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Gate Control - fact or fiction?

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.
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I read a book recently that said that gate control is being questioned because it doesn't explain phantom and psychosomatic pain. The new theory is that pain exists soley in the brain, and the nerve impulse from the pain receptor is just a trigger. The pain can exists with or without this trigger, and it can presumably be blocked entirely in the brain, without bringing the spinal cord into it.
 
aggle-rithm said:
I read a book recently that said that gate control is being questioned because it doesn't explain phantom and psychosomatic pain. The new theory is that pain exists soley in the brain, and the nerve impulse from the pain receptor is just a trigger. The pain can exists with or without this trigger, and it can presumably be blocked entirely in the brain, without bringing the spinal cord into it.
Click to expand...

Sorry, I lost track of this thread....

Not questioned so much as being revised to accomodate the data we now have on phantom limbs, especially the experience of phantom pain below the level of complete spinal cord transection and excision.

Melzack has proposed the neuromatrix theory of pain which suggests that pain is created in the brain. I think some of my other links might describe it.

Today, I received this link so was reminded of this thread:

Melzack's Pain Theories
 
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