Do Neurodiverse People Experience more Pain?

Neurodiversity is a term that encompasses a range of neurological conditions like autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), dyslexia, and more. Neurodiversity has gained significant attention in recent years. This growing awareness has led to crucial discussions about how neurodiverse individuals experience the world differently, including their perception of pain. But do neurodiverse people actually experience more pain compared to neurotypical individuals?

Understanding Pain Perception
Pain perception is a complex process influenced by both physiological and psychological factors.
Although people talk about "pain signals", we actually don't have "pain nerves" that directly communicate pain to our nervous system. Pain isn't an experience that can happen to us - pain is the reaction we have to a sensory experience.
Instead of "pain receptors" we have nociceptors, which are nerves that convey specific types of sensation - hot, cold, sharp, dull, pressure, etc.  The nociceptors transmit information from the body to the nervous system, where these signals are interpreted and responded to. The signal for "hot" isn't always painful, but we each have a threshold for how much "hot" we can tolerate before our nervous system sends a message of "ouch!! Painfully hot now!!" which encourages us to move away from the hot thing!
This is similar for most of our sensory responses, when our nervous system adapts from acknowledging the experience to actively moving us away from danger.
Factors such as genetics, previous experiences, emotional state, neurological and cognitive processes play significant roles in how pain is perceived.
This explains why different people experience pain in different ways.
Over time and with exposure to certain sensations, our nervous system can adapt to either respond faster with a painful, protective response, or respond slower with the experience and memory that the sensation is not a dangerous one.

Autism Spectrum Disorder (ASD) and Pain
Individuals with ASD often exhibit atypical responses to sensory stimuli, including pain. Research suggests that people with autism might experience pain differently due to variations in sensory processing. Some studies indicate that individuals with autism may have a higher pain threshold, meaning they might not perceive pain as intensely as neurotypical individuals. This can sometimes result in delayed responses to injuries or illnesses, posing challenges in medical care and treatment.
Conversely, other studies highlight that certain individuals with autism might experience heightened sensitivity with a lower threshold to experiencing pain, making them more vulnerable to discomfort from stimuli that others might find only mildly irritating. The variability in pain response within the autism spectrum suggests that pain perception in ASD is highly individualised.

ADHD and Pain Sensitivity
Attention Deficit Hyperactivity Disorder (ADHD) is another neurodiverse condition where individuals might experience pain differently. Research on ADHD and pain sensitivity is less extensive compared to ASD, but some findings indicate that people with ADHD may have altered pain perception. For instance, the impulsivity and hyperactivity associated with ADHD can lead to a higher incidence of accidental injuries, potentially resulting in more frequent experiences of pain.
Additionally, the co-occurrence of mood disorders, such as anxiety and depression, which are common in individuals with ADHD, can amplify the perception of pain. Anxiety, in particular, is known to heighten sensitivity to pain, suggesting a complex interplay between psychological states and pain perception in neurodiverse individuals.
Our neurodiverse-friendly team at Simple Wellness includes Rachael Bird (diagnosed ADHD) and Mel Simon (undiagnosed ADHD, but fits the bill!!)

Chronic Pain and Neurodiversity
Chronic pain conditions, such as fibromyalgia and migraines, appear to have a higher prevalence in neurodiverse populations. The reasons for this correlation are not fully understood, but it is hypothesised that the neurological and physiological differences in neurodiverse individuals might predispose them to chronic pain conditions.
For example, the heightened sensory sensitivity often observed in ASD and other neurodiverse conditions might contribute to a greater risk of developing chronic pain syndromes. Furthermore, the stress and anxiety associated with navigating a world not designed for neurodiverse individuals can exacerbate pain perception and contribute to the development of chronic pain.

Psychological Factors and Pain
The psychological aspects of pain perception cannot be overlooked. Neurodiverse individuals often face unique psychological stressors, including social challenges, stigmatisation, and the need to mask or camouflage their differences to fit into neurotypical environments. These factors can lead to increased levels of anxiety and depression, both of which are known to influence pain perception negatively.
This is not to say that pain is "all in your head". Psychological stressors that increase demand on the nervous system genuinely contribute to the overall response of heightened sensitivity.

Improving Pain Management for Neurodiverse Individuals
Addressing the unique pain experiences of neurodiverse individuals requires a tailored approach. Healthcare professionals should be educated on the nuances of neurodiversity to provide better pain management and support. This includes recognising the signs of pain in non-verbal individuals or those who might not express pain in typical ways.
Additionally, creating a supportive environment that minimises sensory overload and stress can help in managing pain more effectively. Cognitive-behavioural therapies, mindfulness practices, and individualised pain management plans can be beneficial in addressing both the physical and psychological aspects of pain in neurodiverse individuals.

Myotherapy for Neurodivergent Patients
Seeking treatment for pain as a Neurodiverse patient can be daunting. Aim to find a therapist who understands that your pain experience may be different to the Neurotypical experience, and that your needs regarding pressure or communication may be different appointment to appointment.
We aim to make our appointments as simple as possible for everyone, not just Neurodiverse patients. That means we lay out expectations at the start of our appointments - no surprises, nothing unexpected.
We also know that making huge changes to your routine can be a nightmare for a lot of Neurodiverse people, which is why we'll focus on small shifts and easy modifications that will have big impacts on your pain or injury.
We'll write down the important stuff so you don't have to try to remember everything that we say.
And don't worry - we always send reminder emails and text messages about your appointment dates and times the day beforehand.

While neurodiverse individuals might experience pain differently, it is crucial for a therapist to approach each case empathetically. Pain perception is highly individualised and influenced by a myriad of factors. By acknowledging and addressing these differences, we can move towards more inclusive and effective pain management strategies that cater to the unique needs of neurodiverse populations. Understanding and empathy are key to ensuring that neurodiverse individuals receive the care and support they deserve.

Do you identify as a Neurodiverse person in need of an understanding Myotherapist to help you navigate through pain or injury? Book with our team to start working with a Myotherapist who can customise the treatment plan to your specific needs.
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Not sure who to book with?
Rachael Bird is a fellow ADHDer who can relate to the struggles of Neurodivergence! Rachael is here 6 days a week, loves a chat, and can make you feel at ease while you seek care for pain.