Understanding the Gate Control Theory of Chronic Pain

Chronic back pain can be difficult to diagnose and treat, particularly when chiropractors are looking for a specific underlying problem to solve. In reality, pain is often much more complex and can be affected by a number of external and internal factors.

One of the major ways today’s chiropractors assess chronic pain and make treatment recommendations is through an understanding of the Gate Control Theory of pain. Developed in the 1960s by Ronald Melzack and Patrick Wal, this theory takes into account the roles that both the body and mind play in regard to pain and how it is processed.

At Ideal Spine, a fundamental understanding of how the brain communicates with the body and how pain is processed lies at the heart of how we develop treatment plans for patients.

Gate Control Theory explained

Essentially, Gate Control Theory explains that pain messages travel through the body up to the spinal cord and brain. Before these pain messages can reach the brain, they must travel through “gates” in the spinal cord that allow some messages to get through and block other messages. A number of different factors can influence whether the gates allow pain messages through or not, which results in different forms of pain for every individual, particularly when it comes to chronic pain.

How pain messages are transferred

The nervous system, which sends sensory and pain messages to be processed by the brain, is made of two major structures:

  • The central nervous system, comprising the spinal cord and brain.
  • The peripheral nervous system, comprising nerves in extremities that connect to the spinal cord and brain.

When someone gets hurt, the damaged tissues in the injury containing peripheral nerves transmit pain signals through the peripheral nervous system up to the spinal cord and the brain. In the theory, before the pain messages can reach the brain, they approach the nerve gates, which may open or closed based on different factors.

The basic understanding of these gates is that open gates allow pain messages through, resulting in experienced pain. Closed gates might mute or prevent pain messages entirely, resulting in the person experiencing little or no pain.

Factors controlling nerve gates

There are a number of factors that might alter whether the nerve gates open or close for different pain messages. Factors may include the intensity of the pain message, other “competing” sensory signals, like touch, or brain signals indicating whether the nerve gates should prioritize certain pain messages.

The theory states these brain signals can potentially alter some pain messages, resulting in a different level of pain each time. Sensory, cognitive, and emotional factors occurring within the brain can change the way a pain message is processed.

For example, sensory factors like injury, cognitive factors like focusing on the pain, and emotion factors like anxiety or depression can trigger the nerve gates to open and actually make the pain worse. On the other hand, pain medication, cognitive distractions, and positive attitudes can help nerve gates remain closed or minimize the effects of pain.

Essentially, Gate Control Theory states that the experience of pain may change as different types of information are processed in the brain.

How Gate Control Theory relates to chronic pain

While both acute pain and chronic pain play a role in the Gate Control Theory, experts have used the theory to better understand the complexities and contributing factors of chronic pain, in particular.

The theory has helped some chiropractor explain why certain treatments, like acupuncture, are effective in reducing chronic pain symptoms. By understanding the concepts of competing sensory messages, contributing factors in nerve gate opening, and the roles both mind and body play in pain reception, Ideal Spine chiropractors may be able to better treat their patients with chronic pain. All of this expertise, combined with a tailored Chiropractic BioPhysics (CBP) adjustment schedule, can unlock personalized results for each  patient’s  unique type of pain.

Chiropractic BioPhysics® corrective care trained Chiropractors are located throughout the United States and in several international locations. CBP providers have helped thousands of people throughout the world realign their spine back to health, and eliminate a source of chronic back pain, chronic neck pain, chronic headaches and migraines, fibromyalgia, and a wide range of other health conditions. If you are serious about your health and the health of your loved ones, contact a CBP trained provider today to see if you qualify for care. The exam and consultation are often FREE. See for providers in your area.

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Meridian, ID 83642

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