The Role of Family History in Pain Management
Has a health care provider ever asked you if you have a family history of chronic pain? I can’t remember being asked this question. But maybe we should all be asking this question, because there is evidence that pain intensity and certain painful disorders can be hereditary.
Two questions about this evidence come to mind. One, do we have genetic differences in the way we handle pain? And two, do painful conditions, such as arthritis or migraine, run in our family?
It turns out hypersensitivity and insensitivity could be genetic. A review of the literature by researcher Sabu James suggests we could have a pain gene. One study cited in the review showed a statistically significant genetic component in pain sensitivity. Could this explain why some of us with the same condition experience significant pain and others don’t?
A 2016 review, “Genetic predictors of human chronic pain conditions,” suggests certain painful disorders do run in families. Researchers in the study wrote, “Numerous genetic risk factors have been identified for musculoskeletal, neuropathic, and visceral conditions, as well as migraine. Among these, migraine and musculoskeletal pain disorders have undergone the most extensive investigation and have accumulated the highest number of implicated genetic variants.”
So it’s possible the condition that causes us persistent pain was passed down through generations.
I write a lot about finding a good role model, someone we look up to for his or her ability to triumph over medical struggles. Maybe you have a family member you admire. Maybe you’ve never met them, but you have heard stories about their fortitude. For instance, accounts of the Robinson women and their determination have survived many generations in my family. My maternal grandmother was a champion of women’s rights when she was young. I didn’t know this until a “Robinson woman,” whose daughter was helping her with the family tree, called me recently. What I knew of my grandmother is that she overcame many obstacles in her life, including chronic pain. Though she didn’t complain, I could see the pain of arthritis and “muscular rheumatism” (an old name for fibromyalgia) in her face.
I also have memories of my paternal grandmother sniffing pure ammonia in an effort to ease the pain of migraine. Both of my grandmothers would carry on, as did my mother and my father, and my maternal and paternal aunts. I have no doubt my role models influenced the way I handle pain.
An old saying my mother used on a regular basis was “The squeaky wheel is the one that gets the grease.” Did that familial attitude influence my decisions for dealing with pain? I think so, to some extent. However, nothing prepared me for societal influence in today’s chronic pain community. I have to wonder if the bias and stigma we see today was as intense for my family members. Maybe it was more so. We didn’t really talk about it. I wish I would have asked more when I had the chance.
It’s possible the answers about what to do, or what not to do, is related to our ancestry. Maybe we should ask questions too:
What medical problems run in the family?
How did doctors see chronic pain back in the day?
Was there anything Grandma did to help manage her pain on her own?
Did any family members suffer the stigma of chronic illness and if so, how? And how did they handle it? Did they speak up or hide in the closet with a glass of sherry, like Aunt Mable, because having pain was seen as a weakness?
As a nurse educator, I found that when one person had a question, someone else had the same question. There is power in knowledge. And as we gather over the upcoming holidays (and beyond), we can move forward in our own pain management journey by learning about the past.