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Gate Control - fact or fiction?

TobiasTheViking

Resident Viking Autist
TobiasTheViking
Joined
Jun 25, 2005
Messages
6,925
I recently had a discussion about acupuncture, and i had to cave in on one subject, due to lack of knowledge.

Basicly the girl i was talking to(not into most of the woowoo stuff, but believes in some of it, seems mostly skeptical enough) claimed that acupuncture worked.

She brought out the aspect of Gate Control to support her.

She did agree that acupuncture wouldn't help with pain in my foot, or head, or stomach, or against cancer, so don't think she is a nut job.

But she claimed that the Gate Control aspect worked(and said there were real clinical studies).

She explained Gate Control to me as... having a pain in your wrist.. and blocking the pain via insirting a needle into your arm.. Thus blocking the pain coming from your wrist.

I can sorta see this working.. to a degree. I promised her i would look into it, but i couldn't find anything i trusted, so i come begging here. :D

She agreed that it wouldn't work for something major(like getting your hand cut off). But claimed it would work for minor pains(like joint pain).


I believe that it is just a placebo effect... but i can sorta believe that you can overwrite(there must be a better word) a minor pain from the wrist, with an even minor pain further up in your arm.


Thanks
Tobias
 
This is a great example of the danger from a smart person who is rationalizing a nonsense idea. She wants acupuncture to work, so she has bought into an idea that sounds justifiable.

If causing a pain in your upper arm could block pain in the lower arm, wouldn't that be incredibly testable? Wouldn't it have been replicated endlessly? The mechanism doesn't matter. A poke, pinch, prick, jab, compression, or even electrical curent. If it were easy to turn off pain by stimulating/manipulating a "Gate", then modern science would be all over it.
 
apoger
That's what i said.

Hey, don't get me wrong, she didn't pursuade me, i just didn't have enough information at that point.

One of the reasons i can(could), kinda believe it, was because she said there had been real clinical tests. Very recent tests, as within the last year.

That would explain why it wasn't part of the medical science yet.

I came here to see if i had missed something, and this aspect was accurate. I see my doubt wasn't missplaced.

I guess what she have heard about must have been a faulty test... with no peer review.

Since my conversation with her was around a fire, no where near a computer, i couldn't go and search at that point...
And i doubt she can give me a reference to the study anyway.

I just promised i would look into it, and i always endeavour to never break a promise. Even though i disagreed with her.


Thanks for your help.

If there is some source i could quote to her, i would appriciate it. That is, if there have been made a paper that disproves it, of course.

Again thanks.

Sincerely
Tobias.
 
TobiasTheCommie said:
[One of the reasons i can(could), kinda believe it, was because she said there had been real clinical tests. Very recent tests, as within the last year.
Click to expand...


well lets what has appeared in the last year

http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=15870415&query_hl=1

no difference found from placebo

http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=15861492&query_hl=1

The smoking cessation success was only 1 case (0.6%) in the case group and none in the control group after 4 weeks.

http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=15844844&query_hl=1

a posertive study from Taiwan well posertivein that:
acupuncture at the P6 point can increase vagal modulation of the subjects.

Just one problem funnel plots of studies from the far east suggest a strong publication bias

http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=15844843&query_hl=1

posertive but no placebo

http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=15804591&query_hl=1

again a slight lack of a placebo

http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=15777857&query_hl=1

mixed resutls with sdome emaseures being posertive and some negative

and one where I can't get the abstract

http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=15743311&query_hl=1

that is every clinical trial carried out this year. I'm not impressed.
 
If I remember my Psych 101 class correctly, the Gate Control Theory posits that the spinal cord acts as a gatekeeper for pain. Say that you stub your toe and slam the car door on your fingers. You won't feel each pain at the same time. The idea is that the spine keeps us from being overwhelmed with pain.

So the theory isn't so bad, it's just another thing that gets used for B.S.

Unless, of course, I'm wrong.
 
geni said:
well lets what has appeared in the last year

< snip >
http://www.ncbi.nlm.nih.gov/entrez/...d&dopt=Abstract&list_uids=15861492&query_hl=1

The smoking cessation success was only 1 case (0.6%) in the case group and none in the control group after 4 weeks.

< snip >
that is every clinical trial carried out this year. I'm not impressed.
Click to expand...

Well. i wasn't talking in general, i was talking specificly gate control.

Thanks a bunch for those links.. i will go through them tomorrow, i need to sleep now :D

LostAngeles:
Exactly, the theory isn't bad. Which is why i wanted to confirm that it was just BS dressed up as science, before i made an ass out of myself.


Atleast i'm not the only one that doubted, atleast, one aspect of it :D

Thanks
Tobias
 
geni
Oh, i thought they were longer, but the abstracts were fine.. Thanks for the read.. while they weren't exactly the situation she talked about, i do feel confident that the studies she talked about either don't exist, or weren't blinded.

Thanks.

I guess i will have to continue my discussion with her, muahahahaha.

Sincerely
Tobias
 
TobiasTheCommie said:
Well. i wasn't talking in general, i was talking specificly gate control.

Thanks a bunch for those links.. i will go through them tomorrow, i need to sleep now :D

LostAngeles:
Exactly, the theory isn't bad. Which is why i wanted to confirm that it was just BS dressed up as science, before i made an ass out of myself.


Atleast i'm not the only one that doubted, atleast, one aspect of it :D

Thanks
Tobias
Click to expand...

I am by no means saying I am an expert, but I don't think the theory is worth much. I had a tumor compressing my spinal cord, and I could feel pain in both feet at the same time.

Granted, there was a tumor compressing it, but it would seem that I still couldn't feel both at once according to the theory.

I may have just given a false dillemma. Hmm. I need to go back through my logic books...
 
fowlsound:
She agreed that it would only work for minor pain.. and her example was with wrist and arm.

I still doubted her.

Thanks.. now i have both real clinical tests.. and you to quote to her, next time.

i hope the tumor is no longer a problem.

Sincerely
Tobias
 
TobiasTheCommie said:
fowlsound:


i hope the tumor is no longer a problem.

Sincerely
Tobias
Click to expand...

Thanks! After surgery and radiation, I'm cancer free. I do have some neat titanium hardware in the spine now, though!

Good luck.
 
TobiasTheCommie said:
fowlsound:
She agreed that it would only work for minor pain.. and her example was with wrist and arm.

I still doubted her.

Thanks.. now i have both real clinical tests.. and you to quote to her, next time.

i hope the tumor is no longer a problem.

Sincerely
Tobias
Click to expand...

Oh, and one last thing, I offer only anecdotal evidence, which should be treated as such, and I committed a logical fallacy by saying it has to be either or. Please quote me if you wish, but be prepared for the rebuttal...
 
Gate Control is the leadingtheory of pain. For a simple explanations see here which also mentions the acupuncture studies.

Some abstracts have already been posted, so I won't bother going through the clinical trials and why placebo acupuncture is such a difficult thing to execute. There was a debate in a series of letters to the Editor about a year ago in . PAIN (the leading journal in the field) about the retractable placebo needles. Although it is not settled, my impression is that they don't work very well and most people can tell whether they are getting placebo or real acupuncture.

Don't forget, as well, that pain perception is strongly influenced by our beliefs, expectations and emotions (which is part of the descending inhibitory controls of gate control theory). Therefore, it is essential to control these factors in any analgesic trial.

In some of the older trials (not RCTs) of acupuncture, Melzack and Wall (who developed Gate Control) showed that it didn't matter where you placed the needles, you got the same effect (evidence against the meridian/points theory and for placebo or nonspecific release of endorphins).

My sense is that your friend was thinking of counter-stimulation. There is some evidence that pain at one site can change our perception of pain at another site. This is probably due to a complex interaction of physiological and psychological factors and is also consistent with a gate control conceptualization.

As for cancer pain...some here know that is my field of study. Gate control certainly applies (I'm giving a talk on exactly that tomorrow) but I think that should have its own thread. Maybe after my talk.
 
TruthSeeker said:
Gate Control is the leadingtheory of pain. For a simple explanations see here which also mentions the acupuncture studies.

Some abstracts have already been posted, so I won't bother going through the clinical trials and why placebo acupuncture is such a difficult thing to execute. There was a debate in a series of letters to the Editor about a year ago in . PAIN (the leading journal in the field) about the retractable placebo needles. Although it is not settled, my impression is that they don't work very well and most people can tell whether they are getting placebo or real acupuncture.

Don't forget, as well, that pain perception is strongly influenced by our beliefs, expectations and emotions (which is part of the descending inhibitory controls of gate control theory). Therefore, it is essential to control these factors in any analgesic trial.

In some of the older trials (not RCTs) of acupuncture, Melzack and Wall (who developed Gate Control) showed that it didn't matter where you placed the needles, you got the same effect (evidence against the meridian/points theory and for placebo or nonspecific release of endorphins).

My sense is that your friend was thinking of counter-stimulation. There is some evidence that pain at one site can change our perception of pain at another site. This is probably due to a complex interaction of physiological and psychological factors and is also consistent with a gate control conceptualization.

As for cancer pain...some here know that is my field of study. Gate control certainly applies (I'm giving a talk on exactly that tomorrow) but I think that should have its own thread. Maybe after my talk.
Click to expand...

I'd love to trade emails on what you may know of solitary plasmacytoma of bone in cases where the subject is under 30. Also cases where it develops into Multiple Myeloma in young patients. (It's not MM yet in my case.)

I'm told I essentially won the lottery with those odds.

I digress.

Yes that would be a good thread...
 
fowlsound said:
I am by no means saying I am an expert, but I don't think the theory is worth much. I had a tumor compressing my spinal cord, and I could feel pain in both feet at the same time.

Granted, there was a tumor compressing it, but it would seem that I still couldn't feel both at once according to the theory.

I may have just given a false dillemma. Hmm. I need to go back through my logic books...
Click to expand...

Well either way, Oh my OW. I'm glad to know you're ok though.
 
LostAngeles said:
Well either way, Oh my OW. I'm glad to know you're ok though.
Click to expand...

Thanks!

I have some great CT scants and MRI's I'm using as cover art on my new cd. I should post them sometime...
 
fowlsound said:
Oh, and one last thing, I offer only anecdotal evidence, which should be treated as such, and I committed a logical fallacy by saying it has to be either or. Please quote me if you wish, but be prepared for the rebuttal...
Click to expand...

All i have gotten is anecdotal evidence from her(and a few others). Oh, and her saying "There have been studies", but since i can't read those studies.... i have to tell her that they don't count for anything.


now... if she could tell me where those studies are, then they would be more than anecdotal evidence.
 
TobiasTheCommie said:
All i have gotten is anecdotal evidence from her(and a few others). Oh, and her saying "There have been studies", but since i can't read those studies.... i have to tell her that they don't count for anything.


now... if she could tell me where those studies are, then they would be more than anecdotal evidence.
Click to expand...

...and a contender for a million bucks, I imagine. :D
 
fowlsound said:
...and a contender for a million bucks, I imagine. :D
Click to expand...

No.. She isn't the type.

She is rather skeptical of most claims, she often makes fun of Funsway(or how on earth you spell that).

It is just this one thing where we disagree, she can be turned aroudn with enough evidence.
:D
 
TobiasTheCommie said:
No.. She isn't the type.

She is rather skeptical of most claims, she often makes fun of Funsway(or how on earth you spell that).

It is just this one thing where we disagree, she can be turned aroudn with enough evidence.
:D
Click to expand...

No I meant the studies would be a contender for the million bucks...
 
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