Last reviewed: May 12, 2026 Last updated: May 12, 2026

Written by: Jay Hastings , CEO of PlexusDx

Jay Hastings is the CEO of PlexusDx, a precision health company focused on genetic testing, blood biomarker insights, and personalized wellness recommendations. He has more than 20 years of experience across healthcare innovation, genomics, laboratory operations, healthcare investing, and strategic finance. His work has included scaling healthcare startups, leading CLIA lab integrations, and helping expand consumer access to precision health tools.

Medically reviewed by: Jayden Lee, PharmD, EMBA

Jayden Lee, PharmD, EMBA, is the PlexusDx Medical Science Liaison with a PharmD and MBA specializing in pharmacogenomics and clinical product development, with a proven ability to bridge the gap between genomic research and practical patient outcomes. Dr. Lee has more than 10 years of professional experience in clinical pharmacy, academia, and research.

This article is part of the PlexusDx Education Hub — your resource for evidence-based guidance on Genetics & Pain. Browse all Genetics & Pain education

Neuropathic pain — the burning, shooting, or electric sensations that come from damaged or misfiring nerves — is notoriously variable. Two people with the same nerve injury or the same case of diabetes can experience wildly different pain, and some develop chronic neuropathic pain while others never do. A major reason is genetic: the ion channels and enzymes that set how loudly your nervous system signals pain differ from person to person, and those inherited differences help explain who is most vulnerable.

What makes neuropathic pain different

Unlike the pain of a cut or a bruise, neuropathic pain arises from the nervous system itself — damaged nerves that fire abnormally, amplify signals, or misinterpret ordinary sensations as pain. Common causes include diabetes, shingles, chemotherapy, nerve compression, and injury. Because the problem lies in the signaling hardware of the nerves, the genes that build and regulate that hardware have an outsized influence on how intense and persistent the pain becomes.

The genes that shape pain signaling

Several named genes govern how pain travels from nerve to brain. SCN9A encodes the Nav1.7 sodium channel, a critical gatekeeper for pain signals; rare mutations can abolish pain entirely or cause extreme pain syndromes, and common variants such as rs6746030 modulate everyday pain sensitivity. SCN10A (Nav1.8) plays a related role in peripheral nerves. COMT, which breaks down stress and pain-related neurotransmitters, carries the well-studied rs4680 variant that influences pain sensitivity and resilience. KCNS1, a potassium-channel gene, has been associated with chronic pain risk. These genes sit within the same neural signaling pathway that determines your baseline pain threshold.

What the research shows

Studies of SCN9A have provided some of the clearest evidence in all of pain genetics: variants that increase Nav1.7 channel activity are tied to greater pain sensitivity, while loss-of-function mutations produce congenital insensitivity to pain. COMT genotype has been linked to differences in experimental and clinical pain across many cohorts. Researchers emphasize that these are contributing factors, not deterministic switches — chronic neuropathic pain emerges from the interplay of genetic sensitivity, the nature of the nerve injury, and psychological and environmental context.

Managing neuropathic pain with a provider

Neuropathic pain is a medical condition that should be evaluated and managed by qualified clinicians. Care is individualized and may involve treating the underlying cause, specific medications, physical therapy, and behavioral approaches — all decisions that belong with your healthcare team. Genetic insight does not diagnose neuropathic pain, does not select or predict response to any medication, and is not a treatment. Its role is to help you understand the pain-signaling pathways involved so your conversations with a provider are more informed.

What pathway-level genetic insight offers

The PlexusDx Precision Peptide Genetic Test analyzes 14 pathways, 49 peptides, 150+ genetic insights, including neural signaling and inflammation pathways relevant to how the nervous system processes pain. It provides context about your biology — not a diagnosis and not a prescription. Understanding tendencies in genes like COMT and the sodium-channel family can help explain why your experience of pain may differ from someone else's, giving you a more informed starting point for a discussion with your clinician.

Everyday factors that influence pain

Beyond genetics, sleep quality, physical activity, stress, mood, and management of underlying conditions such as diabetes all shape how neuropathic pain is experienced. Consistent aerobic activity, good sleep hygiene, stress-reduction practices, and tight control of any underlying disease can all support the nervous system. None of these replaces medical care, but combined with an understanding of your genetic pain-signaling profile, they help you and your provider build a plan suited to your biology.

Curious how your neural signaling pathways are wired? Take the Precision Peptide Genetic Test for pathway-level insight before your next conversation with a provider.

Frequently Asked Questions

Is sensitivity to neuropathic pain genetic?

Genetics is a significant contributor. Variants in SCN9A and SCN10A, which build the sodium channels that carry pain signals, and in COMT, which clears pain-related neurotransmitters, help set your baseline pain threshold. Genes interact with the injury itself and with psychological and lifestyle factors.

Can a genetic test predict my response to pain medication?

No. The Precision Peptide Genetic Test is not a pharmacogenomic test and does not predict your response to any medication. It offers pathway-level insight into neural signaling and inflammation biology, not drug guidance. Medication decisions belong entirely with your healthcare provider based on your clinical picture.

Which genes affect pain sensitivity?

SCN9A encodes the Nav1.7 sodium channel that gatekeeps pain signals, SCN10A plays a related peripheral role, COMT influences neurotransmitter clearance and resilience, and KCNS1 has been linked to chronic pain. These genes shape how loudly the nervous system signals pain.

How is neuropathic pain managed?

Management is directed by clinicians and may include treating the underlying cause, medications, physical therapy, and behavioral strategies. Genetic insight does not treat pain or select therapy; it can help you understand your pain-signaling pathways and support informed conversations with your care team.

This article is part of the PlexusDx Education Hub. Browse all Genetics & Pain education

The Precision Peptide Genetic Test analyzes how your genes influence peptide-related biological pathways. It does not recommend, prescribe, or determine which peptides you should use. Consult a qualified healthcare provider before beginning any peptide protocol.

Medical and Editorial Standards

Medical review process: This article was reviewed for medical accuracy, scientific clarity, evidence alignment, and appropriate discussion of genetics, medications, supplements, biomarkers, and health-related claims.

Sources and evidence: PlexusDx educational content is developed using peer-reviewed research, clinical literature, reputable medical references, and, where applicable, public health or regulatory guidance. References are included at the end of the article when scientific, medical, or health-related claims are discussed.

Commercial transparency: PlexusDx offers genetic testing, blood biomarker testing, personalized supplement recommendations, and related precision wellness services. Product mentions are intended to help readers understand available options and should not be interpreted as medical advice.

Important disclaimer: PlexusDx educational content is for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making decisions about medications, supplements, genetic testing, lab testing, or health-related care.