Menstrual pain, old injuries, chronic pain - Why does the same injury cause different levels of pain? : The Science of "Pain is Not Equal"

Menstrual pain, old injuries, chronic pain - Why does the same injury cause different levels of pain? : The Science of "Pain is Not Equal"

While some people become immobilized by a slight scrape on the knee, others remain unfazed by quite deep wounds. An article published by the French newspaper "Le Progrès" on April 16, 2026, directly addresses this everyday question: why are we not equal in the face of pain? The article points out the obvious yet often overlooked fact that pain is not simply determined by the "size of the wound."

The International Association for the Study of Pain (IASP) defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage." Furthermore, the IASP states that pain is always a personal experience influenced by biological, psychological, and social factors. This means that pain is not a mechanical response determined solely by the presence or absence of injury. The intensity of pain is shaped not only by nerve reactions but also by a person's memories, mood, circumstances, and relationships. Therefore, it is crucial to respect the individual's claim of "pain."

The original article first highlights genetic differences. It suggests that genetic factors play a role in the variability of pain perception, with research reviews indicating significant heritability in responses to experimental pain and susceptibility to chronic pain. Of course, "everything is not determined by genetics." However, considering the possibility of inherent differences in pain sensitivity, it becomes clear how dangerous it is to judge others' pain based solely on mental attitudes like "exaggeration" or "mindset."

Next in importance are the sensitivity of the nervous system and psychosocial conditions. The original article explains that there are individual differences in how signals from peripheral nerves are processed by the brain. The IASP also states that pain cannot be estimated solely from the activity level of sensory nerves. Additionally, research shows that people who have experienced severe pain in the past are more likely to brace themselves in similar situations, and stress and anxiety can amplify pain perception. Pain is not just a "physical issue" but is also connected to mental tension and life circumstances.

Another factor not to be overlooked is the influence of time of day and sleep. In 2022, Inserm reported that the intensity of pain fluctuates in a 24-hour cycle, tending to be stronger at night and weaker in the afternoon. Other studies have shown that lack of sleep increases sensitivity to pain. This means that the feeling of "it didn't hurt yesterday, but it hurts unusually today" might not just be in your head. In today's world, where lifestyle disruptions and sleep deprivation are common, individual differences in pain can be influenced not only by physical constitution but also by daily conditions.

 

This theme resonates strongly on social media because pain is not easily visible from the outside. On X, there are posts expressing that the severity of menstrual pain or PMS varies greatly among individuals, and even among women, it is hard to fully understand each other. On the other hand, there are voices saying, "Even if you replicate just that pain, you can't fully convey the actual suffering." Additionally, there are posts pointing out that "the real pain of others can ultimately only be understood by that person," reflecting empathy for the difficulty of explaining pain. What is spreading on social media is perhaps not so much about the intensity of pain itself, but rather a backlash against the "pain of being presumptuously judged."

In reality, invisible pain tends to be treated lightly. Especially pain that is not outwardly apparent, such as menstrual pain, chronic pain, or migraines, is often dismissed as "everyone's the same" or "that's normal." The IASP points out that biases based on sex and gender can occur in pain research and clinical practice, and a 2024 PNAS paper showed a tendency for pain management of female patients to be less favorable than that of male patients in emergency departments. The stories of "overlooked pain" repeatedly shared on social media are not mere complaints but reflect assumptions on the part of the medical and social systems.

Therefore, the core of this issue is not to compete over "who is more sensitive to pain." Rather, it is about not measuring others' pain by one's own standards. Pain involves genetics, differences in nerve reactions, sleep and anxiety of the day, and past experiences. What is needed, then, is not an attitude of doubting with "Is it really that painful?" but a posture of asking, "How is it painful?" We are not equal in the face of pain. However, we can move closer to a society that understands this inequality and does not belittle others' complaints.


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