A Theory Of Pain
The Mechanism of Pain
The mechanism by which pain is felt is not fully understood. One widely accepted theory is called Gate Control. This theory is useful but it is recognized as being only part of the story.
1. Gate Control Theory
Gate Control Theory says that there are bundles of nerve fibers along the nerve pathway that must be open to allow the pain sensation to travel to the brain. These are the gates. The theory is that if there is a sufficient stimulus the gate closes, preventing further sensations passing through. The theory has never been convincingly proved but nevertheless some aspects of it are helpful.
Gain control may account for the way in which pain can be relieved by rubbing or other stimuli such as acupuncture or massage. These measures act as counter irritants that occupy the nerve pathways so that they are not open to the pain sensation.
2. Loesser’s 'Onion'
A more recent theory is Loesser’s 'Onion' theory. This says that the pain mechanism is a series of nested layers, rather like an onion. The nerve stimulus or damage is at the centre, the next layer is the perception of pain, then come suffering, pain behavior, and finally interaction with the environment. These last two layers; pain behavior and interaction with the environment, are the only factors able to be clinically observed. The currently accepted model of pain theory is an amalgamation of the 'Onion' and the 'Gate Control' theories. Current pain theory likens the pathway of pain to the brain to a set of 3 or more stereo amplifiers representing:
- The body part that hurts
- the spinal cord
- the brain
Between each 'amplifier' or group of nerve fibers, pain can be blocked or its
transmission allowed.
Normally the brain perceives pain when a painful stimulus is applied. But due to the interaction between psychological and environmental factors this is not always the case. These factors are a normal but variable part of our sensory and emotional experiences. The idea of pain as purely psychological or purely physical is invalid. All pain is a mixture of these factors
Treatment Options Based On Pain Theory
Because the sensation of pain and suffering is influenced by all the above factors, treatment must take account of them. Medication, if prescribed, is only a part of the treatment.
We should use all the tools in the pain control toolbox. These include medical remedies prescribed for us by our doctors, as well as complementary therapies designed to block pain from reaching the brain, or to change our perception and of course our suffering.
These complementary treatments all work side by side with any medical treatments your doctor prescribes. I am sure that they will meet with approval, why not discuss them at your next appointment?
Now you can see how the mind influences pain and why mind body therapies are an important part of any chronic pain control plan. It all goes back to pain theory and how pain is initiated in and perceived by the brain. It does not mean that anyone thinks pain is 'all in your head' in the crazy sense.
Talking to Your Family
Explaining pain theory to your family might help you and them to understand what is going on. In the end you can simply smile and agree that, yes pain is all in the head.
