Does dementia affect pain tolerance?

I have seen that when my mother is more confused she complains more of pain. Back when my mom was not sleeping and constantly calling out we were considering dilaudid as nothing seemed to ease her discomfort for long, if it wasn't her hips or knees it was a headache. We tried mirtazapine to help her sleep and it was like a miracle drug, not only did she sleep through the night but she was more lucid during the day and her complaints of pain almost disappeared. Recently the problems with sleeping, agitation and pain have been creeping back, so I definitely see there is a connection.

In my experience, simply observing my mother's plight in enduring sometimes unexplained, transitory twinges of pain, it almost seems as if the more severe her memory loss, the more acute any pain became, even to the point of her becoming nearly inconsolable.Even if given sufficient pain meds, it never seemed to be enough. Neuropathy is one term frequently used in this situation, where the type of dementia is intertwined with nerve dysfunction, described to feel like when our feet "fall asleep' and the pain we feel in their reawakening, but as a constant, unyielding
burn. Medication that inhibits neuro-receptors can sometimes alleviate this, but research shows mixed success. I find that consoling my mom and reminding her that it is not life threatening and that this, too, shall pass, helps more than anything.

Regular massage. Start gentle & gradually go deeper at level tolerated. Always massage before pulling & tugging on arm. If possible excerciser/ stretch in spa or hot water bath. If in bath add bicarbonate of soda. If doc refuses to listen get second appinion (RN)

I know what your Mom is going through regarding a broken bone and pain. Recently been there done that. When wearing a restraint one's arm isn't moving thus very little pain, except for trying to sleep.

But once it is time to start using that arm again the pain is very jarring because the muscles in the arm had tightened up due to non-use. Rehab is quite painful as the therapist is pulling/tugging on that arm to stretch the muscles, I went 3x a week for four months, I still need to go back.

Was the broken arm your Mom's primary arm? If yes, that makes it even worse because you are now forced to use your other arm to try to dress, eat, comb your hair, brush your teeth, write, etc. with that outcome that resembled that of a 3 year old. Try doing everything with just your other arm and see how it can be. And you are using muscles that aren't use to doing these things, so that other arm starts to ache.

Even though my break was back in May, my arm still will ache when I try to lift something heavier than a loaf of bread, and/or if the weather is bad. Yes, the pain is real and will be real for quite some time.