Please Don’t Confuse My Chronic Pain With ‘Low Pain Tolerance’

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By Alexandra Kaye

“Pain tolerance” and “pain threshold” are phrases used to describe how much pain a person can handle, but they don’t actually mean the same thing. Pain tolerance is how much pain you can handle while still functioning (for me, this means how much pain I can handle without taking medication). Pain threshold is when your body actually starts to feel pain (so for example, for some people getting your finger pricked may hurt, and for others it doesn’t).

People who live in chronic pain often have a lower pain threshold because the body’s nerves are constantly firing — they never get a rest, so when they get triggered by “smaller” things, they will hurt more than for a “regular” person. Plus, different sensations will cause different pain for different people. For me personally, things like getting blood drawn and getting my finger pricked hurts incredibly bad for hours after, but then I get shots all the time that only hurt for a second. I’ve had two relatively simple surgeries, wisdom teeth removed and an elbow surgery, after which I never took pain medication for either because it didn’t really hurt that much. However, when I got my stitches removed, I blacked out and got really nauseous from the pain. There are so many different types of pain, and for whatever reason my body reacted to the stitches a lot worse than to the actual procedures. This is how it is for everybody, chronic pain patient or not.

The flip side is people with chronic pain often have a very high pain tolerance. We live and function in pain daily, so we learn to do everything without pain medication, or even with pain medication but in spite of the pain. We get used to being in pain. That doesn’t make it hurt any less, but it makes us able to do things that people with lower tolerance cannot do. For example, I recently pinched a nerve in my neck, something that the doctors kept saying they’d give me pain medication for because “that’s the only thing that helps most people.” I can’t take narcotics for various reasons, and I declined the pain medicine. I couldn’t work because it did hurt really badly, but I also had to sit for several days in severe pain without any relief. That makes my threshold pretty dang high.

Another example — I get migraines, and not much helps them. I’ve tried many medications and other remedies, and the only thing that works is an antihistamine and sleeping it off. I obviously can’t do that any time I get a migraine. If I’m out and about I can’t just stop and sleep, I can’t take a break at work to sleep a few hours, and I can’t go home from work and class every time I get a migraine (I’d be missing a couple days a week at that rate). Instead, I work through it without any pain relief.

Another example — I have even walked on a broken ankle for a few weeks because I was so used to the pain that it didn’t hurt that bad, and I’ve worked a 12-hour shift on my feet with a hip that was sliding in the socket (thanks to Ehlers-Danlos syndrome, it had subluxated).

My pain threshold may be low, but my pain tolerance is incredibly high, and I don’t like when people (doctors, family) brush off my pain because they think that just because I hurt frequently I have a low pain tolerance. I have a very high pain tolerance, I just have a lot of pain.

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