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What Is The Most Painful Thing In The World?

Kill us now.

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Dr. Katie Spalding

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Dr. Katie Spalding

Freelance Writer

Katie has a PhD in maths, specializing in the intersection of dynamical systems and number theory.

Freelance Writer

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Screaming man disintegrating into dust, arms-first, on a grey and brown background

My face when I get kidney stones and get Thanos snapped out of existence from the pain.

Image Credit: TeodorLazarev/Shutterstock.com

Life is pain, highness – but not all pain is created equal. Despite being by definition a subjective experience, there are some facts about pain we all pretty much accept as true. Getting stuck by a pin is less painful than breaking your collarbone, for example, and literally anything is easier than treading on a Lego at 2 in the morning. 

As for the most painful thing in the world, though – that’s a hard question to answer. There are people out there who don’t even find childbirth that painful, for goodness’s sake.

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But never let it be said that we at IFLScience would shy away from a challenge. So here they are: the most physically painful diseases, stings and bites, and bodily experiences that a person can go through. Did yours make the cut?

The most painful diseases

As upsetting as it is, pain is anything but pointless. It’s our bodies’ way of telling us something is wrong – it’s just that sometimes, the wires have gotten a little crossed.

Take complex regional pain syndrome (CRPS), for example. It’s a disease marked by usually continuous burning or throbbing pain, but for no particular reason: sometimes it occurs after the body suffers some kind of damage like surgery or a heart attack – but sometimes it turns up after something small, and sometimes after nothing at all.

Even when it is caused by an injury, though, CRPS is marked by the fact that the pain it causes is completely out of proportion. It can cause sensitivity to touch, swelling, and discoloration of the affected area, and even changes to hair and nail structure. Those with the condition can experience spasms, tremors, and muscle atrophy; it becomes painful even to wear socks.

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“CRPS… is one of the most painful conditions known, registering a staggering 42 out of 50 on the McGill pain scale,” British MP Ruth George pointed out in one 2018 parliamentary debate on the disease. “That is worse than the pain of the amputation of a finger or toe with no anesthetic.”

Worse, she continued, “CRPS is not a short-term pain that will heal in time. The most excruciating part is that the pain is long-term, and likely to be for life.”

How bad is it? Put it this way: it’s sometimes known as “the suicide disease”. Basically, CRPS doesn’t kill you – it's just really, really unbearable.

It’s hard to imagine something worse than a condition that comes with a one-in-two suicidal ideation risk – but according to the UK’s National Health Service, there are a few things that are comparable. They released a list of the 20 most painful illnesses back in 2018; alongside CRPS they included classics such as broken bones and migraines, as well as more niche conditions like trigeminal neuralgia, a sudden and severe facial pain that can be triggered by something as tiny as a gust of wind.

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Also making the list is the notoriously painful endometriosis – a disease where tissue similar to the lining of the uterus grows outside the uterus. Like CRPS, this condition comes with a quadruple whammy of disappointment: not only is it sometimes debilitatingly painful, but it takes an average of 7.5 years to diagnose, has no known cause, and is basically incurable.

Oh, and it can also lead to infertility. Make that whammy a quintuple.

The most painful insect venom

There are so many things in the world that can bite, sting, or otherwise afflict us with deadly poisons, that the question of which is most painful must surely be unanswerable. After all, short of some incredibly unlucky person who just happens to have been stung by like, 150 different things in his lifetime, how could we ever get a fair rating?

Well, we’re in luck, because that guy totally existed. His name was Justin Schmidt, he was an entomologist specializing in the study of killer honeybees, and he apparently spent basically his entire adult life getting stung in various exotic ways.

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“I know people think I’m a bit crazy,” Schmidt told the New York Times Magazine back in 2016. “But I’m really not. I’m just trying to answer a different set of questions.”

Forty years ago, that question was pretty cut and dry: is the pain of a sting related to how dangerous it is? The hypothesis, as it turned out, was a bust, but the methodology would become notorious – because it was in the resulting paper that the world first saw what would eventually become known as the Schmidt Sting Pain Index.

Covering close to 80 species of ant, bee, and wasp, the Schmidt Index ranks how painful a sting is on a scale from zero (barely noticeable) to four (kill me now). Down at the bottom of the pile, with a ranking of just 0.5, we find Triepeolus, a type of parasitic bee whose sting Schmidt describes as “Did I just imagine that? A little scratch that dances with a tickle”; a little higher up, with a ranking of one, its cousin the sweat bee imparts a pain that is “light and ephemeral, almost fruity. A tiny spark has singed a single hair on your arm.”

These descriptions, semi-whimsical and semi-profound, allow for nuances that a single number could never cover. “Numbers are kind of an unnatural thing,” he told Atlas Obscura in 2016. “I can’t even remember the numbers. I have to look at my notebook and see how I evaluated it, whereas the descriptions are much more graphic.” 

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“I think they’re just a much better way of communicating and conveying the essence of what the numbers are really trying to tell you,” he said.

To be sure, his descriptions certainly capture the nuances of the different types of pain available. The honey wasp and the baldfaced hornet both rate a two on the scale, for example, but they’re clearly very different experiences: the former is reminiscent of “a cotton swab dipped in habanero sauce […] pushed up your nose,” while the latter is “similar to getting your hand mashed in a revolving door.”

One step further up the ladder at three, we have critters like the Florida harvester ant – “bold and unrelenting. Somebody is using a power drill to excavate your ingrown toenail” – and the giant paper wasp: “there are gods, and they do throw thunderbolts. Poseidon has rammed his trident into your breast.”

Finally, we come to the acme of the scale: the level four stings. These are the ones that are so bad, they can “just shut you down,” he told Atlas Obscura. “You can’t function in a normal fashion.”

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There are only three insects cataloged that can deliver level-four pain: the warrior wasp, the bullet ant, and the tarantula hawk. But of the three, it’s the bullet ant that’s the undisputed king of sting, Schmidt said. 

“If I made a five on the scale,” he told Smithsonian Magazine in 2016, “it would be just the bullet ant and nothing else.”

The most painful experience

Ah ha, the bit you’ve been waiting for. Which is worse: childbirth or getting kicked in the balls? Well, there’s something out there that hurts worse than either – and it’s completely equal opportunity.

“I don't know that I ever see anyone on a regular basis in the ER who has more pain than a person who's there with a kidney stone,” said Troy Madsen, Adjunct Professor in Emergency Medicine and Assistant Professor in Surgery at the University of Utah, in the Who Cares About Men’s Health? Podcast last year. 

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“You can tell,” he said. “You walk in the room, they're writhing […] It's just incredible pain.”

Kidney stones are pretty much what they sound like: hard, stone-like lumps in the kidneys caused by a build-up of waste products in the blood, forming crystals. “When stones are sitting in the kidney, they don't usually cause pain because they're not obstructing,” University of Utah urologist John Smith said. “They're not bothering you.” 

“But when they start blocking the flow of urine and they get into the ureter, the small tube, your body tries to get rid of that by peristalsing, just the way it does when it moves food through your intestines,” he explained. And that’s when the pain starts: if the stone is big enough, it may block the ureter, causing the kidney to swell and the ureter to spasm painfully.

Worse, they can lead to severe kidney infections if left untreated. “People [can] lose kidneys because they think stones have passed but they never do, and their kidney ends up nonfunctioning," said Brian Benway, director of the Comprehensive Kidney Stone Program at Cedars Sinai, in 2019.

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“Blockage and infection together make the stone act like an abscess,” he explained, “and people can become critically ill and can even die in that scenario.”

And if you’re wondering whether passing a kidney stone can really be more painful than forcing another human out of your body – well, just ask those who know. 

Not only will many people flat-out tell you that their experience with kidney stones was worse than giving birth – “Years ago I had this nail tech, I told her how I was having kidney issues that have me a lot of pain and before I could finish she said: well, I hope it's not stones because I have 4 children, all four natural births, the third one took more than 24 hours to come out, and I would rather birth them all again back to back than pass those kidney stones again,” one Reddit post recalled – but actual, peer-reviewed research bears it out as well.

Opinions are similarly unanimous when it comes to the pain of kidney stones versus being kicked in the balls. “I've had dozens of [kidney stones],” one person wrote. “If I had a choice, I'd que[ue] up for a good nut kick with joy in my eyes.”

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The content of this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.   

If you or someone you know is struggling, help and support are available in the US at the National Suicide Prevention Lifeline on 1-800-273-8255. In the UK and Ireland, the Samaritans can be contacted on 116 123. International helplines can be found at SuicideStop.com.   

All “explainer” articles are confirmed by fact checkers to be correct at time of publishing. Text, images, and links may be edited, removed, or added to at a later date to keep information current.  


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