The Gate Control Theory of Pain
In 1965, Drs. Ronald Melzack and Patrick Wall introduced the Gate Control Theory of pain in an attempt to explain the mechanism by which a sensory-overloaded pathway to the brain will selectively eliminate or dampen the transmission of pain signals. This theory conceptualized a finite-sized sensory “gate” to the central nervous system located in the dorsal horn of the spinal cord. Theoretically, if this gate is flooded with other types of sensation, it will reach capacity and will be unable to accommodate additional sensory input. As a result, further pain input will be blocked.
Opening and Closing of the Pain Gate
The balance between large and small-fiber sensory input to the central nervous system can be tipped in favor of or to the detriment of the pain-sufferer. Here’s how:
Things that open the gate, leading to more pain
- Negative Thoughts
- Anxiety
- Fear
- Depression
- Memory of pain
- Life situation crises
- Stress
Things that close the gate, leading to less pain
Cortical and thalamic methods of the brain
Medication for Pain, tranquilizers, placebos, endorphins, antidepressants, relaxation techniques, biofeedback, meditation, euphoria, TENS and aerobic exercise (by increasing endorphins), TENS (by working both centrally and peripherally).
Spinal cord level blocking methods:
Dorsal column stimulator, endorphins, tractotomy
Peripheral blocking methods:
Acupuncture, electrical stimulation (TENS), heat, cold, massage, traction, manipulation, salves and ointments
Blocking or correcting the source of pain:
Spinal fusion, discectomy, chymopapain, facet neurectomy, NSAID medications
back to top
References
Swanson, David. Mayo Clinic on Chronic Pain. New York, NY: Kensington Publishing, 1999.
Chino, Allan F. & Davis, Corinne D. Validate Your Pain! Bloomington, IA: AuthorHouse, 2004.
Cochran, Robert T. Understanding Chronic Pain: A Doctor Talks to His Patients. Franklin, TN: Providence Publishing, 2004.