Is Back Pain Genetic?
Can we use a genetic test to see who will get back pain? If we do, can we prevent it? As early 21st-century medicine progresses, we will be confronted with these dilemmas. Has the first foray into this next step in diagnosis arrived?
Our Genes Tell Our Past, Present, and Future
Our genetic make-up can trace our history all the way back through our earliest ancestors. DNA ancestry testing is now easily available to anyone who wants to spit in a tube and mail it in. But DNA can also be used medically.
Each of us contains two copies of each gene; we get one from our mother and one from our father. These genes not only determine our physical make-up and tie us to our ancestors, but they also come preloaded with codes for future diseases, anything from heart disease to diabetes to cancer to mental illnesses, and more. How about back pain?
Is Chronic Back Pain Genetic?
The new study was a huge meta-analysis that investigated the genetic association with chronic back pain. More specifically, they were looking for genetic markers that would indicate why some end up battling chronic back pain for months, years, or even the rest of their lives, while others fully recover after an acute episode of back pain.
So did they find that chronic back pain was genetic? Let's look at the results. Three key genetic marker variants were identified as contributing to chronic back pain. These included variants in SOX5 (associated with cartilage defects and skeletal development), CCDC26/GSDMC (associated with disc herniation), and DCC (associated with spinal cord development). Researchers pointed out that these markers were also interconnected with osteoarthritis, disc degeneration, and disc herniation, for example, of which back pain can be a symptom.
What exactly do these findings mean? Just the presence of these genetic variants doesn't mean that someone will get back pain, these just define risk. So should we intervene when we don't know that patient will get back pain for sure?
What Else Our Genetics Can Tell Us About Disease
Genetic testing can reveal inherited genetic signatures that can tell us a lot about our risk for certain diseases. It can also find genetic similarities in certain types of disease to establish links for scientific study that will provide better ways to diagnose patients in the future. I've covered many of these on this blog in the past. Let's take a look at a handful.
- Psychiatric diseases can be particularly difficult to diagnose, and one study suggested this could be due to overlapping genetic signatures in psychiatric diseases such as schizophrenia, bipolar disorder, and autism for example.
- Quinolone antibiotics have had devastating side effects in many patients, and one study suggested that metabolism of these drugs may be disrupted by a certain genetic marker. If this is true, and we know a patient has this genetic marker, this could tell us that quinolones are contraindicated in this patient.
- Are you one of those people who is just prone to injury? If so, it may be genetic. Variations of a specific gene have been shown to be an indication of proclivity to injury in general.
The upshot? These are just the first baby steps of figuring out how genetics will change our management of back pain. Lots still to be figured out!