Acute pain resulting from a cut finger or stubbed toe is
a normal sensation triggered in the nervous system
to alert you to possible injury. Acute pain may fade
relatively quickly. Then there is chronic pain — a
persistent pain that doesn’t fade or stay away for long.
pain can come from back pain, recurring migraines or
fibromyalgia, and it can have a profound effect on
everyday life. A person might have suffered an initial
illness or injury, such as a sprained back, but others
endure chronic pain in the absence of any past injury or
evidence of illness. The American Academy of Pain
Medicine found that even comprehensive treatment with
pain-killing prescription drugs helps only about 58
percent of people suffering from chronic pain.
Fortunately, years of research are beginning to reveal
what is behind chronic pain and the ability to treat it.
A recent study from the University of Edinburgh,
Scotland, disclosed that genetic factors and family
environment contribute substantially to the risk of
chronic pain in an individual. Researchers working with
data from more than 100,000 individuals found that
inherited genetic factors accounted for more than 38
percent of the variation in chronic pain risk.
an evolving field, and we don’t have a genetic test
right now that could help us see who is genetically
predisposed to chronic pain, but what we do know is
there are certain factors that seem to affect chronic
pain,” says Dr. Sarah Endrizzi of Froedtert & the
Medical College of Wisconsin’s Pain Management Center.
According to Endrizzi, observation of chronic pain
patients has shown that illnesses such as irritable
bowel syndrome, fibromyalgia and low back pain tend to
run in families. “There are likely genetic factors at
play that change a person’s anatomy as well as how they
identify and perceive pain,” she explains. “We might see
a patient who tells us that their entire family has
arthritis or migraine headaches, for example. When I am
aware of this type of situation, treating the whole
family is helpful.”
family environment also contributes to risk of chronic
pain, as disclosed in the Edinburgh study and another
study conducted by two researchers from Vanderbilt
University and Oregon Health & Science University.
reveals that people who have a propensity toward chronic
pain often have a familial history of abuse, says Dr.
Nileshkumar Patel, chief medical officer for Advanced
Pain Management. “Many patients come to us with a
history of preadolescent sexual abuse, physical abuse or
the absence of a father figure,” he says. “These
individuals often lack coping skills necessary to deal
living with a parent who has chronic pain may experience
high levels of stress, which can lead to inability to
cope with their own pain, Patel adds. The Vanderbilt
study found that having a parent with chronic pain may
even affect the features and functions of the nervous
system during early development, which explains that a
baby’s development might be affected by the mother’s
stress level or behavior during and after pregnancy.
Later on, children could be exposed to parenting
behaviors linked to unfavorable child outcomes; for
example, the research mentions permissive parenting or
lack of consistency and nurturing.
difficult to imagine how major depressive disorder is
linked to chronic pain. People dealing with long-term
pain can become irritable and short-tempered, with good
reason. Constant pain can leave a person with a greatly
reduced ability to cope with even relatively mundane
problems. Additionally, clinical investigators have
tested chronic pain patients and found that some have
lower-than-normal levels of endorphins, a group of
peptides that produces effects such as pain relief, in
their spinal fluid.
medical community offers a variety of treatments for
chronic pain, Endrizzi says. “We take a
multidisciplinary approach, sometimes using medications,
but there are (other) treatments, such as injections,
biofeedback and acupuncture,” she says.
an advocate of using other treatments as well. “We
search for ways to avoid using opioid medications. A new
treatment for back pain uses high frequency spinal
stimulation to help cut down on the use of opioids,” he
future of this field is going to be in genetics, says
Endrizzi. “We are now piecing together how it affects
people,” she adds. “Someone will develop a genetic test
and that will help greatly with treatment.”