There are some things in life that we generally know can cause pain: touching a hot stove, getting a paper cut, stubbing your toe. Ouch!
But it turns out that we don’t all experience pain the same way, and our genes are partly to blame.
“We’re predisposed for how sensitive we are to pain,” says Kathleen Brady, MD, PhD, vice president of research at the Medical University of South Carolina and a Genomind Scientific Advisory Board member.
For fleeting, minor pains in healthy individuals, these genetic differences may not make an obvious impact on day-to-day life. However, for the millions of Americans living with chronic pain, it can.
In fact, up to 50 percent of this predisposition for chronic pain is heritable, according to a review in Neuroscience. For example, this means you may have a higher risk of developing migraines, low back pain, or other chronic pain condition if a parent has that condition.
Dealing with chronic pain? Here’s what you should know about the causes and treatments.
How You Feel Pain
Usually, how you feel pain is a lightning-fast process.
You injure yourself, and your body’s autonomic response stimulates pain receptors, which send a signal to the spinal cord that carries it to the thalamus and cerebral cortex areas of the brain. Then the signal retraces its path back to the location of the injury, and you feel pain.
This is what happens for acute or short-term pain, and it serves an important purpose: to let you know that you may be hurt.
When this process doesn’t function normally, chronic or persistent pain occurs. Pain signals in your nervous system may keep firing for months and even years, according to the National Institute of Neurological Disorders and Stroke.
Depending on your particular condition, chronic pain can show up in various parts of your body. Arthritis can cause achy joints. Irritable bowel syndrome can lead to belly pain. Fibromyalgia can mean pain all over the body.
Chronic pain can also have a major impact on your quality of life. According to the Centers for Disease Control and Prevention, chronic pain has been linked to reduced mobility, difficulties in school or at work, and anxiety and depression.
The Genetic Factors of Pain
Scientists know that pain sensitivity is partly determined by genetic factors. But if you’re looking for a single gene that’s responsible for your pain tolerance, you’re out of luck—at least for now.
“We really don’t know which genes are in control of pain,” Dr. Brady says.
That’s because there are many genes that may be involved, and chronic pain may be influenced by a complex network of molecular and environmental interactions, according to the Neuroscience review.
Is low pain tolerance genetic?
The SCN9A gene, for example, is in charge of the sodium channels that play a role in relaying pain signals from the body’s tissues to the central nervous system. Mutations in this gene can cause those channels to open too easily or make them unable to close, leading to more pain in an individual. In some cases, this can result in severe pain attacks.
Other mutations in the same gene cause these channels to break down, leading to the exact opposite: the inability to sense pain at all. This leads us to our next question…
Is high pain tolerance genetic?
In addition to the link between certain SCN9A mutations and feeling less pain, research has associated other genetic mutations with high pain tolerance. This suggests that there are parts of our genetic makeup that may contribute to an individual having a higher pain tolerance compared to others.
One study found a mutation, or variant, in the DRD1 gene to be 33% more prevalent in individuals who perceived less pain than those who perceived high levels of pain.
Other research points to the P2X7 gene, which encodes for receptors of P2X7 – a channel found in the immune system, and the central and peripheral nervous systems. These systems regulate the sensation of pain. Variants within the P2X7 gene can change how well the P2X7 channel (which is closely linked to inflammation) functions. It can also disrupt proper muscle contraction. In one study, individuals with certain P2X7 variants reported less chronic pain, as well as less pain in response to cold-processor testing and surgery. This signals that P2X7 variants may impact the body’s pain sensitivity positively, leading to a high pain tolerance.
Even though we don’t know yet exactly how our genes determine pain, it’s clear they play a powerful role.
How to Treat Pain
When it comes to treating pain with medication, the type of pain matters. “Inflammatory pain, headache pain, that kind of stuff, that’s when you use anti-inflammatories like ibuprofen,” Dr. Brady says. “Some of the deeper and chronic muscle pain, that’s when people use opioids.”
Antidepressants and anticonvulsants are other common medications that may be used to treat chronic pain, according to the American Academy of Family Physicians.
In addition to medication, your clinician may recommend behavioral therapy, exercise, breathing techniques, and other strategies to manage pain.
Got Chronic Pain? Follow These Steps
With so many options, how do you and your clinician find the right treatment for you? One key is open and honest communication.
Provide as Much Information as Possible
This will help your clinician make a proper diagnosis. Ultimately, your pain treatment depends on the type of pain you’re experiencing. “So you have to be careful about your pain diagnosis,” Dr. Brady says.
Let Your Clinician Know About Any Medications You Take
This includes prescriptions, over-the-counter drugs, and supplements. Your clinician may also ask if you use alcohol or other substances. This information helps your clinician watch out for harmful drug-drug interactions.
Follow Any Medication Instructions as Provided
You should also know any possible side effects. If you don’t find adequate pain relief, let your clinician know.
Ask for More Help
If you’ve tried treatments for chronic pain and struck out, asking for help is especially important. Pharmacogenetics (PGx) testing, for example, can help your clinician make a more informed decision about your care.
Genomind’s pharmacogenetic testing can look at your genetic makeup to help your clinician determine:
- Which medications may be more effective
- Which medications may have side effects
- How you metabolize medications for personalized dosing guidance
Does Your Medication Work for You?
Get a lifetime of mental health treatment guidance. Genomind’s leading pharmacogenetic test was designed to help your clinician personalize your treatment plan based on your genetic profile. Get started today.