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Chronic Pain Gate Control Theory – How Is It?
Chronic Pain Gate Control Theory – How Is It?

The theory of pain in the gate control states that painless insertion closes the "gates" of the nerve to painful insertion that prevents pain from passing to the central nervous system.

The theory of pain control explains how unpainful stimuli can overpower rising painful feelings. A painful, harmful stimulus triggers primary afferent fiber and transmits it into the brain. Increased cell transmission activity leads to increased perceived pain. On the other hand, decreasing cell transmission activity reduces perceived pain. In this gate control theory, a closed "gate" means blocked access of cells, which reduces the feeling of pain. When an input to the transmission cells is allowed, an open "gate" describes that enables pain sensation.

If you feel negative, like a painful bump or bug itch, a common reaction is to try to remove the feeling and rub the painful bump or scratch the itchy part. These are aspects of the pain control principle most generally applied to gate control. The gate control theory assumes that nervous activity that does not transmit pain signals, called nociceptive fibers, may interfere with pain fiber signals, thereby inhibiting pain. It is suggested that both small and large transmitting diameter afferent nerve fibers carry information from the injury site to two destinations in the dorsal horn:

  1. Cells that bring the pain signal to the brain and

  2. Interneurons inhibiting cell activity transmission.

Sensory factors include injury, inactivity, long-term drug use and poor body mechanics that open pain gates and cause more suffering. Cognitive causes include dwelling on pain, a lack of objective or reasonable goals, pain thinking and concentrating on pain-related bad things. Depression, anger, anxiety, tension, disappointment, hopelessness and helplessness include emotional causes.

Sensory factors, including increasing activity, short term use of pain medicines, relaxation training, meditation and aerobics, close pain gates and cause less suffering. Cognitive considerations include personal desires, pain management and relief from pain. Emotional factors include a positive attitude, a decrease in depression, reassurance that pain is not harmful, self-checking, non-pain management and stress management.

Although the Gate Control Theory describes many complicated observations relating to pain, only a few examples include:

  • Pain responses vary widely in terms of the nature of the situation. Anyone who suffers an injury in a life or death situation could barely notice the pain at that time, but the same pain experience would lead to terrible pain in another situation.

  • If pain is needed for a desired goal such as a game win, a tattoo or a baby's birth, the pain will be much more tolerable than similar pain because of negative events such as accident injury or serious medical condition.

  • Chronic pain occurs with some type of injury but may persist long after the tissue damage is healed.

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