There have been a number of advances in the etiology of the chronic and widespread pain that is the hallmark of fibromyalgia: We learn more and more about the interplay of both physiological and psychological factors; but predicting the onset of such pain remains problematic, even with evidence for a genetic predisposition to the development of chronic pain. (There is data showing that first-degree relatives of patients with fibromyalgia are 8 times more likely to have fibromyalgia.)

The serotoninergic system plays an anti-pain role, and abnormalities in this system have been observed in patients with fibromyalgia. Still, it is uncertain whether this system is directly related to chronic widespread pain, as opposed to the reactive depression associated with being afflicted with chronic widespread pain. For this reason, researchers have tried to find a link between genes in the serotonin pathway and fibromyalgia.

An article in the March, 2011 edition of "Arthritis & Rheumatism" described the first study to explore the genetic susceptibility to both chronic widespread pain and the extent of musculoskeletal pain. Indeed, there were associations of genetic material known as single-nucleotide polymorphism (SNP) with musculoskeletal pain, namely in TPH2 and HTR2A. Another SNP, rs6313, has been shown to be associated with depression and chronic fatigue syndrome, another disorder associated with chronic widespread pain.

It is obvious that the nexus of genetic susceptibility, musculoskeletal pain, and the impact of psychological traits needs to be delineated. The current study indicated that the number of pain sites is only partially related to depression.

Information on ethnicity was not available for these study subjects, but all subjects were in the Northwest of England---a mostly white population. So, it does not appear that ethnicity or race plays a role here.

However, the results described above, indicating that genetic variation in the HTR2A gene is associated with musculoskeletal pain, beg for additional and confirmatory testing, and an exploration of any relationship with psychological status.

I recently posted a blog on using the mind to control pain. Well, before we become too self assured with all that meditation and yoga, we cannot forget where we came from: Our foundation is the human genome. And we continue to struggle with being controlled by our minds or our bodies.

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