This issue of British Journal of Pain (BJP) is themed on pain and ‘nature and nurture’. The phrase ‘nature versus nurture’ was first coined in the mid-1800s by the English Victorian polymath Francis Galton in discussion about the influence of heredity and environment on social advancement.1 This concept expanded to include medicine and fostered the concept that these two parameters were separate and contributed individually to the end result. This paradigm is perhaps highlighted in the quote attributed to psychologist Donald Hebb who, when asked ‘Which, nature or nurture, contributes more to personality?’ answered by asking in response, ‘Which contributes more to the area of a rectangle, its length or its width?’2
To disentangle the effects of genes and environment, behavioural geneticists perform adoption and twin studies. Results indicate that both of these factors have a variable and interrelated contribution in many conditions. There are abundant examples of traits, which are of low heritability (specific language or religion), medium heritability (weight) or high heritability (blood type and eye colour). In low back pain, for example, from a recent meta-analysis, the estimates of heritability effects ranged from 21% to 67%.3 Therefore, it is not possible to accept the model of a binary simplification of two tightly interwoven parameters.1 Epigenetics is an example of how the very fabric of genetic function can be altered by environmental factors.4
Demographic factors, such as gender, age, lifestyle and habits, can all affect the expression of pain.5 Obesity is a prime example: it is associated with an increased risk of chronic pain, and the aetiology of adiposity has both genetic and environmental aspects. The article by McVinnie (a medical student!) on obesity explores the multiple mechanisms by which this condition can effect pain expression. The two articles by James and Cregg discuss the general aspects of genetics and more specific analgesic drug and receptor aspects of genetics and pain. To round off the issue, we have an article by Trim on the fascinating prospects of ‘mother nature’ and some of the potential analgesic benefits of snake venom.
We hope you enjoy this interesting and thought-provoking issue.
References
- 1. http://en.wikipedia.org/wiki/Nature_versus_nurture (accessed 11 August 2013).
- 2. Meaney M. The nature of nurture: maternal effects and chromatin remodelling. In: Cacioppo JT, Berntson GG. (eds) Essays in social neuroscience. Cambridge, MA: MIT Press, 2004, pp. 1–14. [Google Scholar]
- 3. Ferreira PH, Beckenkamp P, Maher CG, et al. Nature or nurture in low back pain? Results of a systematic review of studies based on twin samples. Eur J Pain 2013; 17(7): 957–971. [DOI] [PubMed] [Google Scholar]
- 4. Doehring A, Geisslinger G, Lötsch J. Epigenetics in pain and analgesia: an imminent research field. Eur J Pain 2011; 15: 11–16. [DOI] [PubMed] [Google Scholar]
- 5. Belfer I. Review Article. Nature and nurture of human pain. Scientifica 2013; 2013: 415279 (pp. 1–19), http://www.hindawi.com/journals/scientifica/2013/415279/ (accessed 8 August 2013). [DOI] [PMC free article] [PubMed] [Google Scholar]