Factors that Affect Arthritis Pain
Everyone feels arthritis pain differently. Find out why.
How can two people have the exact same amount of joint damage, yet one is in agony while the other feels modest discomfort? The perception of pain starts as a series of biochemical processes – chemical and electrical signals that travel from the injured area and alert your brain that you’re hurt. From there, things get personal. Everyone’s threshold and tolerance for pain is unique.
“Pain is obviously subjective, and one person’s experience cannot be compared to another’s,” says Joshua Goldner, MD, medical director of pain management at Akron General Hospital in Ohio. “A multitude of factors go into it.” Everything from emotions to other medical conditions can shape your response to pain.
Factors That Influence Your Perception of Pain
Besides physical features, like the amount of joint damage and inflammation you have, a number of other factors determine how intensely you feel pain. These include:
Pain becomes a bigger concern the older you get, with as many as 75% of adults age 65 and older reporting persistent pain from arthritis and other chronic conditions. Brain regions that process pain change in structure and function with age, but that doesn’t necessarily mean you’ll get any reprieve from discomfort in your later years. “In the past, people thought that older people didn’t feel pain as intensely…that their nerve endings became less sensitive,” Dr. Goldner says. But recent studies of pain sensitivity have shown conflicting results. Sometimes the sensation of pain is dampened in older adults and sometimes it’s enhanced. The intensity depends on the type of pain you have, and how long it lasts.
Almost four out of five older adults live with not one, but multiple chronic health conditions. When these health problems trigger pain, the constant barrage of pain signals can create a hypersensitivity that heightens the discomfort. Living with other medical conditions can also influence the way you manage pain – but not always in a negative way. “It can give people a perspective, as well,” Dr. Goldner says.
Research on the genetics of pain is still relatively new, but some early studies suggest we inherit a genetic vulnerability to pain sensitivity in much the same way we inherit susceptibility to disease. Scientists have pinpointed a number of genetic variations that make us more likely to develop chronic pain conditions and have a naturally higher or lower pain threshold than someone else.
Women are more likely to develop chronic pain conditions, including fibromyalgia, osteoarthritis and rheumatoid arthritis. Research also indicates that women feel pain more intensely than men. Sex hormones may play a role in women’s perception of pain and their likelihood of developing chronic pain conditions.
Pain is more than just a physical experience. It affects your emotions, too. Pain and depression are closely linked. People with chronic pain are about three times more likely to develop depression and other mood disorders, and those with depression are three times more likely to have chronic pain. “Some of the same chemicals that are depleted in depression impact the neurotransmission of pain,” Dr. Goldner says. Certain depression medicines can relieve pain. People who are depressed can also feel like their pain is harder to control. Talk therapy can help with feelings of control.
Having caring family members, friends or members of a religious group around you can improve your ability to cope with pain. “When you are in a good place psychologically and you have good support around you, generally pain is affected in a positive way,” says Dr. Goldner. Yet pain can make you withdraw from your usual social circles. When you’re lonely your unhappiness grows, and with it, your pain increases.
Dr. Goldner explains, “If you address the pain, sometimes that patient will be motivated enough to break that cycle, which leads to a successful outcome.”
Joining a support group or meeting with a therapist can improve your outlook and ability to cope with pain.
Dealing With the Feeling of Pain
No matter how you perceive pain, it can be a disruptive force in your life. Constant pain can negatively affect your career and home life. That’s why it’s important to understand what factors besides physical joint damage exacerbate your pain. Then, work with your doctor to develop a comprehensive and effective pain management plan.