Epigenetic

Epigenetic changes are modifications to gene expression that occur without altering the underlying DNA sequence.

They include processes such as DNA methylation, histone modification and regulation by non-coding RNAs. These changes act like molecular “switches,” turning genes on or off in response to environmental factors such as stress, injury or inflammation.
In pain medicine, epigenetics is highly relevant because chronic pain is not only shaped by structural damage but also by how genes are expressed over time. For example, prolonged inflammation or nerve injury can trigger epigenetic changes in neurons and glial cells, increasing the expression of receptors and ion channels that heighten pain sensitivity. This creates a long-lasting “memory of pain” in the nervous system, even after tissues have healed.

Epigenetic research has also shown why individuals differ in pain perception and treatment response. Factors such as trauma, stress or even early-life experiences can leave epigenetic marks that make some people more vulnerable to chronic pain. On the positive side, epigenetic changes are reversible — meaning therapies that calm inflammation and reduce oxidative stress (including PRF) may help restore a healthier epigenetic profile.