors that determine the threshold of unpleasant sensations. For example, before a traumatic procedure it is recommended to get enough sleep and not drink alcohol or drugs. Tune in to a positive outcome, to the desired result. Regular physical activity and sex increase endurance, strengthen you, and stimulate the production of endorphins, which suppress unpleasant sensations. There are several other home remedies to temporarily increase your pain threshold:

• meditation, yoga, relaxing massage;
• following a diet, eating foods rich in vitamin B, which promote the secretion of serotonin;
• distracting the receptors by eating ginger, red pepper, mustard, horseradish, chili pepper.

Many people associate pain with something negative, but this is one of the main human defense mechanisms. Evolution has tried to prevent us from ruining ourselves through stupidity. However, the perception and tolerance of pain are purely individual characteristics. The bane of a considerable number of people is a low pain threshold. How to increase and what does it depend on? Let's figure it out.

Low pain threshold: how to increase

Unfortunately, it is impossible to increase the pain threshold at the genetic level. However, scientists are closely studying this issue. Their research will help improve the effectiveness of painkillers and better understand the nature of pain.

But what to do if you need to reduce pain here and now? If we are not talking about serious damage, then you need to configure yourself correctly. It has been noticed that pain dulls during aggression. No, this does not mean that it is necessary to destroy everything around (although this option should not be ruled out).

For example, imagine that going to the dentist is a feat, and pain is your sworn enemy that you have to overcome. Controlled rage makes a person more resistant to physical stress. Thanks to this method, athletes achieve their goals despite fatigue and burning muscles.

If you want to increase your pain tolerance in the long term, then rethink your lifestyle. Move more, look at the world positively. Constantly challenge yourself, go on long hikes, conquer peaks, play sports.

Martial arts are especially effective in this regard. After conducting several dozen sparring sessions, a person will harden the body and become less susceptible to pain and emotional stimuli.

Low pain threshold: reasons

Previously, it was believed that the ability to endure pain depended on the character and emotional stability of a person. Boys who screamed or cried when slapped on the head were called crybabies. But, as it turned out, it’s not just about fortitude.

Scientists conducted a large-scale experiment in which 2,700 volunteers participated. Each person experienced regular pain for various reasons. They were asked to describe how much pain they felt:

• 46% of respondents experienced moderate pain.
• 45% of respondents had severe and chronic pain.
• Mild pain was detected in 9% of subjects.

After that, genetic material was taken from them for study. It turned out that several genes somehow affect the sensitivity of nerve endings.

Those who reported minor pain were 30% more likely to have the DRD1 gene, which encodes a cell membrane protein for internal cell communication.

A DRD2 variation was found in the genes of people with chronic pain. In them it occurred 25% more often than in subjects with a high pain threshold. This gene is involved in the regulation of bone growth.

The COMPT and OPRK1 genes were found to be linked in people with average pain tolerance. They were observed 25 and 19% more often than in respondents with a high pain threshold.

Thus, the perception and tolerance of pain depends on the genetic predisposition of each person. However, it is not only genes that influence the pain threshold.

This indicator is not constant and can change depending on the external environment, emotional and physical state of a person. For example, people who are depressed are characterized by a lower pain threshold. Active and cheerful people are less susceptible to external stimuli.

In medicine, people are divided into four groups based on their pain threshold:

1. Low pain threshold and tolerance.

You cannot envy such people. They respond to a relatively small stimulus with acute pain. Injections are just terrible, and there’s no need to talk about going to the dentist or giving birth. Any medical procedure, no matter how minor, must be performed under anesthesia.

1. Low threshold and high tolerance.

This type of people perceives pain in approximately the same way as the first, but they are able to endure and not show it. The main thing is to mentally prepare for the upcoming stress.

1. High threshold and low tolerance.

At first glance, a person of this type figuratively resembles a stone. That is, it can be absolutely immune to tissue damage (impacts, punctures, cuts). However, it is necessary to calm him down, since the nervous system is not able to resist pain for a long time. For this purpose, sedatives and psychological support are used.

1. High threshold and tolerance.

Real flint. Such a person doesn’t care about anything. It seems that pain does not exist for him. The injections are weaker than a mosquito bite, and he either does not notice more serious injuries or is able to endure them for a long time. Usually such people are emotionally stable, strong-willed and energetic.

Many people would like not to feel pain, but this is a mistake. There are about five hundred people on Earth who lack this protective mechanism. Are you jealous? But in vain, because this rare disease, called syringomyelia, often does not allow people to live to at least forty years. Absence of pain does not mean protection from damage. Therefore, without this kind of notification, a person may not notice a minor or serious burn. Take care of yourself.