Autism intensifies experience of pain, Israeli study finds, challenging assumptions

Largest study on pain responses may affect medical treatment by making doctors and nurses aware that patients with autism may be hurting more than others, but don’t communicate it

Nathan Jeffay is The Times of Israel's health and science correspondent

Illustrative: A nurse cleaning a wound on a patient (Serhii Hryshchyshen via iStock by Getty Images)
Illustrative: A nurse cleaning a wound on a patient (Serhii Hryshchyshen via iStock by Getty Images)

People with autism feel pain more intensely than others, according to a recent Israeli study that turns on its head the long-held notion that they had significantly reduced awareness of pain.

Researchers told The Times of Israel this week that the findings should have a major impact on how medical professionals treat people with autism.

The idea that those with autism are less sensitive to pain has begun to be questioned over the last decade. A 2013 study found the latest research suggested that “the idea that individuals with [autism spectrum disorder] are pain insensitive needs to be challenged.”

Now, Israeli researchers have conducted the most comprehensive study to date gauging the pain responses of people with autism. They didn’t only challenge the belief that people with autism are pain insensitive, but in fact concluded that the opposite is true.

“The results of our study indicate that in most cases, the sensitivity to pain of people with autism is actually higher than that of most of the population,” said Dr. Tami Bar-Shalita of Tel Aviv University’s medical faculty, one of the authors of the peer-reviewed research, published in the journal Pain last August but only publicized by the university now.

She said the research offers important lessons that should be acted upon immediately by medical professionals.

“Sometimes, medical professionals actually treat autistic people with the assumption they feel pain less,” she said. “Not only is this wrong, but our research shows doctors, nurses and others should treat autistic people knowing they feel pain more intensely, and take steps to reduce or manage pain.”

Tami Bar-Shalita of Tel Aviv University (courtesy of Tel Aviv University)

This could range from steps like applying a numbing cream before taking blood to taking extra time at the bedside to acknowledge the pain.

The study, which Bar Shalita conducted with colleagues at Tel Aviv University and collaborators at the University of Haifa and the Rambam Health Care Center, included 52 adults with high-functioning autism and normal intelligence, making it the largest reported sample in the world in studies on pain among people with autism.

Controlled pain, like heat, was administered to the participants with autism as well as to a control sample, and people ranked the pain on a scale of 0 to 100. The experiment was conducted on volunteers and was cleared by ethics committees.

The findings “prove beyond doubt that people with autism hurt more,” the researchers concluded.

Bar-Shalita said that often doctors assume those with autism don’t feel pain because “they may not communicate it to medical professionals in the same way as other people.

“Hopefully this research will encourage medical professionals to understand better how patients with autism experience and express pain.”

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