Close the gate on pain

In our lifetimes we will all experience pain to some degree.  Pain can be classified into two broad categories, acute and chronic pain and how we deal with pain depends on the category.

Acute pain

Acute pain serves as a warning to our body that it is being harmed by some internal or external process which could be accidental or intentional.  The warning is generated as part of our innate fight or flight response and signals to the brain that we should take action to minimise further damage.  In a sense, acute pain is a system that helps the mind to focus attention on the damaging event or process taking place.

Chronic pain

Chronic pain is a much more complex problem and lasts longer than acute pain.  It’s divided into two further subcategories, malignant or benign.

Malignant pain relief has many treatments including the use of opioids and other drug therapies to manage the pain.

Benign chronic pain serves no immediate biological purpose and many people suffer from this type of pain. It can occur when there is no underlying pathology and sometimes exists after recovering from illness

Often other conditions are associated with benign chronic pain including:

  • Fatigue
  • Depression
  • Anxiety
  • Poor Appetite

So it may be that the other factors are contributing to the existence of benign chronic pain.  Quite often when a condition such as depression is managed successfully, chronic pain is either reduced or removed entirely.

…we feel different levels of pain (intensity) based on our mood and mindset…

Pain Gate Theory – Melzack & Wall

Pain messages

When tissue in the body is damaged, chemicals are released which activate nociceptors and thus begin the process of sending messages to the brain via the spinal cord along nerve fibres.  The brain then sends out signals to remove the danger and begin the repair process, i.e. withdraw the hand quickly from the fire by invoking motor neurons etc.

With benign chronic pain it is believed that this process may have gone awry and the body is seemingly remembering pain rather than experiencing it.

Treatment for chronic pain

Prescription medicine such as anti-inflammatories, corticosteroids, antidepressants etc. can be prescribed for chronic pain.

Therapies such as massage, acupuncture, psychotherapy can help also as well as lifestyle changes (dietary, stopping smoking, stress management etc).

Pain gate theory

The Pain Gate Theory was published in 1965 by Ronald Melzack and Patrick Wall.  It proposes that we feel different levels of pain (intensity) based on our mood and mindset and that our experience of pain will differ from one person to another.

Ostensibly the theory describes how different nerve fibres can influence our perception of pain. The fibres in question are the large diameter sensory fibres, that have nothing to do with pain and carry information to the brain about touch, vibration, pressure, whether an object is hot or cold. 

The other fibres in question are the smaller pain fibres or pain receptors.

The theory suggests that these sensory fibres open and close a ‘gate’ that can prevent the pain receptors from delivering their message to the brain via the spinal cord.  Thus, when the gate is closed, pain is not registered in the brain.

Whilst the pain gate theory is just that, a theory, it may explain why rubbing (sensory stimulus) an injured area can often have the effect of dulling the pain.  Just focusing attention on sensory information coming into our brains, can have a pain-relieving effect.

Opening and closing the gate

When we focus on pain, we keep the gate open and allow the messages from the pain receptors to pass unhindered.  Similarly, if we are stressed, anxious, have negative thoughts the gate stays open.

Conversely, the gate closes when we relax, feel happy and good about ourselves, socialise and generally act in a positive way.

Often people suffering from chronic pain may notice that the pain associated with a new injury, such a cut to the skin, will take precedence over the chronic pain and for a period of time the chronic pain seems to disappear.

How does hypnotherapy help?

Hypnotherapy is a useful intervention for chronic pain management.  The therapy can help reprogram the established negative patterns around chronic pain and how we think about pain.  It can also help with the stress and tension that develops as a result of being in constant pain and to establish improved sleeping patterns that are so essential for the body to repair itself.

As with all pain it is essential that you first consult with your GP to determine any underlying condition and the most appropriate course of treatment.

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