The Complexities Of Determining Genetic Risk Factors For Chronic Pain

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The concept of complex traits is particularly relevant to the study of pain. Indeed, researchers and clinicians have long appreciated that sensitivity to pain and pain-related traits (e.g. response to analgesics) are highly variable. Both classic and novel genetic techniques are essential tools to study the genetics of pain in both animals and humans. These approaches will be enhanced through the use of precise measures to characterize a particular painful condition (i.e. the "pain" phenotype) or pain management intervention (Table 4.2). While the investigation of specific traits such as sensitivity to pain or opioids has met with some success (for a review see Mogil et al.37), systematic investigations of the role of genetics in pain perception, painful conditions, and responses to pain management interventions are still in their infancy.

An additional caveat to assessment of familial aggregation is that environmental or cultural factors can lead to familial clustering and risk in the absence of a genetic component. Both acute and chronic pain states are known to be influenced by a variety of environmental, social, and cultural factors. Therefore, these factors will need to be considered and measured as part of studies that evaluate the genetics of pain and pain treatments. Currently, there are no published reports of multi-generational family studies of pain. This approach might

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