One of the most common things I hear from clients is some version of this: "I've tried everything. I don't understand why my body won't cooperate."
The link between genes and chronic pain is something most practitioners never look at and after 30+ years of clinical work, I can tell you it's one of the biggest missing pieces. "Everything" usually means everything aimed at the symptom. It rarely includes a real look at the biological wiring that shapes how a person feels, processes, and holds onto pain in the first place.
Short on time? Listen to the overview
And the research from the last two years has made this clearer than ever, especially for women, who carry a significantly higher genetic burden for pain than most people realize.
What the Research Says About Genes and Chronic Pain in Women
In 2025, a landmark genome-wide association study published in the British Journal of Anaesthesia analyzed data from over 400,000 participants in the UK Biobank, one of the largest genetic databases in the world, specifically looking at sex differences in chronic pain (Parisien et al., 2025).
The findings are worth highlighting; women carry approximately 4,500 sex-specific genetic markers linked to overlapping chronic pain conditions, roughly four times more than men, which accounts for the higher heritability of chronic pain in women. And it gets more specific than that: the genes associated with pain were primarily active in specific brain regions, but this pattern was seen only in women. Two hundred measurable brain features were significantly associated with pain in women. In men? Six.
Read that again. Two hundred versus six.
This is science finally catching up to what so many women with chronic pain have been saying for decades: my experience of pain is different, and it is not in my head. It turns out it's partly in the brain, literally, measurably, genetically, and that is not the same thing as imagined.
Your pain sensitivity is not a personality flaw
There's a particular kind of harm that happens when someone is told they have a low pain threshold, or that they're "sensitive," as if that's a character issue to work on.
Research consistently shows that women with chronic pain experience greater sensitivity, increased frequency, and longer duration of pain with profound effects on quality of life, daily functioning, and employment.
These are not exaggerated responses. They reflect real differences in how the nervous system processes signals, and some of those differences are written into the genome before you take your first breath. PubMed Central
Take OPRM1, the gene for your body's built-in pain relief system. Variations in it can affect how you perceive pain, how you respond to stress, and how well certain pain medications actually work. It's one example of many, and it points to something the standard pain management protocol has never accounted for: most early clinical research was done on men.
That's not a small design flaw; it's a fundamental mismatch between what the system offers and what the biology actually needs.
How Inflammation Drives Chronic Pain
Chronic pain and inflammation are not the same thing, but they are close neighbors, and genetics plays a significant role in how your body handles inflammation.
Specific genetic variants, including FTO, APOE, and MTHFR, significantly influence how individuals respond to nutrients, with downstream effects on metabolic pathways, inflammation, and oxidative stress. In plain terms, two people can eat the exact same diet and have completely different inflammatory responses, based on how their genes process what comes in.
If your body carries variants that drive higher baseline inflammation, that inflammation becomes fuel for the pain cycle. The structural work I do, the bodywork, the fascia, the nervous system resets, has a ceiling when the inflammatory environment isn't addressed. It's like mopping the floor with the faucet still running.
A precision nutrition intervention study published in 2025 found that individuals with a pro-inflammatory genetic profile responded significantly better to nutrition plans tailored to their inflammatory genetic markers, compared with those given generic dietary recommendations. Personalized, not standardized, that distinction is the entire argument for looking at your genetic profile. SciOpen
The gene-diet conversation your body is already having
Here's something most people don't know: your genes are not static instructions. They're more like a conversation between your biology and your environment, and food is one of the loudest voices in that conversation.
Knowing your genetic blueprint allows for proactive dietary interventions before deficiencies or damage accumulate.
Your genes aren't your destiny, they're a starting point; one you can work with once you know what you're actually working with
Continued improvements in genetic testing technology and increasingly accessible direct-to-consumer testing are moving us toward gene-based plans that can prevent chronic disease rather than simply react to it.
This is exactly the shift I've been making in my practice for the past several years. I work with 3x4 Genetics, a translational nutrigenomics platform that examines specific gene variants affecting inflammation, hormone metabolism, detoxification, nutrient processing, and recovery, all of which have direct clinical relevance to chronic pain. It gives me foundational information about how your body reacts to its environment, how it responds to stress, to injury, to inflammation, and that changes everything about how I approach your pain.
I haven't been talking about it much recently, but that's changing.
What this doesn't mean
Understanding genetic testing for pain doesn't mean you have a life sentence, and it doesn't replace everything else.
Your genes don't override everything else. The structural work still matters, so does your nutrition, your nervous system patterns, your movement, and your stress load. All of it is connected, and all of it is part of what I look at. Genetics is one layer of that picture, but it's often the layer that explains what nothing else could do. When a client's inflammation keeps spiking despite all the right structural work, when supplements that work for most people don't seem to land, when recovery just takes longer than it should be, that’s usually when looking at the genetic picture gives us the answer we've been missing.
Where I'm heading with this
If this is landing for you and you've been curious about what your genetic picture looks like, now is a good time to take that step. I'm offering $100 off genetic testing packages through June 16th. Use code SAVE100 at checkout. You can learn more here.
Pain that keeps moving, keeps returning, keeps defying the treatment you're getting is a pattern. And patterns have roots. This is one way we find them.
References
Parisien, M., Fillingim, M., Tanguay-Sabourin, C., Roy, M., Vachon-Presseau, E., & Diatchenko, L. (2025). Sex-specific genetics underlie increased chronic pain risk in women: Genome-wide association studies from the UK Biobank. British Journal of Anaesthesia, 135(2), 401–415. https://www.bjanaesthesia.org/article/S0007-0912(25)00234-X/fulltext
Varrassi, G., et al. (2025). Sex-related differences in chronic pain: A narrative review by a multidisciplinary task force. Pain and Therapy. https://pmc.ncbi.nlm.nih.gov/articles/PMC12298038/
Galmés, S., Palou-March, A., Pigsborg, K., et al. (2025). Personalized nutrition to mitigate inflammation in genetically predisposed individuals: A secondary analysis of the Danish PREVENTOMICS intervention. Food Science and Human Wellness, 14(6), 9250318. https://www.sciopen.com/article/10.26599/FSHW.2024.9250318
