Athletes are often seen to put on a ‘brave face and carry on’ when they sustain an injury, which supports the theory that they have a higher pain threshold than non-athletes, regardless of inconsistent and sometimes even contradictory evidence from previous studies on pain perception in athletes.

The June issue of PAIN reports that researchers from Heidelberg University have discovered in a meta-analysis of previous research that athletes can in fact tolerate higher levels of pain than non-athletes, but there was no difference between athletes and non-athletes in terms of pain threshold, i.e. the lowest intensity of stimulation at which pain is experienced.

Leading researchers Jonas Tesarz, MD declares:

“Our analysis reveals that pain perception differs in athletes compared to normally active controls. Studies in athletes offer the opportunity for an evaluation of the physical and psychological effects of regular activity on pain perception, which might foster the development of effective types of exercise for relief in pain patients.”

They reviewed fifteen international studies, involving a total of 568 athletes and 331 normally active controls of both genders to assess artificially induced pain thresholds in athletes and normally active individuals in disciplines like endurance sports, game sports and strength sports. Twelve studies assessed pain tolerance, i.e. the highest intensity of painful stimulation that a tested subject is able to tolerate, whilst nine studies evaluated pain threshold.

They observed that athletes consistently had a higher pain tolerance than normally active adults, although the magnitude of pain that athletes were able to withstand varied depending upon the discipline of the sport they participated in. For instance, endurance athletes had a moderate tolerance for pain with relatively equal scores, whilst those participating in game sports had a higher pain tolerance compared with other athletes. However, there were large variations in the results, which suggests the physical and psychological profiles of endurance athletes are more similar, whilst those of athletes involved in game sports are more diverse.

Dr. Tesarz states that the results clearly demonstrate that regular exercise is linked to a higher pain tolerance, whilst the association with pain thresholds are rather more ambiguous and tends to have clinical implications.

He declares:

“Numerous studies of the effect of physical exercise in pain patients demonstrate a consistent impact on quality of life and functioning without an improvement in pain scores. It may be advisable in exercise treatment for pain patients to focus on the development of their pain-coping skills that would affect tolerance, rather than the direct alleviation of pain threshold.”

He concludes, saying:

“Further research is needed to clarify the exact relationship between physical activity and modifications in pain perception, and to identify the involved psychological factors and neurobiological processes. However, the observation that pain perception is modifiable by physical activity provides promise for the use of non-invasive methods with few side effects for patients with chronic pain conditions.”

Written By Petra Rattue