Why do some people feel more pain than others?

Co-author of the book "The Painful Man" (1), this neurobiologist has spent years studying cases of individuals with hypersensitivity to pain. "Tests have shown that when it comes to the perception of pain, we are absolutely not equal. And this is true regardless of the severity of the organic dysfunction, the lesion, the pathology... At the biological level, individuals have few differences. The main one is above all our individual history of more or less pain."

For example, there is a high probability of being more sensitive to pain if one has an anxious temperament or is placed in a more or less stressful environment. "It has been shown that patients undergoing the same surgical procedure by the same team of surgeons and in the same hospital consume 2.5 times less strong analgesics, particularly opioids (morphine or derivatives), when they are placed after the operation in a room overlooking the trees in the hospital park than in a room overlooking the walls of another building," illustrates Guy Simonnet.

"We also know that after hospitalization, if the patient returns home, to precarious housing, alone, with family or financial problems, their sensitivity to pain will undoubtedly be greater."

Similarly, having lived with or accompanied a sick person (parent, spouse, etc.) can also activate this hypersensitivity, through an effect of "emotional contagion." Everything can also depend on the context in which the pain appears. If an injury is caused by the inattention of a reckless driver and we consider this injury to be "unfair," if we feel guilty, or if we are in the middle of a divorce or unemployment... All of this can modify our perception of pain.

Other factors come into play: gender, social status, whether or not they exercise, diet, the relationship of their family or social group to the illness, etc. The past also weighs heavily in the balance. For example, among those suffering from long-term chronic pain (fibromyalgia, back pain, migraines, etc.), it has been shown that these people have often been marked by childhoods full of hardships: incest, abandonment, abuse, etc.

"A deep narcissistic wound often redoubles the feeling of pain. We see many people with damaged childhoods who, for years, were ultra-dynamic and devoted to others, are suddenly at the end of their rope and report extremely painful feelings, for example, back pain. In these cases, the pain acts as an alert, a signal to oneself or others... it is a psycho-biological sign of what you are," adds Guy Simonnet.

Guy Simonnet, Professor Emeritus at the University of Bordeaux, member of the CNRS Aquitaine Institute of Cognitive and Integrative Neuroscience.

If, in the past, the individual has been confronted with pain, has already suffered accidents or injuries, it is also very likely that, faced with a new pathology, he will feel the sensation of pain more strongly. For the neurobiologist, "the hypersensitivity and memory system connects to the neural networks of pain... Our research has also shown that the more or less frequent intake of analgesics, opioids, morphine, etc. can lead to hyperalgesia in the long term, i.e. an exaggerated feeling of pain," adds Guy Simonnet,

It is essential "to no longer separate the soma from the psyche and to no longer reduce the care of patients to the sole biomedical and pharmacological approach by once again placing man and his history at the heart of his suffering."

Marianne Peyri

(1) “The Painful Man” , Guy Simonnet, Bernard Laurent, David Le Breton, Ed. Odile Jacob, Sciences, Nov. 2018.