Pain Thresholds in Autistic People

Autistic people have different responses to pain. Many families have tales of their family member ending up in A&E when they hadn't realised that anything was wrong. For a long time, it was thought that it meant that autistic people felt pain less than non-autistic people, but that certainly doesn't appear to be the case!

Twitter: @SarahJaneCritch

[autisticjenny]

Thank you. I am a late diagnosed autistic woman and I have found that to be the case for me. I experience pain worse and it baffles my doctors. I'm so sensitive to pain. And my chiropractor is always amazed how "in tune" I am with my body as far as being aware when something is out. Thank you for this video.

[CannabrannaLammer]

I'm autistic. I go non verbal when I'm in pain and completely focused. I can't hear you, i can't respond. I just focus on riding through that wave of pain. For me it makes absolutely no difference where i am or how happy or sad i am when experiencing pain. I have lots of kids and it wasn't a happy pain it was just pain. I have a very high threshold. As in being about to have a baby and midwives don't realise until baby is suddenly born. Or walking around on a semi dislocated ankle or carrying a 2 year old with a chipped elbow bone, bursitis and ripped tendons. Yet i had a sore lip last week and it really bothered me.

[umbrellahat]

This is really interesting. I'm autistic and I have a really high pain tolerance. I also can communicate when I'm hurt pretty well, but when I was a kid there were times I got hurt and didn't realize for a while or at all. I actually broke a finger and it healed without me realizing when I was 10 years old. I knew it hurt of course, but never realized anything more was wrong and never said anything. I did relate to the thing about pain lingering though, I definitely experience that when I get a shot or blood drawn.
Now that I'm older I can recognize when I'm hurt pretty well and in general I have pretty good awareness of my body. Part of the reason for that is that I want to be a doctor, so I've learned about a lot of injuries and anatomy, which makes it easier to see in yourself as well.

[loekverheijden]

Before I got diagnosed with autism and ADHD, I've had problems with being addicted to opioid painmeds. They allowed me to suddenly do what I wanted to do. I was only when I started using them that I realised I experiences fysical pain at all times every day, which claimed such a big part of my brain that it crippled my cognitive abilities. But being neurodivergent, I could not seperate pain from anxiety, being sleepy, hungry or having to go to the bathroom. All I knew was that whenever I stopped taking the painmeds, The feeling of fysical discomfort would become so intense I would burnout.

[shatteredprism]

I have a high pain threshold and a high pain tolerance. Causes me some issues because of the fact that I don't really know something is seriously wrong. Examples: Appendix that was about to burst (that I didn't know until surgery), broken tailbone (didn't know until the next day), uti that turned into a kidney infection that was one step away from sepsis (doctor was surprised that I wasn't in more pain)

[skwervin]

My daughter and I are both ASD and ADHD and we can go nonverbal when we get over stressed, I just cannot form words and stammer terribly. We have come up with a set of about 10 hand gestures such as thumbs up for yes or ok and thumbs down for no. These situations tend to happen when we are out and about and are often accompanied by shaking, sweating, unsteadiness so one of the first questions we always ask is "Do you want to go home?/get out of here?" If she doesn't ask me this, I touch her arm to get her attention, tap myself on the chest them make a swimming fish movement with one hand away from me to show I need to get out NOW!
A thumb to the lips with the rest of the fingers curled over and the little one extended, then tipping the hand up means drink, two fingers to the lips, food. Shading the eyes - lights are too bright, I need somewhere darker and so on.

My daughter is also a type 1 diabetic so that is why we have the questions about food and drinking, because if she is starting to have a hypo/hyper, the shaking etc can seem similar and I ALWAYS check her blood glucose when she goes nonverbal incase it gets too low or high and I need an ambulance.

[groushka]

I cannot agree more! For example, I feel hungry only when I am reaally hungry, like after 7/8h + since the last meal. But, I know I am hungry if I feel nervous, anxious, cannot focus on anything, angry, and I check the time and I know last time I ate was 4/5 hs ago. Since I am more aware of this, my life became more bearable. Eat sometimes guys!

[dees]

I didn’t need any pain medication after surgery for cancer. During all the tests, biopsies, various needles etc everything was fine. I think because everything made sense and was for a purpose. I can to an extent, reason the pain to make it manageable or make it go away. And I’m happy to watch procedures be done on me, which freaks drs out….which makes it more fun….. but is a good distraction from the pain too.
What I haven’t been able to cope with is the unremitting pain from chronic migraines (which last weeks or months sometimes). The level of pain may not always be super severe, but I can’t cope with it at all, it absorbs all my attention and energy.
Drs have always commented my pain response is abnormal. (That I’m in general abnormal). Makes sense now. Thank you.

[hannekezijlmans]

My midwife was absolutely certain I wasn't in labour up until 15 minutes (!) before my son was born. I had told her I was in a lot of pain, but according to her "I didn't look like I was', "this was nothing" and "if I was making a fuss out of this already, I would certainly not be able to get through it because I had at least eight hours to go".
I thought if that was nothing, I would certainly die.
I still hate that woman.
Years later, I became a maternity nurse. Of all the births I have ever witnessed, only one mother didn't look like she was in pain. The midwife, her husband and I all believed her when she told us what she felt. Being there for her in that moment helped me heal my own trauma, which I didn't even realise I still had.
Many more years later, I'm now close to getting diagnosed with autism and suddenly that all makes sense.
I still hate my midwife though, nothing will ever change that.

[thelotuseater]

That bit about blood tests/clinical contexts rings so true for me. The worst pain I’ve ever been in was at the dentist getting a filling. I screamed so loudly that I had to reassure the others in the waiting room outside that I was actually still alive.

[strawberrysultan]

I was late diagnosed with ASD last year and have personally always had a super high pain threshold - for example, I absolutely LOVE tattoos, and during my rib tattoo I fell asleep. I have also always loved to watch the needle when I get vaccines or blood drawn which Drs always found so weird, it's just something I find fascinating. It is super dangerous to have a high pain tolerance though, as a kid when I fell and hit my head off of a rock, or when I touched the hot muffler on my parents' car I never cried, so unless the thing causing pain is physically obvious I can see how it would be easy to miss.

[AlastorTheNPDemon]

My pain tolerance is nigh on nonexistent for most things, but extremely spicy food is fine. My heat pain threshold is about 115°F, and blunt force has an escalating impulse. I used to cry when in pain up to age 9 until the sadistic human males in my worthless family used their instrumental rage to shut that impulse down. I used to get spanked for crying when I was younger, even threatened. All other pain expressions were met with rage and gaslighting. Nowadays, I have engineered an entire personality construct to avoid acute pain, because feeling it makes me paranoid and irritable for several hours and ruins my self-esteem.

My entire family can beg the Devil for mercy for all I care (except for my biological mother... she's like the cool aunt I wish was my actual mother) because even the thought of forgiving them makes me nauseous.

[aspidoscelis]

I have high pain sensitivity and high pain tolerance.

However, describing a pain threshold as the point at which pain becomes unbearable is... optimistic. If we're conscious, we bear it. We might wish it were unbearable, but...

[wendee]

I am autistic and have a generally high tolerance to pain. However, I actually feel no pain when I have ear infections. It’s not about being unable to explain it, I really don’t feel any pain. The only time I do have pain in my ear is when my ear drum is about to rupture. Then it is sheer agony.

[moonbeamstry]

I'm in the process of being evaluated for ASD and I have an incredible pain threshold. Since the age of 9 or 10 I started ripping off all my toe nails except the big one. I rip them off completely including the bit that sits underneath the skin at the nail base. I just really don't like the sensation of my toe nails touching things like the inside of my shoes or rubbing against my blanket.

When my wisdom teeth finally started to rot I broke off and pulled most of the tooth of each of them out myself. Took a few years to get the roots pulled because I was very poor at that time and had no dental coverage.

When I get ear infections I hardly notice it till my eardrum perforates and I start bleeding out my ear- at that point I do feel it but I'm able to stay very calm through it.

Labor with my two children was easy- I feel like I've had bowel movements that hurt worse.

The worst pain I've ever felt was a ruptured brain aneurysm. It was an instantaneous drop me to my knees screaming bloody murder headache that was a 15 on a scale of 10 and I just went home and sat in a bath till the pain subsided and then saw a dr a few days later- took them a long time to properly diagnose because they just couldn't believe I didn't immediately get myself to an ER. That one could've easily killed me. Very VERY lucky it didn’t.

Now I'm wondering about my late father because he also had incredible pain tolerance. When he was 5 he broke his toe clean through and then actually started taking the bone out and putting it back in like it was a curiosity to him. This went on for a few days- but doing this obviously caused it to become gangerous and he finally passed out while walking to school. Some other children found him and carried him home. They were going to amputate his foot but his father had recently learned about the discovery of penicillin and begged the Dr to wait and allow him to try to procure some. He did, it worked and it saved his foot.

Is it possible that this physical pain threshold carries over into an emotional pain threshold? Might someone with asd potentially remain far too long in a toxic relationship? Because my father and I both seemed to have a knack for that as well...

[emmettobrian]

My family are all autistic but low support needs. My son had severe double ear infections but had no idea. I've cut off the tips of two fingers, it honestly didn't hurt but I was sad about the damage it did to my hand. Toothaches are a thing, but I've had fillings with no numbing without any pain.

My take away is we need to be more careful with ourselves and children because the signs that something is wrong might not be there.

[Milkshakecutie]

I’m dealing with cyst on ovaries and I feel like the whole hospital thought I was over exaggerating and I couldn’t even SPEAK! And they kept asking me to talk with them it was awful and now I’m back home laying in bed feeling like I should jump out a window

[sayusayme]

This truly resonates, I have been hit as a pedestrian and seem to want to think urge lain away because the medical community can’t see past my ken denial and lack of accessing my pain. So I look like I’m lying.
Wow, this was incredibly helpful. Thank you

[lulumoon]

I'm highly reactive but have a terribly high pain threshold which has caused conditions to be worse because of delayed treatment.

[nv]

I can never tell when I’m sick, or how badly I am sick. Cause I’ll be like “am I really in lots of pain or am I experiencing little pain? What if I’m just thinking I’m sick but I’m not?” Often times I will get stabbed by things or just get cut by things and I won’t feel it or even know until I see blood or the cut on my skin. I remember one time I was driving home from work and didn’t know I had accidentally cut my finger until I noticed it had felt wet. Often times I have random bruises and will have no idea how they got there or when (I’m clumsy and will ram into stuff when I’m in a hurry)