Do You Believe That This Area Was Medically Under-Served Question Do You Have A High Pain Tolerance?

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Do You Have A High Pain Tolerance?

A common statement from a new patient in our office (and many chiropractic offices I have talked to) is “I have a high pain tolerance.” This is usually when they describe their pain, during the first consultation. “The pain level is like a 100 on a scale of 1 to 10… and I have a high pain tolerance!”

There is no way for anyone to know how much pain you are feeling. A rough and subjective way is to measure pain. All health care providers use the same scale, but patients interpret the scale based on their own perception. A “0″ is no pain and a “10” would be “the worst pain you can imagine.” (Consider: Giving birth without an epidural) However, almost every new patient who comes into our office describes their pain as a 10.

I have spoken to MDs who are very upset about this. In the medical definition of a pain scale, a “10” would indicate such severe pain that you are unable to perform ADLs (Activities of Daily Living). So, the fact that you drove to their office, went in and filled out the paperwork… you’re not a 10. Somehow, barely able to walk, holding my back, using a back brace, and icing like crazy. not just “5.” It’s closer to being 5 than being 10.

Ironically, if you describe your pain as a 2 or a 3, there are insurance plans that may say that your treatment is no longer “medically necessary” because you need to take care of yourself. The truth is that 2 or 3 are enough to get your attention that you have a problem that probably won’t go away on its own.

So do you have a high pain tolerance? Apparently not. In almost 17 years of practice, very few patients (2, true) that I would say have a high pain tolerance. These are people who come to my office indicating a pain level of a 2 or 3, but after several weeks of treatment without much improvement, we refer to an MRI. Advanced imaging studies revealed a disc herniation that was beyond what I felt comfortable treating, but they were walking around like they had worked hard the day before.

For example, I have had people come to my office after days without sleep, unable to complete the initial paperwork before their consultation because they could not sit or stand long enough to get the job done. They may receive an MRI and find that they have a disc bulge of 3 millimeters or less. Three millimeters doesn’t sound like much, but it’s a lot in the small spaces of the spine. A 3mm disc bulge is enough to cause a lot of pain in the average person.

Patients who had an MRI and only complained of pain, had disc bulges greater than 10mm. More than 3 times the disc bulge of the average person who can barely move to walk out the door. That’s a high pain tolerance! They bear the pain so much, they hardly know they are in pain!

Even if you don’t have a high pain tolerance, it doesn’t mean you’re not in severe pain. It doesn’t mean that we don’t take your pain seriously. When I hear a patient say they’re a “10” – I just know they’re in a ton of pain and it’s my job to help them in any way I can. I also treat it as a jumping off point. If they are a 10 today and a 7 tomorrow, I know they are better.

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