Chronic pain is a complex medical condition with no easy answers. And unfortunately, doctors often struggle to identify its causes. Some types of pain can be easily linked to a previous injury or developmental disorder, but others persist for months or years without a clear cause. While many doctors first try to look for behavioral or environmental factors for this pain, there is an increasing amount of evidence that many people who experience persistent pain without a clear cause could have hereditary chronic pain, caused by genetic factors.
What Is the Difference Between Acute Pain and Chronic Pain?
It is fairly easy to believe that all forms of pain are the same, but there are many differences that separate acute pain from chronic pain. Acute pain is usually sudden and related to a specific illness or injury, while chronic pain is prolonged and often difficult to assign to a specific cause. Acute pain disappears once the underlying condition is resolved, while chronic pain does not.
Experts define chronic pain as any health condition with pain symptoms that lasts three months or longer. This type of pain is considerably more problematic for health care providers because it is almost always unknown what is causing the symptoms. There may be a foundational health issue that is causing the pain, but it may be difficult to diagnose, or modern medicine may have a limited understanding of the condition.
A recent analysis from the National Institutes of Health (NIH) found that 125 million American adults reported at least some pain in the three months before they were surveyed. And roughly 50 million of them reported daily chronic pain or severe pain. In addition, about 65% of people experience some sort of hereditary condition, whether mild or severe. Though research into hereditary chronic pain syndromes is still a new field, there is a lot of evidence to suggest that many people who suffer from chronic pain may have genetic risk factors.
Do Chronic Pain Conditions Run in Families?
There have been a number of genetic studies in recent years that suggest that genetics play a role in developing chronic pain conditions. One study by Wolters Kluwer Health concluded that as much as half of the risk of adult chronic pain may be due to genetic factors. Other factors include changes during early neurological development, social learning, and environmental factors.
A recent study in PAIN, a scientific journal dedicated to studying chronic pain syndromes, examined the medical histories of 8,000 sets of twins to find chronic pain syndromes common to both siblings. The study found that several pain conditions—including pelvic pain, dry eye disease, irritable bowel syndrome and musculoskeletal pain—were likely to be hereditary chronic pain. The researchers concluded that hereditary factors accounted for almost two-thirds of the risk potential of developing chronic pain, with environmental factors making up the remainder.
Another study in Utah examined the medical history of more than 2 million patients. Looking into the family history of more than 1,200 patients who had herniated or degenerated spinal discs, researchers found that close relatives had at least a four times higher risk of also developing lower back pain if they were related to somebody who had already developed it. Even second or third degree relatives had a moderately higher risk of spinal disc degeneration.
In addition to a genetic component for specific chronic pain conditions, heredity may also play a role in how intense perceived pain is. A new study involving more than 2,700 patients with chronic pain suggests that pain tolerance may be related to certain genes.
The genetic study revealed that the gene variant DRD1 was 33% more common in patients who classified their pain as low compared to those who classified it as high. Those with moderate pain had a 25% higher chance of having the gene variant COMT and a 19% higher chance of having the OPRK gene. It isn’t yet understood how these genes influence hereditary chronic pain, but it is a strong starting point for future research.
Is My Chronic Pain Hereditary?
It has become apparent that genes influence certain chronic pain conditions. Growing research into hereditary chronic pain reveals that more and more of these are influenced by genetics. Migraine gene research has exploded in recent years, and experts now believe that they have located more than 38 potential gene variants that govern the expression of this ailment.
Fibromyalgia is another well-known chronic pain condition that appears to have some genetic components. Although fibromyalgia does not pass directly from parent to child, there is an elevated risk if family members have FM. Genetic studies have begun to identify gene variants that are essential in pain modulation that may be mutated among FM patients. Some of these genes also play a role in developing anxiety and depression, which may help to explain why antidepressants are effective in treating fibromyalgia.
However, just because a family member has chronic pain doesn’t guarantee that you will develop hereditary chronic pain. Environmental factors like diet, sleep habits, injuries, and managing stress are still critical factors in controlling your health.
One upside of these hereditary conditions is that they may provide new insights into treating chronic pain disorders. A new field called pharmacogenomics is emerging that aims to customize medication treatments to individual patients. Pharmacogenomics analyzes the DNA of patients to identify key genetic markers that may play a role in medication responses. Although the field is still quite young, it holds enormous promise for patients with hereditary chronic pain.
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