Downstream Regulatory Element Antagonistic Modulator, or DREAM for short, is a protein critical to pain sensations experienced by organisms. Recent research has suggested that this genetic origin to pain might be possible to exploit for the purpose of pain management (Cheng et al., 2002; Cheng and Penninger, 2003). This paper discusses the ethical implications of DREAM for sport to advance the debate on what constitutes a legitimate method of performance modification. Initially, it is argued that DREAM presents a more complex problem for anti-doping authorities than other methods of gene doping, since it cannot easily be characterised as enhancing or therapeutic. Indeed, the basis of this distinction is criticised by exploring a biocultural definition of health. On this model, which seems unlikely to be endorsed by anti-doping authorities, but, nevertheless, which is perpetuated by sport physicians, the use of DREAM would seem more difficult to prohibit on medical grounds. Its use is consistent with a medical desire to alleviate suffering, even where it is self-induced. A similar dichotomy exists when discussing the relevance of pain from a sporting perspective. While one might presume that the ethics of sport is such that any legal mechanism to improve performance is desirable for an athlete, pain tolerance appears to have a symbolic value that would undermine the usefulness of DREAM. This tension demonstrates greater complexity to the debate about the role of technology in sport and its ideological connotations about what it means to be an athlete.