Science, Art, Litt, Science based Art & Science Communication
Dad, this is why I scream when ever I hurt myself!
When I was a very young school girl, I still remember very well, my Dad used to tell me to bear the pain out and not to scream and cry whenever I hurt myself and was in severe pain. I never ever saw my dad uttering even a simple 'bah' - even when his entire toe nail came out when he hit his foot on the steps of our house. And I screamed on his behalf when I saw this happening to him making him laugh!
I always wanted to be like my dad but could never figure out how that could be done when the pain was so severe for me and made me scream. I always wondered how my dad managed his pain. He was a hero to me then.
But now I know why my dad could bear the pain so well while I cannot. Now my dad is not there to tell him I am not at fault and other things made me scream! Dad, where ever you are, are you listening? This is what I want to tell you:
According to new research results, Pain threshold genes are amplified by lifestyle. Environmental factors might retune your genes to make you more sensitive to pain! Stressful life events such as diet, smoking, drinking and exposure to pollution all have effects on your genes, but we didn't know if they specifically affected pain genes. Now, a study of identical twins suggests they do. It seems that epigenetic changes – environmentally triggered chemical alterations that affect how active your genes are – can dial your pain threshold up or down. This implies that tweaks of this kind, such as the addition of one or more methyl groups to a gene, may account for some differences in how our senses operate.
Tim Spector of King's College London and his colleagues assessed the ability of hundreds of pairs of twins to withstand the heat of a laser on their skin, a standard pain test. They selected 25 pairs who showed the greatest difference in the highest temperature they could bear. Since identical twins have the same genes, any variation in pain sensitivity can be attributed to epigenetic differences.
The researchers screened the twins' DNA for differences in methylation levels across 10 million gene regions. They found a significant difference in nine genes, most of which then turned out to have been previously implicated in pain sensitivity in animal experiments.
The greatest difference was seen with the TrypA1 promoter gene, which governs the activity of an ion channel on the surface of nerve cells that detect pain. "It's like a thermostat, dictating how we perceive heat and turn that into pain," says Spector. An increase in methylation of around 10 per cent in TrypA1 equated roughly to feeling pain at 2 degrees lower (Ref 1)
The results were corroborated in 50 unrelated individuals: those that had the highest levels of methylation on those nine genes were the most sensitive to pain, and vice versa.
Identification of epigenetically altered pain genes opens up ways to screen people for which painkiller might work best, and potentially identify new drugs, says Spector.
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Scientists have also found that mutations in a gene functions like an on-off switch for agony (3).
The gene in question is SCN9A, which is responsible for producing a pain-related protein called Nav1.7. In patients who feel nothing, SCN9A is pretty much broken. In those who feel searing random pain, the gene is cranking out far too much Nav1.7.
That discovery raises an obvious question: Can blocking Nav1.7 provide relief for many types of pain—and someday, perhaps, replace dangerous opioid therapies and anti-inflammatories like ibuprofen or with opioids, which bring serious side effects and the potential for abuse?
A pill based on this knowledge tested by Pfizer did well in patients with inherited erythromelalgia, but had little effect on dental pain. A later study testing the same pill on nerve pain related to diabetes was similarly disappointing, and Pfizer quietly shelved the effort last year.
So although the science has been so fascinating, the drug discovery has been challenging. but scientists are optimistic. It’s just a matter of finding the right way to approach the problem.
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Dad, although I inherited half of my genes from you, epigenetic factors might have changed my pain threshold. I know now you want me to change my lifestyle so that I too can increase my pain threshold. Well, I already have a good lifestyle. I don't smoke, drink, or do drugs. I eat very healthy food ( Ref 2). But pollution and stress are what I have no control on. But still I will try to increase my tolerance to pain! Promise!
References:
1. http://www.nature.com/ncomms/2014/140204/ncomms3978/full/ncomms3978...
2. http://kkartlab.in/group/some-science/forum/topics/the-road-to-a-he...
3. https://www.statnews.com/2016/07/05/pain-drug-opioid-alternative/
(Read the full paper on pain tolerance by clicking on the first link)
Q: Is there a difference between pain threshold and pain tolerance?
Krishna: Yes! Pain ‘threshold’ or pain ‘tolerance’? Because they’re different things.
Your pain threshold is the point where a sensation (temperature, pressure, the spiciness of food and so on) crosses a line, going from being innocuous to causing you to experience actual pain. The extent to which you can withstand and endure the pain you’re experiencing, while continuing to function, is your pain tolerance.
Pain thresholds and tolerance are things where age, sex and other factors have a significant impact. For instance, it’s regularly assumed that women have much higher pain tolerance than men because they can experience childbirth. But research shows that, while women often report experiencing more pain than men, their pain tolerance increases dramatically during pregnancy and labour, due to the many significant physiological and hormonal changes they undergo as a result of the process.
Overall, someone’s ability to experience, process and endure pain is determined by many, constantly shifting, factors. It’s hard to say how many of these apply to us. But there’s no guarantee that they always will.
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The Battle over Pain in the Brain
A new study adds to a heated debate about where pain signals are processed
http://www.scientificamerican.com/article/the-battle-over-pain-in-t...
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Brain changes behind pain sensitivity may affect older women more
A new study has found that the brain system enabling us to inhibit our own pain changes with age, and that gender-based differences in those changes may lead females to be more sensitive to moderate pain than males as older adults.
Researchers used fMRI scans to examine brain responses in men and women who had rated the intensity and unpleasantness of pain during exposure to increasing levels of heat. The results suggested that established gender differences in pain perception could likely be traced at least in part to this brain network, and offered new evidence that those gender differences may become more disparate with age.
Michelle D. Failla et al, Gender Differences in Pain Threshold, Unpleasantness, and Descending Pain Modulatory Activation Across the Adult Life Span: A Cross Sectional Study, The Journal of Pain (2023). DOI: 10.1016/j.jpain.2023.10.027
https://medicalxpress.com/news/2024-01-brain-pain-sensitivity-affec...
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https://www.sciencenews.org/blog/scicurious/your-epigenetics-can-be...
Your epigenetics can be a painhttp://esciencenews.com/articles/2014/02/11/revolutionary.new.view....
Revolutionary new view on heritability in plants -
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Study identifies hormone that causes women to experience more pain than men
https://medicalxpress.com/news/2020-03-hormone-women-pain-men.html?...--
Research reveals why redheads may have different pain thresholds
New research led by investigators at Massachusetts General Hospital (MGH) provides insights on why people with red hair exhibit altered sensitivity to certain kinds of pain. The findings are published in Science Advances.
In people with red hair (as in numerous other species of animals with red fur), the pigment-producing cells of the skin—called melanocytes—contain a variant form of the melanocortin 1 receptor. This receptor sits on the cell surface, and if it becomes activated by circulating hormones called melanocortins, it causes the melanocyte to switch from generating yellow/red melanin pigment to producing brown/black melanin pigment. Earlier work by David E. Fisher, MD, Ph.D., director of the Mass General Cancer Center's Melanoma Program and director of MGH's Cutaneous Biology Research Center, demonstrated that the inability of red-haired individuals to tan or darken their skin pigment is traced to inactive variants of this receptor.
To investigate the mechanisms behind different pain thresholds in red-haired individuals, Fisher and his colleagues studied a strain of red-haired mice that (as in humans) contains a variant that lacks melanocortin 1 receptor function and also exhibits higher pain thresholds.
The team found that loss of melanocortin 1 receptor function in the red-haired mice caused the animals' melanocytes to secrete lower levels of a molecule called POMC (proopiomelanocortin) that is subsequently cut into different hormones including one that sensitizes to pain and one that blocks pain. The presence of these hormones maintains a balance between opioid receptors that inhibit pain and melanocortin 4 receptors that enhance perception of pain.
In red-haired mice (and therefore, possibly humans), having both hormones at low levels would seemingly cancel each other out. However, the body also produces additional, non-melanocyte-related factors that activate opioid receptors involved in blocking pain. Therefore, the net effect of lower levels of the melanocyte-related hormones is more opioid signals, which elevates the threshold for pain.
"These findings describe the mechanistic basis behind earlier evidence suggesting varied pain thresholds in different pigmentation backgrounds. Understanding this mechanism provides validation of this earlier evidence and a valuable recognition for medical personnel when caring for patients whose pain sensitivities may vary.
Kathleen C. Robinson et al, Reduced MC4R signaling alters nociceptive thresholds associated with red hair, Science Advances (2021). DOI: 10.1126/sciadv.abd1310
https://medicalxpress.com/news/2021-04-reveals-redheads-pain-thresh...
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Some people say they have a high pain threshold. Here's why
We've all heard someone claim they have a "high pain threshold" as if it's a mark of strength or resilience. But does science support the idea that some people genuinely feel less pain than others?
Pain is an experience shaped by our psychology and social context, with many variables.
In our interviews with children about their experiences of pain, many link pain to "toughness." It seems that social expectations shape our understanding of pain from a young age.
There are also plenty of misconceptions about pain thresholds, which contribute to health-care inequities that affect millions of people.
What is (and isn't) a pain threshold?
A pain threshold technically refers to the point at which an event—such as heat, cold, or pressure—becomes painful.
It's not the same as pain tolerance, which measures how much pain someone can endure before they require relief.
While these two terms often become muddled in everyday language, they describe different facets of the pain experience. Distinguishing between them is crucial, especially in research settings.
How stable is a pain threshold?
The stability of a pain threshold is controversial, and probably depends on how it is tested. Certain techniques produce fairly consistent results.
But the pain threshold may be more of a "zone of uncertainty" than a fixed point of transition from non-painful to painful.
We have argued that how variable someone's pain threshold is may, in future, provide valuable information that could help us understand their risk of chronic pain and the best treatment options for them.
Biological influences on pain thresholds
Pain thresholds are influenced by a variety of biological factors. For now, let's explore genetics, hormones, and the nervous and immune systems.
Sex and gender differences
Men often have higher pain thresholds than women in experimental settings. This may be due to hormonal differences, such as the influence of testosterone.
On the other hand, gender-based differences in pain sensitivity could reflect social norms that demand more stoicism from men than from women.
The redhead question
Some research has found that people with red hair may experience pain differently, due to the MC1R (melanocortin-1 receptor) gene variant.
However, the mechanisms underpinning this finding are not yet clear. For example, redheads may have a lower pain threshold for certain noxious threats, such as heat, but a higher threshold for others, like electricity. Overall, the evidence is far from settled.
The nervous system in chronic pain
Some people with long-lasting pain can have lower pain thresholds. This may be due to central sensitization, where the nervous system appears to be on higher alert for potentially harmful events.
It's not yet clear whether some people have lower pain thresholds before they develop chronic pain, or whether their thresholds drop later. However, the presence of central sensitization may help clinicians to work out what treatments will work best.
The immune system and pain thresholds
The immune system can influence nerve signals and pain thresholds. Inflammation in the body, such as when you have a cold or the flu, can drop your pain threshold quite suddenly.
Many people experienced a short-lived version of inflammation-induced central sensitization when they had COVID. Suddenly, the smallest things produced a headache or body pain.
An acute injury such as an ankle sprain also triggers inflammation that drops your pain threshold. One of the reasons why ice helps an ankle sprain is it controls inflammation at the injury site, allowing your threshold for pain to recover a little.
All of these biological influences (and more) are just the beginning of the pain threshold puzzle.
Psychological influences
Psychological factors such as anxiety, fear and worrying about pain are associated with lower pain thresholds.
On the flip side, strategies like mindfulness and relaxation may raise pain thresholds.
Social influences on pain thresholds
Cultural norms shape how we perceive and express pain. Some cultures encourage stoicism, while others normalize openly vocalizing discomfort.
These norms influence how health-care providers interpret and treat pain, often leading to disparities. Researchers are now zooming out to identify these sorts of social influences on pain.
Implications for pain recovery
Understanding pain thresholds is not just an academic exercise; it has practical implications for health care. Misjudging someone's pain can lead to inadequate treatment or the overuse of pain medications.
Research has shown women and people from minoritized groups are more likely to have their pain dismissed by health-care providers.
We need to better understand pain thresholds to enable tailored pain treatments. A whole-person perspective could shake up pain treatments and usher in a more supportive, helpful version of personalized health care.
From genetics to psychology to culture, pain is as diverse and complex as the people who experience it.
This article is republished from THE CONVERSATION under a Creative Commons license. Read the original article.
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