Download Gate-Control Theory: Role of Nonpainful Stimuli in Pain Management and more Study notes Psychology in PDF only on Docsity! 8 ❚ JULY 2002 ATHLETIC THERAPY TODAY The gate-control theory of pain states that nonpainful stimuli can block painful stimuli. Melzack and Wall developed the gate-control theory, which is the basis for many traditional and nontraditional modality choices by athletic trainers and therapists. The central-biasing theory of pain integrates the notion of learned behavior into the gate-control theory. An athlete’s pain tolerance is physiological in nature, as well as psychological, and should not be judged because it is so subjective in nature. Endogenous opiates and enkephalins are natural peptides produced and released by the body to relieve pain. Key Words: gate-control theory, central-biasing theory, pain tolerance, endogenous opiates, enkephalins Key Points © 2002 Human Kinetics • ATT 7(4), pp. 8-13 Pain Theories—A Review for Application in Athletic Training and Therapy PATRICIA A. ARONSON, ATC, MEd, LPTA • Lynchburg College Knowledge is an important tool in treating pain. With the knowledge of pain etiology, the pathways that carry the message of pain to the brain, the social and psychological aspects of pain perception, and the ways in which pharmaceutical agents block pain, athletic trainers and therapists can communicate pain- management options to their athletes. In the daily course of the job, we must deal with our athletes’ pain in order to treat and manage their sports-related in- juries. Disregarding an athlete’s pain in the injury-management process can retard reha- bilitation. The objectives of this article are to re- view three current and well-accepted pain theories, provide ideas to clinicians who are teaching injured ath- letes about pain, and apply the theories to athletic training and therapy practice in tra- ditional and nontradi- tional patient treat- ment. Pain has been defined as an unpleasant sensory and emotional ex- perience arising from actual or potential tissue damage or described in terms of such damage. . . . [P]ain includes not only the perception of an uncomfortable stimulus but also the response to that perception. (Thomas, 1997, p. 1387) Pain perception is the body’s way of signaling danger but also can often hinder rehabilitation, activities of daily living, and athletic activities. Gate-Control Pain Theory Melzack and Wall’s gate-control theory of pain is the first of the three pain theories reviewed. Within the spinal cord lies a group of nerve cells known as the substantia gelatinosa, also referred to as Laminae II and III of the dorsal horn. Using a gate as an analogy, the substan- tia gelatinosa is a “gate keeper” that deter- mines whether a sensory message will reach the brain or be blocked. The gate plays an important role in pain management of the central nervous system (CNS). Pain messages that pass through the gate stimulate T cells (transport cells) of the dorsal horn in the spi- nal cord and facilitate message transport to the brain. T cells send messages up the spinal cord, much as an elevator transports people to the top floor of a building. The gate-control theory is predicated on transporting messages to the brain via impulses that are received on a “first come, first served” basis, and the strength of the incoming impulses also seems to dictate their influence on the gate.
