• Teresia Nyman, Marie Mulder, Anastasia Iliadou, Magnus Svartengren, and Christina Wiktorin.
• Department of Public Health Sciences, Division of Occupational and Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. teresia.nyman@ki.se
• Spine. 2011 Oct 15;36(22):E1469-76.

Study DesignA cross-sectional study on 21,225 twins based on a Web-based questionnaire was performed in 2005-2006 and administered by the Swedish Twin Registry.ObjectiveTo investigate the importance of genetic factors for the occurrence of "Concurrent low back (LBP) and neck-shoulder pain (NSP)" as well as of "Solely LBP," and "Solely NSP" in an adult population of women and men.Summary Of Background DataMany individuals suffering from LBP also have concurrent NSP, and little is known about the factors influencing the occurrence of this spinal comorbidity.MethodsHeritability of Concurrent LBP and NSP, solely LBP, and solely NSP was analyzed in 2934 monozygotic twin pairs, 2009 same-sex dizygotic (DZ) twin pairs, and 1960 opposite-sex DZ twin pairs without any known rheumatic disorders using structural equation modeling (SEM).ResultsThe SEM showed that 60% of the total variance for concurrent LBP and NSP can be explained by additive genetic effects, which was twice as large as for solely LBP (30%) and more than twice as large as for solely NSP (24%).ConclusionGenetic factors had a considerably greater importance for the occurrence of concurrent LBP and NSP compared with solely LBP or solely NSP. The influence of genetic factors was similar for solely LBP and solely NSP.

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