Pain is a concept we talked about very early in this semester. We explored how childbirth experiences tend to be portrayed negatively in American culture / sitcoms and how it is very much exaggerated. I think we pretty much came to the conclusion that pain tolerance differs from person to person. This also seems to be a truth at which even researchers have arrived because they seem to find it a little difficult to adequately measure pain. It’s just so subjective. Nevertheless, I became curious about it because we recently had our pain lecture in Fundamentals class, and an Asian girl in the class said she felt that Asians had high pain tolerance. She said that she had never taken pain medication. I was really shocked at her admission, especially when I thought about the horrible pain I experience during menses – Motrin is my best friend! Based on this, I decided to take a peek at the literature about pain tolerance in Asians. Surprisingly, pain tolerance in Asians is under the radar in terms of research. I couldn’t find much about it. I did find a source that talked about it being important for Asians to be quiet during childbirth, but this does not suggest higher pain tolerance necessarily. I also found this literature review (http://rheumatology.oxfordjournals.org/content/38/12/1184.full) that compared the level of pain tolerance in Asian patients with the pain tolerance in European patients following upper abdominal surgery. It found that Asian patients required less postop analgesia than the European patients. The review contends that this could be due to cultural and psychological factors such as Asians being more prepared / expected to tolerate more pain or differences in pain perception. However, the pain scores between the two groups were similar throughout treatment (although it was not indicated how they were obtained), so the results do not seem very conclusive. Regardless, the Asian patients did exhibit a higher pain tolerance, but there’s still much more room for study on this topic. I wonder if any of this translates into childbirth experiences?
Njobvu, P., Hunt, I., Pope, D., & Macfarlane, G. (1999). Pain amongst ethnic minority groups of south asian origin in the united kingdom: A review. Rheumatology, 38(12), 1184-1187. doi: 10.1093/rheumatology/38.12.1184
Tabitha, I did a search of the literature, too, and I found just a little bit of information out there regarding Asians and pain. It’s very interesting that most are studies with Asians only or Asians vs. European Americans or Europeans. I didn’t see much representation of other races.
Yes, we learn and can clearly see that pain is something that is handled on a case by case basis. In fact, it can even vary with the same person and change with time. People can increase or decrease their pain tolerance over time. One study I found regarding Asians and pains assessed their acculturation level in the US. The first study they performed in this compared first generation Asian Americans (AAs), second generation AAs, and European Americans. Researchers found that there were differences in the categories of threshold, intolerance, and intensity between first generation AAs and second generation AAs. Actually in all three of those categories, the second generation AAs were more like the European Americans. The researched guessed that the increased stress levels related to acculturation of first generation AAs was associated with their pain responses. Those who have been here longer were more like the European Americans who have been here a while. All this, however, was done on only 57 undergraduate students at UCLA, so I don’t know how applicable it would be in other situations. It would be interesting to see an expanded study on pain during labor experienced by first and second generation AAs. Maybe even third generation.
Chan, M., Hamamura, T., & Janschewitz, K. (2013, January). Ethnic differences in physical pain sensitivity: Role of acculturation. The Journal of Pain, 154(1), 119-123.
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Thanks for the response, Chau! Oh wow, what a very interesting concept. I did not think of pain as something that could evolve with time. I think of it as something pretty steady throughout the lifespan. Thinking about it though, it makes sense because of all the age-related changes we experience as we grow older. But more importantly, I think your study demonstrates that culture/environment definitely influences pain perception.
Hey Tabitha,
You bring up an interesting point. Although pain is totally subjective and depends on the person, there are factors that control one’s perception and expression of it and they vary. With the use of pain analgesics (NSAIDS and opioids), one can achieve a sort of numbing effect that overrides the pain. There is something called the gate theory of pain, where if something that is applied has a stronger stimulus than the current stimulus of pain, the higher stimulus overcomes pain and pain is not felt. The question is whether this stronger stimulus can be derived from solely the mind and not pharmacological intervention. This could be a reason why the Asian pain tolerance is so high. Perhaps cultural expectations and other pressures have molded the way Asian individuals perceive pain. Perhaps their mind is a greater stimulus than the pain being experienced.
http://en.wikipedia.org/wiki/Gate_control_theory
Thanks for the response, Deanna! I have heard little of the gate theory of pain. It’s a little bit confusing, but I think the basic concept is small nerve fibers become active with a pain stimulus, and these small nerve fibers block inhibitory interneurons, which block pain responses. Hence pain is felt with the activation of small nerve fibers. This is unlike large fibers which are activated in response to non-painfull stimuli, and no pain is felt because the inhibitory interneurons are active, hence no pain. I can easily see how medications can affect this neuronal activity. It would indeed be very interesting to see if it could be discovered if this inhibition can be induced without pharmacological conditions. I would not rule it out, because interventions like guided imagery and distraction are used to “reduce” pain. Perhaps something of that sort is involved when Asians experience a painful stimuli. Cultural expectations may also play a huge role for sure.