Individual Essay on group topic (gate theory of pain) PDF

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Physiological Systems

Constructing and Deconstructing the Gate Theory of Pain Lorne M. Mendell. (2014). Pain, 155 (2), 210-216. Introduction Since its proposition to the scientific world in 1965 by Ronald Melzack and Patrick Wall, The Gate Control Theory of Pain has kickstarted extensive research and experimentation to explore the theory in depth. Since pain itself can cause adverse effects which can negatively affect healing (Bechert & Abraham, 2009), understanding the theory of pain is imperative. Once the physiological cause of pain has been located and the mechanics are understood, treatments can be synthesised in order to abolish it completely. In 2020, 3.37 million Australians lived with chronic pain (Painaustralia, 2019), this statistic is expected to nearly double by 2050. This article discusses how the Gate Control Theory of Pain explicitly handles the conflict between theories of sensory neurons with specific response, and stimulation of small fibres in peripheral nerves, in order to explain the mechanisms of pain. The conflict is dealt with by the creation of the ‘gate’ theory that will be explained later. Further, Mendell ensures to highlight that despite the Gate Theory of Pain later being proved somewhat inaccurate, the theory evidently prompted research and widens our understanding of how pain works.

Main Points of the Article Throughout the article Mendell explores the process of research and experimentation that, primarily, Melzack and Wall carried out in order to create the Gate-Control Theory of Pain. More importantly, prior to the discussion of Melzack and Wall’s work, major advancements in the pain theory are discussed – both success stories and failure. Mendell ensures to highlight that elucidating both the advancements and failures of past scientists including Melzack and Wall, provides a wholistic perspective in order to deconstruct the evolution of modern pain theory. Mendell explains the early studies of Melzack and Wall including, “presynaptic effects of activity in smalldiameter unmyelinated afferent fibres” (Mendell, 2014). Many smaller experiments lead up toward the eventual proposition of the gate theory. The gate theory most generally explained, involves not just pain transmitted up the spinal cord directly to the brain but hypothesises pain impulses encountering “gates” in the spinal cord that control whether or not these signals are allowed to continue up to the brain. These “gates” are hypothesised to be located in the dorsal horn in the spinal cord (Cherry, 2019). Two distinct areas of the dorsal horn receive information carried by both small and large nerve fibres. What made Melzack and Walls theory unique, was that it not only suggested that there was a psychological aspect to pain but mapped out the basic beginning of research into understanding individual pain threshold and mechanics. Mendell further illustrates that with further subsequent research decades later, the gate mechanism is proved to be postsynaptic as opposed to presynaptic (Basbaum & Jessell, 2013). Despite the gate theory of pain proving to be somewhat inaccurate, Mendell’s main message was to appreciate the theory’s hypothesis as it gave rise to the conversation of modern pain theory.

Relation to Physiology As discussed in the lecture on sensory physiology, the “gate” is the inhibitory interneuron which “turns off” when a painful stimulus is detected, activating the fibre and sending pain stimulus to the brain. Further discussion provoked the illustration of simultaneous painful and nonpainful stimulus “turning on” the inhibitory interneuron which in turn, would lessen the pain felt. The article explored above was written by Lorne M. Mendell in 2014, deconstructed the gate theory of pain from early experimentation to later more recent experimentation and highlighted the efforts of Melzack and Wall, which ultimately, excited the brainstorm into modern pain theory.

Physiological Systems

References: Basbaum, A. I., & Jessell, T. M. (2013). Pain. Principles of Neural Science, , 530-555. Retrieved from www.scopus.com Bechert, K., & Abraham, S. E. (2009). Pain management and wound care. The journal of the American College of Certified Wound Specialists, 1(2), 65–71. https://doi.org/10.1016/j.jcws.2008.12.001 Cherry, K., & Block, D. (2020). Gate Control Theory for Pain Signals to the Brain. Retrieved 19 April 2021, from https://www.verywellmind.com/what-is-gate-control-theory-2795208#:~:text=This%20theory %20suggests%20that%20the,continue%20on%20to%20the%20brain.&text=Pain%20signals%20traveling %20via%20small,large%20nerve%20fibers%20are%20blocked. Mendell L. M. (2014). Constructing and deconstructing the gate theory of pain. Pain, 155(2), 210–216. https://doi.org/10.1016/j.pain.2013.12.010 Painful Facts. (2019). Retrieved 11 April 2021, from https://www.painaustralia.org.au/about-pain1/painaustralia-painful-facts...