It’s funny how it appears to be our human nature to look for someone or something else to blame. Particularly in recent years it seems that everyone is quick to look for an external cause to suffering or simply when things don’t go our way.
Maybe it’s a generational thing? There are certain generations that don’t want to seek help or advice, they want to bury their heads in the sand and plough on through – admirable in some senses, stubborn and unhelpful in others.
I have already spoken about my views on the need of medical-legal companies to promote and maintain illness rather than wellness behaviour and I see this reinforces the need for people to look towards external factors as a reason for problems in day to day life.
I was told in clinic recently that “I’ve inherited my dad’s pain gene”, it made me think that this is simply another external factor that we look to to find a solution for what’s wrong. I have pain because of this or that. David Butler talks about a magic bullet, where would we send it to resolve our pain? This client is under the impression that if she had different parents (they both have chronic pain) then she wouldn’t suffer – is she right or wrong?
I am reading a book at the moment called the Epigenetics Revolution, an interesting read and one part in the early Chapters of the book made me think. It is a study done on pregnant women in the Second World War. They looked at baby weights from mothers who were in the third trimester of pregnancy when rations were introduced compared to mothers who got pregnant during the later stages of the war and for whom rations were lifted in their final trimester.
The findings initially were much as expected, babies born to mothers who had less available food during their final trimester were smaller and those who had access to greater amounts of food in the latter stages had bigger babies. We all know that babies gain weight mostly in the third trimester so this doesn’t seem too odd.
What is interesting is that researchers studied following generations and found that all subsequent generations of the smaller weight babies had small babies and struggled to gain weight, making them naturally slimmer throughout life. Likewise, those of higher birthweight had babies who were heavier and each generation gained weight more easily.
Therefore can it be inferred that a behavioural or environmental change in the key growth period during the foetal developmental stage had an effect on genetic expression that was passed down generation to generation?
I started to think that maybe this could also work for pain. Maybe those who have been exposed generation after generation to long term pain conditions, behaviours and stressors during the foetal developmental stage also causes an alteration to gene expression. Maybe this contributes to the familial link of persistent pain conditions. Maybe it’s more than just purely nurture, growing up in a pain related environment, maybe there are some genetic changes as a result of the behaviour and environment of their home before they were even born. I am under no illusion, by the way, that Nature plays an incredibly significant role in the future development, behaviour and perceptions an individual has as they grow. It would be impossible to test this out, I know this too but the thought is still there, are some pre-disposed to pain related conditions? There is the same argument about depression, addictions and other medical conditions.
I see a lot of young clients with chronic pain who attend with parents with chronic pain who are all in need of good quality pain education that they can understand and then use to move forward. As therapists we have the ability to change people’s perception of pain and influence or de-threaten the fear of activity or movement. Many of them have been told that there is nothing that can be done or they believe they have “the pain gene” and therefore expect that this is their lot in life because dad and grandad had the same thing.
From a Neuroscience perspective we know that the brain is plastic and neurotags can be changed. Parts of the brain activated during a pain experience or in the case of a perceived threat can be ignited but this surely means that they can also be pruned, broken down or removed in the same way by exposure and paced activity.
If there is some epigenetic link with families in pain, or it’s just reinforced behaviour through environmental influence then maybe this can be changed for their next generation. It’s not about looking for external factors to blame, it’s about changing the way people think about pain and helping people to find the answers for themselves.
Sally Allbrighton BSc (Hons) Physiotherapy, Msc, Lecturer NOI UK