Are your friends very pain tolerant? Then it is likely that you are as well. A recent study, published in the Scandinavian Journal of Pain, shows that there is a positive association between the pain tolerance of males and their friends.
By Solveig Engebretsen and Christopher Sivert Nielsen
Chronic pain is a common and highly debilitating health problem and societal costs exceed those of cardiovascular disease, cancer and diabetes. Reduced pain tolerance is a key feature and risk factor for chronic pain and prevention strategies aimed at increasing pain tolerance could potentially reduce the number of people affected by chronic pain.
Genetic and environmental factors play a role
Research has demonstrated that pain tolerance varies dramatically among the population. In part this is explained by genetic difference between individuals, but environmental factors outside the family of origin are known to play an equal or greater role. In the study published in the Scandinavian Journal of Pain, the role of the social environment among peers was investigated.
The Tromsø Study: Fit futures mapped pain tolerance and social relationships among nearly a thousand adolescents in the first year of upper secondary school in Northern Norway. The adolescents named up to five friends, providing the social network of the group. The adolescents completed a test for pain tolerance: the amount of time they were able to endure holding their hand in cold (3°C) circulating water.
Tolerance greatest among male-male friendships
Analysis demonstrated that pain tolerance was strongly associated with friendships. Hence, friends tend to be similar in terms of pain tolerance. Further analysis, where the friendships are analysed separately for boys and girls, revealed that the friendship effect was present for boys only, and only through their male-male friendships.
When a trait is associated with friendship ties, there are two possible explanations: Either people who are similar tend to become friends (homophily), or friends influence each other so that they become more similar (social transmission). Since pain tolerance is not a directly observable trait, it is not obvious how either of these processes might work.
One possibility is that friends share a similar lifestyle and that this again affects pain sensitivity, resulting in similar pain tolerance among friends. This hypothesis was tested by statistically controlling for physical activity and smoking – two lifestyle factors that are known to affect pain. Results were unchanged, suggesting that similar lifestyle among friends does not explain the similarity in pain tolerance.
Peer pressure – an influencing factor?
A second possible mechanism of social transmission is peer pressure. The adolescents were tested consecutively and it is conceivable that they might brag to their peers about being able to endure the maximum testing time (105 seconds). If so, one would expect higher pain tolerance among those who were tested later. This effect accounted for some, but not all, of the similarity among friends.
In his Editorial Comment on the Tromsø study, pain geneticist Jeffrey S. Mogil from McGill University in Montreal emphasises how this is just the beginning of understanding the social influences on pain: “Studies like this suggest we have just scratched the surface of an extremely interesting set of questions, the answers to which will contribute importantly to our emerging appreciation of social influences on pain,” he concludes in his Editorial.
The Tromsø study is the first to apply social network analysis to pain tolerance and is a contribution to understanding the effect of social factors on pain. If there is indeed a social influence.
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