Migraines and Back Pain are NOT Inherited

By Dr. Jason Slagel | July 4th, 2022

There is a misconception out there that certain conditions like migraines and back pain are passed down in a family. Some things I’ve heard people say are, “Everybody in my family has a bad back!” or “Migraines just run in my family.” Well, I am here to tell you that migraines and back pain are not passed down, they are not hereditary, and they are not in any genes.  I am going to explain to you where they come from.  

To explain this, you first must know the difference between genotype and phenotype.  Genotype is the genetic code, you can think of DNA, information that is passed down. Phenotype is the physical expression of the genotype. So, genotype would be like computer code, all the zeros and ones, and phenotype would be the image we see because of that code.  Another way to think of it would be, genotype is like the script that an actor reads from, the information, the script, the screen writing. The phenotype is the actual movie itself, the expression of that, the actual physical representation of that script that the actors are reading. So, genotype is the genes and phenotype is the physical trait we see in your body.

There is no migraine gene and there is no back pain gene. Genes are passed down; the genes create certain phenotypes. These phenotypes are similar in families because genes are passed down in the family.  Some examples of phenotypes that are similar within family structures are skin color, eye color, height, hair type, foot size, the amount of body hair a person has, things like that are phenotypes, the physical expression of these genes that are passed down. There is one thing with phenotype when we look at the spine.  Just like when we look at a person’s ears, ears can be different sizes, shapes, different angles, all these kinds of stuff. Your spine is like that. When we look at the phenotype in your spine, we are looking that the shape of the bones, the size of the disks, the attachment points of muscles and the ligaments in your spine, things like that, and there is going to be some variation between people, but families are going to have similar characteristics. So, certain genes are passed down, and certain phenotypes will arise. Just like eye color can be inherited certain spine characteristics can be inherited as well.

This means that there can be certain strengths and weaknesses in the structure of someone’s spine. But the weaknesses don’t cause problems unless they get damaged by an accident or injury.  Now, these weaknesses are more susceptible to receive an injury. If there is a weaker point in the spines in one family and it never gets damaged, then no problems are going to develop. But, just like if you have a weak link in a chain, it doesn’t matter that there is a weak link in the chain, unless the load on that chain exceeds the amount that weak link can handle.  It’s at this point that the weak link will break, and then it does matter. Its similar in your spine, if the weak spot in your low back, for example, gets damaged through an accident or an injury then you end up with low back pain.  Or if the weak spot in your upper neck gets damaged through accident or injury then you can end up with migraines.  So, if a whole family, parents, and kids, all have similar weak points in their spine and then multiple of them have injuries, then the whole family will experience similar conditions, like migraines or back pain. However, the injuries are not genetic or inherited, the genotype and phenotype are.

So, the phenotype is inherited but it still takes an accident or injury to cause damage to that area of weakness. What does this mean? It means that that area can be repaired or fixed or stabilized and get better. It’s just like replacing the link on the chain that broke. You can go in and replace the broken link and then the chain is just fine again.

To review, there is no gene for back pain or migraines.  What we have are just weak points in the phenotypes that are passed down.  These weak points can make a person more susceptible to injury, and if there is an injury, then the problem can be fixed, and you can heal. So, in our office what we do is we examine your phenotypes in detail.  We look at you while standing and laying down, from the front, the back, right and left sides. We also take x-rays so we can see the internal structures. These x-rays are of the low back, mid back, the head, and the neck.  With these x-rays we can measure everything. We know if your hips are off center, we know exactly the shape of all the bones in your spine, and we measure them all so we can see exactly what is going on with your phenotype. Through this we can look at where the injuries have been, and we can calculate how to fix the problem.  Once we fix it, your body can heal up. Now, you are still going to have the same phenotypes, but it will be a healed phenotype, so it can get better.

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