Five ways chronic pain risk transmits from parents to kids

Genetics, effects on early development and social learning are some of the factors that contribute to the risk of chronic pain being transmitted from parents to children, a new study has found.

Amanda L Stone from Vanderbilt University and Anna C Wilson from Oregon Health & Science University in the US presented a conceptual model of transmission of chronic pain, including potential mechanisms and moderating factors. “Such a framework highlights chronic pain as inherently familial and intergenerational, opening up avenues for new models of intervention and prevention that can be family-centred and include at-risk children,” they said.

Knowing that offsprings of parents with chronic pain are at increased risk of developing chronic pain, as well as the adverse mental and physical health outcomes associated with chronic pain, researchers developed an “integrative conceptual model” to explore possible explanations for this risk.

They identified five “plausible mechanisms” to explain the transmission of chronic disease risk from parent to child.

The first mechanism was genetics. Children of parents with chronic pain might be at increased genetic risk for sensory as well as psychological components of pain, researchers said.

Studies suggest that genetic factors may account for roughly half of the risk of chronic pain in adults, they said.

Early neurobiological development also plays a role in the transmission of pain. Having a parent with chronic pain may affect the features and functioning of the nervous system during critical periods in early development.

For example, a baby’s development might be affected by the mother’s stress level or health behaviours during and after pregnancy, researchers said.

The third mechanism was pain-specific social learning. Children may learn “maladaptive pain behaviours” from their parents, who may act in ways that reinforce those behaviours.

Catastrophising – exaggerated responses and worries about pain – might be one key factor, researchers said. General parenting and health habits also contributes in the transmission of pain. Chronic pain risk could be affected by parenting behaviours linked to adverse child outcomes – for example, permissive parenting or lack of consistency and warmth. The parents’ physical activity level and other health habits might also play a role, researchers said.

The fifth mechanism was exposure to stressful environment. There may be adverse effects from growing up in stressful circumstances related to chronic pain – for example, financial problems or parents’ 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, researchers said.

These include chronic pain in the other parent; the timing, course, and location of the parent’s pain; and the children’s characteristics, including their personal temperament, they said.

The study was published in the journal Pain.