Summary: People with autism perceive pain with greater intensity, not less. A new study compared 52 people with autism to 52 healthy people. It found they were significantly more sensitive to pain. That overturns the common belief that people with autism don’t care about pain. Treating their pain takes a special approach.
Autism is common, and people with autism often struggle to communicate.
Until now, most researchers suggested people on the autism spectrum feel less pain. But a new study found the opposite. It suggests people with autism feel pain more strongly.
Autism Spectrum Disorder (ASD) is a neurodevelopmental (brain development) disorder. It affects communication, social life and behavior. In the United States, ASD has become more common over the years. The Centers for Disease Control and Prevention (CDC) says that as of 2020, about 1 in 36 children are diagnosed with ASD.
ASD is a spectrum disorder, which means it affects each person differently. For example, some people with ASD may have significant problems with communication and social life. Others may have mild symptoms that are barely noticed. Still, some common signs of ASD include:
- Trouble with social life: Children with ASD may struggle to make eye contact, read social cues and make friends.
- Repeated behaviors: People with ASD may repeat the same actions, like flapping their hands, lining up toys or saying the same phrases.
- Late language: Children with ASD may learn to talk late, or may not speak at all.
- Sensory issues: People with ASD may be sensitive to certain sounds, textures or lights.
- Fixed interests: People with ASD may be deeply focused on one topic or object and may want to talk about it nonstop.
Note that the signs of ASD vary a lot from person to person. Some people may not show all of them. And the signs may not show up until a child reaches a certain age.
So many people live with autism that we need to understand what other health problems they have and how their symptoms look. People with autism struggle with social contact. So they are more likely to under-report pain and other health problems. They are also more likely to live with chronic pain.
So it is no surprise that most studies say people with autism have fewer painful conditions. But a new study now shows that people with autism may feel pain more strongly.
The study looked at how people with autism process pain. The researchers thought autistic people might be worse at shutting down pain signals. That could make them feel pain more strongly. They tested 52 people with autism and compared them to 52 people without autism of the same age and gender. They used heat to create different pain levels and asked people to rate how much it hurt. They also checked how each body reacted to pain, such as whether the pain eased over time. People with autism felt pain more strongly than people without autism, especially when the pain lasted a long time. They also had a harder time shutting down pain signals, which could make the pain last longer. So people with autism may be more sensitive to pain in daily life. Their caregivers need to know this.
These findings matter because they challenge the common belief that people with autism don’t care about pain. Instead, people with autism may feel pain more strongly. And they may be worse at shutting down pain signals, especially when pain lasts a long time.
These findings matter for health workers and caregivers of people with autism. They show we need better ways to manage pain in people with autism, because their pain may not be noticed or treated. Health workers also need to know that people with autism may be more sensitive to pain. That may change how they react to medical procedures or treatments.
These findings show how complex pain is in people with autism. They also show we need more research on how to manage and treat pain in this group.
Frequently asked questions
Do people with autism feel pain more intensely?
Yes. One study compared 52 people with autism to 52 people without autism of the same age and gender. Researchers used heat to create different pain levels. The people with autism rated the pain as stronger, especially when it lasted a long time. They do not ignore pain. Many feel it more.
Do people with autism have a high pain tolerance?
That is the old belief, and this study challenges it. Earlier research suggested people on the autism spectrum feel less pain. But people with autism are more likely to under-report pain, because social contact and communication are harder for them. Quiet is not the same as comfortable. The study found more pain sensitivity, not less.
Why do people with autism feel pain more?
The researchers found that people with autism have a harder time stopping pain signals from their bodies. In most people, the body turns pain down over time. In people with autism that braking system works less efficiently, so pain can feel stronger and last longer. That matters most with long-lasting pain.
What are the common signs of autism?
Autism spectrum disorder affects each person differently. Common signs include trouble with social life, like eye contact and making friends. Others are repeated behaviors like flapping hands or lining up toys, late language, sensitivity to sounds, textures or lights, and intense fixed interests. Not everyone shows every sign. Some signs show up only as a child gets older.
How should pain be managed in someone with autism?
Pain in people with autism may not be noticed or treated properly. So caregivers and clinicians need to look for it instead of waiting to hear about it. Doctors should expect that a person with autism may feel more pain during medical procedures or treatments, and plan for it. Managing their pain calls for a special approach.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
