• Jean Jordan

Could I Learn Chronic Pain From Mum Or Dad?

Updated: Oct 10



If you learnt how to have chronic pain - is it time to get retrained?


There are many reasons why people have chronic pain. The specific reason I want to discuss with you today is: can pain or chronic pain be learnt? Yes, just like we learn how to ride a bicycle, how to dance, like Zumba (my favourite exercise) or learn how to decorate a celebration cake.


In each of these instances:

o first you watch;

o you observe what is happening;

o think about how something is done.


Lier et. al (2014) has shown that the paternal or maternal chronic pain increased odds for musculoskeletal pain in adult sons or daughters from 20% to 40%, that can increase as children grow older or if both parents have chronic musculoskeletal pain.



How Your Environment Can Worsen Your Pain


The environment in which we live and in which we grow up, has a major impact on our health that is well recognised by health professionals. Any doctor or specialist we visit wants to know our familial health conditions, such as diabetes or cardiovascular disease so they can track our health or propensity to develop an illness, especially chronic illness that necessitates constant medication. Unfortunately, as Zadro (2018) highlights preventative strategies are worth investigating, as not learning to do the wrong thing may help prevent familial chronic musculoskeletal pain. I'm not aware of questions about mother or father's pain history been regularly used on induction forms even when visiting a pain specialist? It's worth clarifying; here I am referring to lifestyle choices and influences, not to diseases such as rheumatoid arthritis and genetic components of diseases. My interest is learnt behaviour such as eating the wrong food and sitting around all day that isn't the best thing to do if we don't want to get diabetes.


This article argues for exactly that approach, finding out how learnt behaviour can impact the person suffering chronic pain. Such as if we know diabetes affects a family member we have an opportunity to make changes, preventing being the next family member to get diabetes.


Before I return to talk about chronic pain, in its many forms from back pain, knee pain, or post-operative pain; I'd like you to consider some examples of how we learn. Not just learning information, but learn how to move, how to act and how to do things that we'd like to do really well like create a fabulously decorated celebration cake!



First Example: Riding A Bicycle


Learning begins by observation:


o see people riding bicycles;

o see the pedals going around under somebody's feet;

o watch the handlebars being turned;

o (but rarely noticing the brake being put into action the gears being changed)


Those later two actions are learnt when we start to do! That is when we actually get on the bicycle and bring movement and action to the learning process.





Learning Zumba - Helped Me Recover From Post-Surgical Pain


When you walk in the exercise class it certainly looks like everyone knows how to move. How do I do this?


o watch and watch and watch, as the steps look so complicated;

o music and rhythm, more instinct here, start to move;

o steps are broken down, demonstrated, and talked through by the instructor.


Then we start to do, observing, following steps, usually watching our feet move, watching the instructor's feet move and trying to do the same. And for me, I'm always going in the opposite direction!


My last learning example is learning how to decorate a celebration cake. This is a very complex process for a cake to look amazing and often left to the professionals. We just admire the beautifully decorated cake.



Learning To Emulate Complicated Movements


Before people begin to learn and adopt ingrained methods and movements, and sooner or later developing emotional connections, remember even professionals had to learn:


o They watched demonstrations;

o They followed spoken instructions, practiced how to move hands evenly and smoothly;

o They drew diagrams, photos then created designs and I haven't even got to the cake yet;

o Then they practiced, practiced and practiced.


Perhaps there are some of you readers who can do your own celebration cake usually because you've learnt, had a bit of trial and error and practiced.



Now Back To Thinking Of Pain


Let's reflect on the examples above. As the examples above can we really learn pain?


Let's use back pain as an example; chronic back pain, middle or lower back. Whichever, it's pain that goes on for months, for years and without many real solutions to your back pain.



Growing Up Around People With Constant Pain



What do you think happens to a child who grows up with a mother or father that has chronic back pain?


o They watched the painful way mom gets up from the sofa.

o They see their father's expression when his pain hurts as he moves.

o They experience the grumpy day with a tired parent in pain

o For some children they'll be their parent's carer, or helper when the pain is just too difficult.




What's The Research Say Causes Chronic Pain?


Genetic research to find genes that either cause illness or can make us prone to health conditions has increased in recent years. Therefore an area of research into the causes of chronic pain is looking for genetic reasons why some of us develop chronic pain. Perhaps there could be a genetic weaknesses or susceptibility of a person's spine to injury or disability? Don't you think that there is an easier place attribute to consider, the possibility of "pain training" within families that could be more informative than a genetic test? Campbell (2018) says that in certain pain conditions "family members are more likely to have similar symptoms" p.41.



Another Way To Look At Family Pain Culture


"For example, two households one is a "rugby household", watching rugby, children play with an oval shaped ball, they play for their school rugby team etc."

"Then perhaps the house next door is a "football household", kicking a round football around the garden, making goalposts, and enthusiastic fans of Manchester United."


A Case study - A Daughter's Chronic Pain


It was a discussion with a woman who had chronic back pain that prompted me to write this article. A chronic pain client in her 60s, she had suffered back pain for over 20 years but what drove her to find me for treatment was recently added painful hands, hands becoming so painful work was becoming too difficult and now pain was a risk to her financial future.


When we discussed family history she described how she could only remember mother being in chronic pain and its disabling effects. She had one sibling, a sister who although younger, was already suffering disability from chronic pain, already using a walking stick and had reduced her lifestyle.


I can hardly draw an effective conclusion from one case study, and even finding a dearth of information on what I have called the ability to learn pain behaviour, to learn to have and live in chronic pain I think this is an important article. The example above draws attention to the "complex interactions between an individual with chronic pain and their family environment" Campbell et al (2018). Going forward I’d like to suggest on the induction forms or history taking interviews, some questions or some emphasis needs to be whether a parent, grandparent or even perhaps an uncle or aunt had suffered chronic pain for an extensive period. If this turns out to be the case as is it time for re-training pain?


Re-Training Or Updating The Pain You Learnt


Let's return to my cake decorator. Could there be an opportunity when getting bored with professional cake decorating to change their career to a carpenter making a wooden cabinet, or growing trees because they want to work outdoors. Yes there certainly is this opportunity, with re-training. In happens every day.




I Re-trained From:

o A high school teacher,

o To a naturopath,

o Now a chronic pain therapist specialising in natural and self-help therapy.


In much the same way, once you have the awareness of what you watched growing up, other members of your family who unwittingly gave you instruction by demonstrating pain signals. Could there be an opportunity to retrain your pain?



Final Thought For Pain Suffers Or Pain Practitioners


If you are a person with pain reading this article there may or may not be some relevance to you. If there is perhaps, as Zadro (2018) says a familial predisposition to have pain because another family suffered with chronic pain, or if you are the parent struggling yourself with pain, ask some questions of your pain therapist, awareness and information is powerful medicine.


To health professionals who work with, and treat chronic pain, do have a look at what questions are on your intake form, relating to a possible family culture of pain. It may open amazing doors of discussion and an option to re-train your patients thoughts and intentions for self-help.




This article is the personal opinion of the author, Jean Jordan who is a natural therapist who works online with people who have chronic pain and related stress and anxiety.

Learn more about Jean and discover her philosophy and holistic approach.






References


Campbell, P. , Jordan, K. , Smith, B. , Scotland, G. & Dunn, K. (2018). Chronic pain in families: a cross-sectional study of shared social, behavioural, and environmental influences. PAIN, 159 (1), 41-47.


Lier, R., Mork, P.J., Holtermann, A., & Lund Nilsen, T.I. (2016). Familial Risk of Chronic Musculoskeletal Pain and the Importance of Physical Activity and Body Mass Index: Prospective Data from the HUNT Study, Norway. Plos One; 11(4)


Lier, R., Nilsen, T.I.L., & Mork, P.J. (2014). Parental chronic pain in relation to chronic pain in their adult offspring: family-linkage within the HUNT Study, Norway. BMC Public Health,14,797


Zadro, J.R., Neilsen, T.I.L, Shirley, D.,Amorim, A.B., Ferreira, P.H. & Mork, P.J. (2018). Parental chronic widespread pain and the association with chronic widespread pain in adult offspring: Family-linkage data from the Norwegian HUNT Study. European Journal of Pain, 22(8), 1485-1493



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