UPFRONT | Roundup RESEARCH Take 5 Researchers investigate if chronic pain runs in the family Can an increased risk of chronic pain be transmitted from parents to children? Several factors may contrib-ute, including genetics, ef-fects on early development, social learning and more, according to a report in the journal Pain, the official publication of the Interna-tional Association for the Study of Pain (IASP). Amanda Stone of Vander-bilt University, in Nashville, Tenn., and Anna Wilson of Oregon Health & Science University, in Portland, Ore., present a conceptual model of transmission of chronic pain, including po-tential mechanisms and moderating factors. Knowing that offspring of parents with chronic pain are at increased risk of devel-oping the same condition, Stone and Wilson developed an “integrative conceptual model” to explore possible explanations for this risk. The researchers identify five “plausible mechanisms” to explain the transmission of chronic disease risk from parent to child: Genetics. Children of parents with chronic pain might be at increased ge-netic risk for sensory as well as psychological compo-nents of pain. Research suggests that genetic factors may account for roughly half of the risk of chronic pain in adults. Early neurobiological development. Having a parent with chronic pain may affect the features and functioning of the nervous system during critical peri-ods in early development. For example, a baby’s development might be af-fected by the mother’s stress level or health behaviors during and after pregnancy. Pain-specific social learning. Children may learn “maladaptive pain be-haviors” from their parents, who may act in ways that reinforce those behaviors. Catastrophizing – exagger-ated responses and worries about pain – might be one key factor. General parenting and health habits. Chronic pain risk could be affected by parenting behaviors linked to adverse child out-comes; for example, permis-sive parenting or lack of consistency and warmth. Exposure to stressful environment. There may be adverse effects from growing up in stressful cir-cumstances related to chronic pain; for example, financial problems or par-ents’ inability to perform daily tasks. The model also identifies some “moderators” that might explain when and under what circumstances children are at highest risk of developing chronic pain. These include chronic pain in the other parent; the tim-ing, course and location of the parent’s pain; and the children’s characteristics, including their personal temperament. Stone and Wilson note. They hope their model will provide a framework to guide future research – to-ward the goal of developing effective prevention and treatment approaches for children of parents with chronic pain. NUMBER CRUNCHING Practice profile Our latest survey of Canadian chiropractors provides a snapshot of current practice environments in Canada Group practice with other chiropractors 22% 31% Solo practitioners 43% Practices with other alternative health practitioners 6% Practices with medical practitioners, i.e. medical doctors, nurses www.canadianchiropractor.ca 8 Canadian Chiropractor October 2016
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