Abstract
Musculoskeletal pain conditions, such low back pain, are characterized by a report of pain greater than expected based on the results of a standard physical evaluation. The pathophysiology of these conditions is largely unknown, we lack biological markers for accurate diagnosis, and conventional therapeutics have limited effectiveness. Growing evidence suggests that chronic pain conditions are associated with both physical and psychological triggers, which initiate pain amplification and psychological distress; thus, susceptibility is dictated by complex interactions between genetic and environmental factors. Herein, we will review phenotypic and genetic markers of common musculoskeletal pain conditions, selected based on their association with musculoskeletal pain in previous research. The phenotypic markers of greatest interest include measures of pain amplification and “psychological” measures (such as emotional distress, somatic awareness, psychosocial stress, and catastrophizing). Genetic polymorphisms reproducibly linked with musculoskeletal pain are found in genes contributing to serotonergic and adrenergic pathways. Elucidation of the biological mechanisms by which these markers contribute to the perception of pain in these patients will enable the development of novel effective drugs and methodologies that permit better diagnoses and approaches to personalized medicine. Acknowledgments for Grant Support • 1K12DSE022793/PHS HHS/United States • AG033906/AG/NIA NIH HHS/United States • P01 NS045685/NS/NINDS NIH HHS/United States • R01-DE16558/DE/NIDCR NIH HHS/United States • U01-DE017018/DE/NIDCR NIH HHS/United States Disclosure of Interest Substantial shareholders: Attagene, Inc., Algynomics, Inc.; Consultant: Clontech, Inc., Algynomics, Inc.; Officer position: Algynomics, Inc.
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