Short answer: the spots every tattoo pain chart calls worst (ribs, spine, fingers, feet) are educated guesses about anatomy, not a measured ranking. The largest survey behind this page, 1,092 tattooed people in Poland in 2020, found that how long the session ran and how stressed the person was moved pain scores more than which part of the body got the needle. Charts are still a decent tiebreaker. They are just not data.
That is a less satisfying answer than “ribs are a 9.” It is also closer to what the research says, so let’s go through it.
Where the usual tattoo pain chart comes from
Healthline’s tattoo pain chart is a widely shared one, and it sorts the body into two groups. The higher-pain group covers the skull, neck and spine, the rib cage, nipple and areola, armpit and inner bicep, the elbow, wrist, palm and fingers, the stomach, groin and inner thigh, the kneecap and the back of the knee, the shin, and the ankle, foot and toes. The lower-pain group is the chest, back, upper arm and shoulder, forearm, outer thigh and calf.
The reasoning is anatomy. Places with lots of nerve endings, bone close to the surface, little fat or thin skin tend to hurt more. Places padded with fat, with tighter skin and fewer nerve endings and no bone right under the surface tend to hurt less. It is sensible logic. It is also logic, not a dataset. The page does not cite a study that ranked body areas.
Plenty of other charts put a neat 1 to 10 number beside each body part, which looks scientific. No peer-reviewed ranking behind those numbers turned up in the sources used for this page, only anatomy and artist opinion.
What the 1,092-person study measured
The closest thing to real data is a 2020 paper by Witkos and Hartman-Petrycka in the International Journal of Environmental Research and Public Health. It surveyed 1,092 people, 863 women and 229 men, recruited at tattoo studios and online in Poland between June 2019 and June 2020. Everyone rated their worst pain from 0 to 10, during the tattoo and again directly afterward.
Here is what stood out:
- During tattooing, the average score was 4.31 for women and 4.48 for men, and that gap was not statistically significant.
- Directly afterward, women reported more pain, 2.15 on average against 1.76 for men.
- The authors’ own summary says the most important factors increasing pain were time, bleeding and the level of stress.
- Body area, which the paper sorted into upper limb, lower limb, torso and neck, was not a significant predictor of pain during tattooing. It did matter for radiating pain, which the survey asked about as a separate yes or no question.
Read that last point carefully, because it is easy to oversell. It does not prove the ribs are fine. Four broad regions cannot tell you whether the inner bicep stings more than the outer thigh, and the paper does not report pain by specific spot. The authors also list their own limits: people filled in the survey up to a month afterward, the recruitment switched from in-studio to online partway through, and they did not record tattoo size or whether people were first-timers.
So the fair reading is this. A chart can be a reasonable guess about specific spots. No measured ranking turned up. And the thing that clearly tracked with pain was the clock and the nerves, not the map.
Does having tattoos already make the next one hurt less?
People say it all the time. The research does not back it up neatly. A 2017 study in Physiological Research, “Do multiple body modifications alter pain threshold?”, tested 105 people with and without multiple body modifications. The authors found that body modification did not explain the results. People with and without modifications both had higher thermal pain thresholds at a party run by a piercing and tattoo studio than they did under neutral lab conditions. The authors read that as the setting changing how pain feels, rather than the ink changing the nerves.
That fits the stress finding. Mood, setting and company may matter at least as much as skin. If you are nervous, the first hour may feel longer than it is.
How to use a pain chart without being fooled by it
Treat it as a tiebreaker. If two placements are equally good for the design, pick the one the chart calls easier. If you really want the ribs, the chart is not a reason to give up.
Think in sessions, not spots. Pain climbed with time in that survey, so a palm-sized piece on a “bad” spot can be over quickly, while a huge piece on a “good” spot is a long afternoon. Ask your artist how many hours your design takes and whether it can be split.
Ask the person holding the machine. Your artist knows how their own work feels on different people, and how deep they go. Healthline notes that pain can increase when an artist works too deep, and that is also how blowouts happen, which we cover in our post on tattoo blowouts.
Plan around the cost beyond pain. Some spots are harder to heal, harder to look after, or fade faster. We have spot-specific posts on tattooing elbows, finger tattoos, neck tattoos and back pieces, and the small tattoo ideas are a friendlier place to start if you are nervous.
Be careful with numbing products. The FDA warned in March 2024 about over-the-counter lidocaine products sold for tattoos, and it advises against ones with more than 4 percent lidocaine. Talk to your artist before you buy anything. The FDA release has the details.
How much will it hurt afterward?
Less than during, at least in that survey. The average score directly after the tattoo was around 2 out of 10 for both groups, compared with about 4.3 to 4.5 during. What comes after is healing, with its own timeline of itching, flaking and scabs. Our tattoo healing guide goes through it, and the American Academy of Dermatology page on skin reactions after a tattoo explains the signs that mean you should see a doctor.
So here is the practical version. Use the chart. Do not believe the numbers on it. Shorten the session, find an artist you trust, and eat breakfast.
Sources
- Witkos and Hartman-Petrycka, Gender Differences in Subjective Pain Perception during and after Tattooing, International Journal of Environmental Research and Public Health, 2020.
- Yamamotova, Hrabak, Hribek and Rokyta, Do multiple body modifications alter pain threshold?, Physiological Research, 2017.
- Healthline, Tattoo pain chart.
- U.S. Food and Drug Administration, FDA warns consumers to avoid certain topical pain relief products, March 26, 2024.
- American Academy of Dermatology, Tattoos: 7 unexpected skin reactions and what to do about them.
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