Gate Control Theory of Pain
The Gate Control Theory of Pain was first proposed in 1965 by Ronald Melzack, a psychologist, and Patrick Wall, a biologist. Though the theory is not a nursing theory, it is directly applicable to nursing practice because it can be applied to patients experiencing pain who are seeking treatment by nurses.
The theory proposes that pain is inhibited through a gating mechanism at the level of the spinal cord, before the pain is recognized by the brain. More specifically, the theory proposes that pain is affected by interactions between three spinal cord systems: the substantia gelatinosa, the dorsal column and T-cell activation (Melzack & Wall, 1965). The proposed gating mechanism is located in the substantia gelatinosa in the dorsal horn of the spinal cord (Melzack & Wall, 1965). When large-diameter, fast nerve fibers are activated via sensations such as touch, vibration, warmth, or cold, these transmissions block the slower, small-diameter pain fibers (Grossman & Porth, 2014). This mechanism has therapeutic benefits and explains why massaging, brushing the skin with a soft brush, using warmth, or using transcutaneous electric nerve stimulation (TENS) can reduce pain.
The theory proposes that pain is inhibited through a gating mechanism at the level of the spinal cord, before the pain is recognized by the brain. More specifically, the theory proposes that pain is affected by interactions between three spinal cord systems: the substantia gelatinosa, the dorsal column and T-cell activation (Melzack & Wall, 1965). The proposed gating mechanism is located in the substantia gelatinosa in the dorsal horn of the spinal cord (Melzack & Wall, 1965). When large-diameter, fast nerve fibers are activated via sensations such as touch, vibration, warmth, or cold, these transmissions block the slower, small-diameter pain fibers (Grossman & Porth, 2014). This mechanism has therapeutic benefits and explains why massaging, brushing the skin with a soft brush, using warmth, or using transcutaneous electric nerve stimulation (TENS) can reduce pain.
To better understand The Gate Control Theory of Pain, please view the video below:
The Gate Control Theory of Pain is summarized by the schematic below which was included in Melzack and Wall’s original 1965 article (Melzack & Wall, 1965).
Suggested reading from above: Melzack, R. & Wall, P.D. (1965). Pain mechanisms: A new theory. Science, 150(3699), 971-979. Retrieved from http://www.pain.anes.pitt.edu/sites/default/files/documents/MelzackandWallGateControlTheory.pdf