Back Pain Without Disease or Substantial Injury in Children and Adolescents: A Twin Family Study Investigating Genetic Influence and Associations

Overview

Journal Children (Basel)

Specialty Health Services

Date 2023 Feb 25

PMID 36832504

Authors

Tessa Beerstra

Minh Bui

Tiina Jaaniste

Aneeka Bott

John Hopper

G David Champion

Affiliations

Soon will be listed here.

Abstract

This twin family study first aimed to investigate the evidence for genetic factors predicting the risk of lifetime prevalence of non-specific low back pain of at least three months duration (LBP (life)) and one-month current prevalence of thoracolumbar back pain (TLBP (current)) using a study of children, adolescents, and their first-degree relatives. Secondly, the study aimed to identify associations between pain in the back with pain in other regions and also with other conditions of interest. Randomly selected families ( = 2479) with child or adolescent twin pairs and their biological parents and first siblings were approached by Twins Research Australia. There were 651 complete twin pairs aged 6-20 years (response 26%). Casewise concordance, correlation, and odds ratios were compared for monozygous (MZ) and dizygous (DZ) pairs to enable inference about the potential existence of genetic vulnerability. Multivariable random effects logistic regression was used to estimate associations between LBP (life) or TLBP (current) as an outcome with the potentially relevant condition as predictors. The MZ pairs were more similar than the DZ pairs for each of the back pain conditions (all values < 0.02). Both back pain conditions were associated with pain in multiple sites and with primary pain and other conditions using the combined twin and sibling sample ( = 1382). Data were consistent with the existence of genetic influences on the pain measures under the equal environments assumption of the classic twin model and associations with both categories of back pain were consistent with primary pain conditions and syndromes of childhood and adolescence which has research and clinical implications.

References

Freidin M, Tsepilov Y, Palmer M, Karssen L, Suri P, Aulchenko Y . Insight into the genetic architecture of back pain and its risk factors from a study of 509,000 individuals. Pain. 2019; 160(6):1361-1373. PMC: 7066867. DOI: 10.1097/j.pain.0000000000001514. View

Evans A, Scutter S . Prevalence of "growing pains" in young children. J Pediatr. 2004; 145(2):255-8. DOI: 10.1016/j.jpeds.2004.04.045. View

Arendt-Nielsen L, Morlion B, Perrot S, Dahan A, Dickenson A, Kress H . Assessment and manifestation of central sensitisation across different chronic pain conditions. Eur J Pain. 2017; 22(2):216-241. DOI: 10.1002/ejp.1140. View

Dario A, Kamper S, OKeeffe M, Zadro J, Lee H, Wolfenden L . Family history of pain and risk of musculoskeletal pain in children and adolescents: a systematic review and meta-analysis. Pain. 2019; 160(11):2430-2439. DOI: 10.1097/j.pain.0000000000001639. View

MacDonald J, Stuart E, Rodenberg R . Musculoskeletal Low Back Pain in School-aged Children: A Review. JAMA Pediatr. 2017; 171(3):280-287. DOI: 10.1001/jamapediatrics.2016.3334. View

El-Metwally A, Mikkelsson M, Stahl M, Macfarlane G, Jones G, Pulkkinen L . Genetic and environmental influences on non-specific low back pain in children: a twin study. Eur Spine J. 2008; 17(4):502-8. PMC: 2295279. DOI: 10.1007/s00586-008-0605-1. View

You D, Albu S, Lisenbardt H, Meagher M . Cumulative Childhood Adversity as a Risk Factor for Common Chronic Pain Conditions in Young Adults. Pain Med. 2018; 20(3):486-494. PMC: 6387984. DOI: 10.1093/pm/pny106. View

Dongen J, Slagboom P, Draisma H, Martin N, Boomsma D . The continuing value of twin studies in the omics era. Nat Rev Genet. 2012; 13(9):640-53. DOI: 10.1038/nrg3243. View

Fitzcharles M, Cohen S, Clauw D, Littlejohn G, Usui C, Hauser W . Chronic primary musculoskeletal pain: a new concept of nonstructural regional pain. Pain Rep. 2022; 7(5):e1024. PMC: 9371480. DOI: 10.1097/PR9.0000000000001024. View

10.

Champion D, Bui M, Bott A, Donnelly T, Goh S, Chapman C . Familial and Genetic Influences on the Common Pediatric Primary Pain Disorders: A Twin Family Study. Children (Basel). 2021; 8(2). PMC: 7911833. DOI: 10.3390/children8020089. View

11.

Saunders K, Von Korff M, LeResche L, Mancl L . Relationship of common pain conditions in mothers and children. Clin J Pain. 2007; 23(3):204-13. DOI: 10.1097/AJP.0b013e31802d7807. View

12.

Cohen M . Clarifying "chronic primary musculoskeletal pain"? The waters remain murky. Pain Rep. 2022; 7(5):e1021. PMC: 9371484. DOI: 10.1097/PR9.0000000000001021. View

13.

Donnelly T, Bott A, Bui M, Goh S, Jaaniste T, Chapman C . Common Pediatric Pain Disorders and Their Clinical Associations. Clin J Pain. 2017; 33(12):1131-1140. DOI: 10.1097/AJP.0000000000000496. View

14.

Hartvigsen J, Nielsen J, Kyvik K, Fejer R, Vach W, Iachine I . Heritability of spinal pain and consequences of spinal pain: a comprehensive genetic epidemiologic analysis using a population-based sample of 15,328 twins ages 20-71 years. Arthritis Rheum. 2009; 61(10):1343-51. DOI: 10.1002/art.24607. View

15.

Craner J, Lake E, Barr A, Kirby K, ONeill M . Childhood Adversity Among Adults With Chronic Pain: Prevalence and Association With Pain-related Outcomes. Clin J Pain. 2022; 38(9):551-561. DOI: 10.1097/AJP.0000000000001054. View

16.

Burton A, Balague F, Cardon G, Eriksen H, Henrotin Y, Lahad A . Chapter 2. European guidelines for prevention in low back pain : November 2004. Eur Spine J. 2006; 15 Suppl 2:S136-68. PMC: 3454541. DOI: 10.1007/s00586-006-1070-3. View

17.

Ahlholm V, Ronkko V, Ala-Mursula L, Karppinen J, Oura P . Modeling the Multidimensional Predictors of Multisite Musculoskeletal Pain Across Adulthood-A Generalized Estimating Equations Approach. Front Public Health. 2021; 9:709778. PMC: 8385412. DOI: 10.3389/fpubh.2021.709778. View

18.

Yunus M . Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness. Semin Arthritis Rheum. 2008; 37(6):339-52. DOI: 10.1016/j.semarthrit.2007.09.003. View

19.

Betensky R, Hudson J, Jones C, Hu F, Wang B, Chen C . A computationally simple test of homogeneity of odds ratios for twin data. Genet Epidemiol. 2001; 20(2):228-38. DOI: 10.1002/1098-2272(200102)20:2<228::AID-GEPI5>3.0.CO;2-4. View

20.

Kaplan C, Schrepf A, Mawla I, Ichesco E, Boehnke K, Beltz A . Neurobiological antecedents of multisite pain in children. Pain. 2021; 163(4):e596-e603. PMC: 8720318. DOI: 10.1097/j.pain.0000000000002431. View