What Is the Gate Control Theory? – Cleveland Clinic

You stub your toe on a piece of furniture and bend over to hold it.

You accidentally touch a hot stove and fan your hand.

Your child scratches his elbow after a fall and asks you to kiss him to “make it better”.

If these situations sound familiar, you’ve learned the basic premise behind the “gate control theory of pain.” This theory states that neurological gates in our brain decide which pain signals are let through and which are not.

Pain specialist and behavioral psychologist Judith Scheman, PhD, explains what gate control is and what it means for the pain you’re feeling — or Not feel, maybe

What is Gate Control Theory?

“Gate control is why rubbing a boo-boo works,” says Dr. scheme. “Part of what makes it so effective is that it distracts from the injury, which reduces the amount of pain felt. But the other reason it works is explained by gate control theory.”

Researchers Ronald Melzack and Patrick Wall coined the term in 1965 to explain how nonpainful stimuli can reach the brain faster than painful ones.”

“Gate control theory posits that perception of a noxious stimulus can be blocked by a non-noxious stimulus transmitted by nerve fibers that reach the brain before the painful entrance, because these nerve fibers are slower,” explains Dr . scheme.

In other words, gate control theory states that neurological “gates” in the periphery decide which pain signals pass and which are blocked. This affects how much pain you feel.

How the gate control theory of pain works

To understand gate control, think about what a regular gate does: it creates a barrier between what goes in and what stays out.

Let’s say you’re having a barbecue in the backyard. When your friends arrive at the gate, open it so they can join the fun. But if a stranger appears from the street at the same gate, keep it closed to keep him out of your party.

In the case of gate control theory, of course, there is no physical gate. Instead, neurological receptors act as metaphorical gates that protect your brain from pain.

When you are physically injured, your body sends signals to your brain to say you are injured. But according to gate control theory, some signals get through and others don’t.

When the gates are “open” you feel more pain; When they are “closed” you feel less pain.

The reason for this goes back to our caveman ancestors.

“Gate control is literally a survival mechanism,” explains Dr. scheme. “Imagine, for example, that a saber-toothed tiger attacked you. If you were paralyzed by this excruciating pain, the animal would kill you. But if you don’t feel all the pain, you can fight it or run away.”

Saber-toothed tigers may be extinct, but this special survival mechanism lives on in humans.

The role of large vs. small fiber activity

Think of nerve fibers as the tiny pathways that carry messages from your body to your brain. Different types of nerve fibers are responsible for transmitting different types of messages.

• Large nerve fibers Send your brain information about things like touch or pressure on your skin.
• Small nerve fibers Send information about pain and temperature to your brain.

Large fiber activity sends messages to your brain very quickly, while small fiber activity moves a little more slowly. “Studies show that when there is more large fiber activity than small fiber activity, you actually experience pain as less painful,” says Dr. scheme. “Pain stimuli are prevented from reaching the brain by fibers that transmit their sensation faster.”

Stimulating a lot of fiber activity can then help “close the gates” by getting to your brain first. They tell pain signals (carried by small fibers) that they won’t be let in.

And both touch and pressure stimulate large-fiber activity, which explains why kissing a boo-boo or clutching a stubbed toe can help relieve some of the pain.

“This sensation of something else actually blocks other signals from getting through to our brain,” explains Dr. scheme. “The gate closes and the pain signal doesn’t reach your brain.”

The role of your thoughts

Beyond gate control theory, your mental state also affects your perception of that pain. Feelings like anxiety, fear, depression, and a tendency toward disaster (or imagining the worst) all play a role in the way you experience physical pain.

dr Scheman explains some of the factors that can affect how you think about pain and how much you experience it.

• Expectations: If you expect something to hurt, your brain is more likely to register it as painful. “Expectations brighten the brain and spice up the nervous system,” says Dr. scheme.
• anticipation: Similar to expectations is anticipation. If you expect pain, you will feel pain, regardless of whether something has already happened or not. In one study, people in an MRI machine were told they would receive a small shock when a red light came on. When the lights came on, their brains lit up as if they were in pain even before the shock hit.
• Context: Where and how pain occurs can play a role in how painful it feels. For example, if a soccer player is attacked on the field, they are unlikely to experience the same pain as they would if attacked randomly at, say, the grocery store or in a dangerous environment. In a different context, the effect feels different.

“That’s just to say, sometimes we just don’t have control over the messages that are sent to our brains,” says Dr. scheme. “These messages all go as far as your brain — but once they get there, there’s a whole lot you can do to convey your experience of pain.”

As you try to relieve your pain

dr Melzack, one of the first to identify gate control theory, also created a questionnaire to help people identify the types of pain they feel. It divides the words used to describe physical pain into two categories:

• The sensory dimension of pain refers to intensity – what kind of pain you experience. These feelings, processed in a part of your brain called the somatosensory cortex, can be described with words like “throbbing,” “pain,” “sharp,” “tingling,” or “burning.”
• The affective dimension of pain refers to the psychological element, such as B. How uncomfortable or uncomfortable your pain is. These feelings, processed by your brain’s limbic system, may include words like “agonizing,” “agonizing,” “miserable,” or “excruciating.”

“The affective or emotional component of pain—the suffering component—plays an important role in the perception of how a lot of pain you feel,” says Dr. scheme. “When people learn to turn off these limbic areas of the brain, they rate their pain as significantly less and they tolerate it better.”

So the key is figuring out how to keep that part of the brain inactive to keep those gates closed. These three things can affect your limbic system and reduce your pain.

1. Distraction

When your brain is busy with something else, it can’t fully focus on your pain. “When you’re distracted, that area of ​​the brain shuts down, reducing the pain you’re feeling,” says Dr. scheme.

Have you ever heard of people with chronic pain not feeling that pain while pursuing their hobbies? That’s the power of distraction. For example, if you’re recovering from surgery, you can use virtual reality to evade, knit, do crossword puzzles, or even watch your favorite TV show to occupy your mind and keep your pain at bay.

2. Deep relaxation

“When our brain is very deeply relaxed, it releases endorphins,” says Dr. scheme. “Endorphins are the body’s natural painkillers. They are chemically identical to opioids but without all the negative side effects.”

In fact, they are so potent that practicing deep relaxation techniques has been shown to help people minimize, and sometimes even avoid, the use of opioids post-surgery. Studies also show that surgical wounds heal faster in people who practice deep relaxation techniques.

3. Thoughts

The way you think about pain matters — and can literally determine how much physical pain you feel and how long it takes to heal.

“Our thoughts about pain actually play one of the most important roles in how much pain we actually feel,” notes Dr. scheme. “When you undergo medical treatment or surgery without addressing issues such as anxiety, depression, or disaster, the outcome is almost always less than ideal.”

She recommends practicing a technique called thought-stopping, which is exactly what it sounds like: recognizing certain thoughts as they arise and then deciding to redirect them elsewhere.

“When you find your brain walking down this path, imagine you are standing at a stop sign. You decide: will I continue on this path?” She says. “You can Go this route – but if you know it will make your pain worse, you can choose to go in a different direction.”

Does this mean that pain is imagined?

You may be wondering, “Does that mean my pain is only in my head?”

Well, to an extent, yes – but that doesn’t mean it’s made up, fake, or imaginary. As the line from the Harry Potter Series says, “Of course it’s happening in your head, Harry, but why on earth would that mean it’s not real?”

That’s because, as Dr. Scheman emphasizes body parts themselves do not feel pain; only the brain can do that. “We can only perceive pain as long as the brain is involved,” she says. “Furthermore, once it reaches the brain, even the same painful stimuli feel different depending on our thoughts.”

So the next time your little one falls, try to “close the gates” by kissing that boo-boo goodbye. It can help more than you might have thought!