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Theories of Pain

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13 views9 pages

Theories of Pain

Uploaded by

nikhil raj
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Pain

2.2 Theories of pain


Cartesian Dualistic Theory
 The oldest explanation for why pain manifested in specific populations was rooted in
religious beliefs.
 Throughout history, religious ideologies have had a substantial influence on people’s
thoughts and actions.
 As a result, the majority of people believed that pain was the consequence of committing
immoral acts.
 The dualism theory of pain hypothesized that pain was a mutually exclusive phenomenon.
Pain could be a result of physical injury or psychological injury.
 However, the two types of injury did not influence each other, and at no point were they to
combine and create a synergistic effect on pain, hence making pain a mutually exclusive
entity.
 Descartes also included in his theory the idea that pain has a connection to the soul.
 He claimed that his research uncovered that the soul of pain was in the pineal gland,
consequentially designating the brain as the moderator of painful sensations.
 The dualistic approach to pain theory fails to account for many factors that are known to
contribute to pain today.
 Furthermore, it lacks an explanation as to why no two chronic pain patients have the same
experience with pain even if they had similar injuries.
 Despite these shortcomings, it still provided future researchers with a solid foundation to
continue expanding the scientific understanding of the intricate phenomenon of pain.
 This theory, initially presented by Charles Bell (1774–1842), is referred to as the
specificity theory.
 This theory is similar to Descartes' dualistic approach to pain in the way that it delineates
different types of sensations to different pathways
 Bell also postulated that the brain was not the homogenous object that Descartes believed
it was, but instead a complex structure with various components.
 scientists and philosophers alike spent the next century and a half further developing the
specificity theory.
 In the mid-1800s, Muller published in the Manual of Physiology that individual sensations
were the result of specific energy experienced at certain receptors.
 Furthermore, Muller believed that there was an infinite number of receptors in the skin,
and this surplus of receptors accounted for the ability of an individual to discriminate
between different sensations.
 Maximillian von Frey made another critical addition to the specificity theory that served to
advance the concept.
 This contribution to the theory was the discovery of the four separate somatosensory
modalities found throughout the body. These sensations include cold, pain, heat, and touch.
 But it still fails to account for factors other than those of physical nature that results in the
sensation of pain.
 Much like the dualistic approach to pain, this theory also lacks an explanation for why
sometimes pain persists long after the healing of the initial injury.
Pattern Theory
 The pattern theory of pain has the greatest coverage in the scientific literature.
 The American psychologist John Paul Nafe (1888-1970) presented this theory in 1929. The
ideas contained in the pattern theory were directly opposite to the ideas suggested in the
Specificity theory in regard to sensation.
 Nafe indicated that there are no separate receptors for each of the four sensory modalities.
Instead, he suggested that each sensation relays a specific pattern or sequence of signals to
the brain.
 The brain then takes this pattern and deciphers it. Depending on which pattern the brain
reads, correlates with the sensation felt.
 At the time of its introduction, the pattern theory gained significant popularity among
many researchers.
 However, through further research and the discovery of unique receptors for each type of
sensation, it can be stated with certainty, that this theory is an inaccurate explanation for
how we feel pain.
Gate Control Theory

 In 1965, Patrick David Wall (1925–2001) and Ronald Melzack announced the first theory
that viewed pain through a mind-body perspective. This theory became known as the gate
control theory.
 The gate control theory of pain states that when a stimulus gets sent to the brain, it must
first travel to three locations within the spinal cord.
 These include the cells within the substantia gelatinosa in the dorsal horn, the fibers in the
dorsal column, and the transmission cells which are located in the dorsal horn as well
 The substantia gelatinosa of the spinal cord’s dorsal horn serves to modulate the signals
that get through, acting similarly to a “gate” for information travelling to the brain.
 The sensation of pain that an individual feels is the result of the complex interaction
among these three components of the spinal cord.
 Simply stated, when the “gate” closes, the brain does not receive the information that is
coming from the periphery to the spinal cord.
 However, when the signal travelling to the spinal cord reaches a certain level of intensity,
the “gate” opens.
 Once the gate is open, the signal can travel to the brain where it is processed, and the
individual proceeds to feel pain.
 The information mentioned above accounts for the physical component of pain, but as
stated earlier, the Gate Control Theory was one of the first to acknowledge that
psychological factors contributed to pain as well.
 In more recent times, researchers have postulated that these cortical control centres are
responsible for the effects of cognitive and emotional factors on the pain experienced.
 Current research has also suggested that a negative state of mind serves to amplify the
intensity of the signals sent to the brain as well. For example, somebody who is depressed
has a “gate” that is open more often, allowing more signals to get through, increasing the
probability that an individual will experience pain from an otherwise normal stimulus.
 Also, there are reports that certain unhealthy lifestyle choices will also result in an “open
gate,” which in turn leads to pain that is disproportionate to the stimulus.

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