The Volume Knob Analogy

Imagine pain as a stereo system. For some, the volume knob is turned low—they barely register discomfort, even when it’s blaring. For others, it’s cranked to max, making minor aches feel deafening. This “volume knob” is your pain threshold: the point at which your brain decides, “This hurts.” But here’s the twist: you aren’t the DJ. Your genes, life experiences, and even your friendships tweak that dial in ways science is only beginning to unravel.

As a clinician who’s spent years studying pain, I’ve seen thresholds vary wildly. I’ve treated patients who faint from a light pinch and others who laugh off procedures that would leave most screaming. Let’s explore why—and what it means for your journey with pain.

Genes vs. Life: Who Controls the Knob?

Twin studies reveal that 50–60% of pain tolerance is genetic. If your parents handled pain stoically, you likely do too. But genes are just the starting point. The rest? It’s shaped by your life—not your upbringing, oddly, but your choices and experiences.

Take the cold pressor test, where subjects submerge a hand in ice water. Research shows those who tolerate it longer are less likely to develop chronic pain after surgery. Why? Their nervous systems are wired to process pain efficiently. But here’s the kicker: this resilience isn’t fixed. It’s honed through hardship.

Culture, Friends, and Ghost Peppers

Pain tolerance isn’t just personal—it’s cultural. Studies find:

• Asian individuals and women often report lower pain thresholds, partly due to societal attitudes.
• Men with close male friends share similar pain tolerance—like a silent pact to “tough it out.” While this phenomenon is not seen in females with no obvious reason why. 
• Japanese mothers rarely use pain relief during childbirth, viewing labor as a transformative process rather than a crisis. Only 5–7% of Japanese women use epidural analgesia during childbirth, compared to 70–80% in Western countries. However, hospitals in Japan often lack epidural services due to staffing and cost barriers, reinforcing cultural norms.

But culture can’t explain Craig.

Craig: The Man Who Redefined Pain

Craig, an old colleague of mine, once ate five raw ghost peppers—the kind used in pepper spray—as a garnish. He shrugged it off as “spicy.” His pain resume includes kickboxing injuries, needle-covered “shakti mats,” and rehab sessions that’d break most humans. 

Why? At age three, Craig spilled boiling water over a third of his body. Third-degree burns. Years of grafts. Most kids would develop a terror of pain. Craig’s brain did the opposite: it rewired to treat pain as background noise. His nervous system learned, “This is normal. Survive.” Craig isn’t superhuman. He’s proof that childhood trauma can permanently adjust your pain threshold.

The Pain Spectrum: Where Do You Land?

Pain thresholds exist on a spectrum:

• High Threshold (Craig’s Zone): Built through repeated exposure (athletes, soldiers) or trauma.
• Average Threshold: Most of us. We dislike pain but cope.
• Low Threshold: Fear or inexperience magnifies pain.

But there’s a wild card: emotional trauma.

Trauma’s Double-Edged Sword

Childhood abuse or neglect can push people to extremes:

• Hypoalgesia: Dissociating from pain. “I don’t feel anything.”
• Hyperalgesia: Overreacting to pain. “Everything hurts.”

I’ve treated both. A car crash survivor who barely flinched at broken ribs (hypoalgesia). A fibromyalgia patient who felt paper cuts as searing wounds (hyperalgesia). Both were shaped by trauma—one numbed, one hyper-alert.

Why This Matters for Chronic Pain

Your threshold isn’t fixed. It’s a mix of:

1. Genes (the hand you’re dealt).
2. Experience (how often you’ve “practiced” pain).
3. Trauma (what your nervous system learned to fear).

If you’re stuck in chronic pain, ask:

• “Did my brain learn to amplify pain?”
• “Can I retrain it?”

Turning the Volume Down

Strategies I use in my clinic:

1. Graded Exposure: Slowly reintroduce movement to desensitize the nervous system.
2. Cognitive Reframing: Shift from “Pain = danger” to “Pain = signal.”
3. Mind-Body Practices: Yoga, meditation—tools to reclaim control.

Final Thoughts

Pain thresholds aren’t badges of honor or flaws. They’re stories written by your genes, scars, and struggles. Craig’s story shows even severe trauma can forge resilience. Yours might be quieter—but no less powerful.

If pain feels too loud, remember: you can adjust the volume. Not overnight, but through patience, practice, and partnership with your care team. Your pain isn’t “all in your head.” But your head can change your pain. If you have any questions surrounding pain thresholds, don’t hesitate to contact us online or on 04 385 6446.