Thoughts on Pain: Part 2

The Pain-Gate Theory


As a physiotherapy student, I quickly learned that when I didn't know the answer to a question, if I threw "the Pain-Gate Theory" in somewhere, there was a pretty good chance I could talk my way round to the right answer.


What is the Pain-Gate Theory, I hear you cry? Let's get a little technical for a second...so there are two types (for the purposes of this illustration) of nerve fibres in our body – pain fibres (which carry signals about pain between the damaged tissue and the brain) and sensory fibres (which carry signals about normal sensation between tissue and the brain). When tissue is damaged, the pain fibres are activated and signals are sent to the brain, telling us we are sore.
However, when we, for example, rub an area of skin, the sensory fibres are activated and signals are sent so that we can feel the sensation. The sensory fibres are bigger than the pain fibres and the theory is, therefore, that when the sensory fibres are activated, their signals override the signals that the pain fibres are sending and the pain is therefore diminished. It’s why we automatically rub our elbow when we hit our funny bone. It’s a natural instinct that just happens in our body’s attempt to keep us free of pain.


Got it? Cool.


It's a good theory. It works. It's the reason why a lot of physio techniques work. But what happens when we start to apply it to other types of pain? When we're hurt by someone else's anger or jealousy, someone else's words or actions, when we're hurt by our own mistakes. When we're sad and disappointed and angry and lonely and just in pain.

What if, to stop the pain, we do more stuff? We watch more TV, eat more chocolate, work harder, run further, fight more. We do  and do  and do  and do  to try to cut of the signals that the pain fibres are sending. We do anything, anything at all to try to stop the constant reminders that it hurts.

Going back to the physical pain, the thing with the pain-gate theory is that it takes away the pain when the stimulus is applied but it does not fix the damage. Rubbing the sore bit lightly doesn’t make the torn ligament knit back together, it doesn’t heal a broken bone. When the stimulus is removed, the damage remains and the pain starts again. 

And how true that is of emotional pain. Eating more cake makes you feel good for a moment, but what about when the cake is done? Watching another Ryan Gosling movie distracts you for a couple of hours, but when it’s over? Doing more exercise keeps you healthy and gives you a sense of accomplishment, but does it really close the wound?

Damage is not fixed by avoiding the damage or the pain it causes. It is fixed by acknowledging it, admitting that there is something wrong, that it hurts, that something needs to be done about it and that something is not simply trying to dull it.

That is step two...