Gate Control Theory of Pain: What is It and How Can It Benefit Me?

by Eric Bostrom October 23, 2020 4 min read

Gate Control Theory of Pain: What is It and How Can It Benefit Me?

Have you ever taken a minute to stop and think about how complex and fascinating the human body is? From top to bottom and everything in the middle, each component of our bodies has a specific purpose.

Scientists and medical professionals have been studying the body for decades, even centuries, trying to figure out how it all works. This includes how we deal with pain. 

Generally speaking, we’ve come to accept the notion that signals are being sent through the nervous system to the brain when we hurt ourselves, resulting in what we know as pain.  

But what if I told you there’s a different school of thought when it comes to pain perception. With the example above, it’s a one-way street: You get injured, signals travel to the brain, and your brain says you’re hurt. 

We know, however, that the body and mind are much more nuanced and complicated than that. An alternate, two-way street explanation for our perception of pain is the gate control theory of pain, wherein your brain decides what to accept as pain and what level to take it as. Allow me to explain.

Gate Control Theory of Pain: What is It and How Can It Benefit Me?

How It Works

The gate control theory of pain can trace its roots to the 1960s when two researchers, Ronald Melzack and Patrick Wall, suggested that the spinal cord features a neurological “gate” that filters which pain signals continue to the brain. To understand this theory better, let’s break down the nervous system into its two parts: 

  • The central nervous system, consisting of the brain and spinal cord
  • The peripheral nervous system made up of all the nerves throughout the body that lead to the brain and spinal cord 

Using the example I started with earlier, pain signals travel to the brain when you’re injured. The difference with gate theory is before these signals are passed to the brain, “nerve gates” control whether a signal is passed through or not – major injuries pass intense pain responses. In contrast, minor pain messages might not even make it to the brain at all. 

From a physiological point of view, Melzack and Wall propose this inhibitory interneuron, or “gate,” is located within the dorsal horn of the spinal cord and receive inputs from two sources: small nerve fibers (which transmit pain) and large nerve fibers (which transmit the other, normal, senses like touch and pressure).   

When everything is normal, neither nerve fiber is activated, and the inhibitory neuron is closed. We don’t feel anything. 

When the gate receives input from the large nerve fibers, it’s received as normal sensations, not pain, and again the gate is closed.  

When the small nerve fiber sends signals to the inhibitory neuron (or when it sends more signals than the large nerve fiber), the gate opens, sending the message to the brain that we’re feeling pain. 

How It Can Benefit You

Sounds wild, right? I thought so, too, when I first heard about it. It’s still a very controversial topic in the medical community and is far from agreed upon, but some aspects to the gate theory seem to make sense. 

For example, when you snub your toe, those signals are firing through the small nerve fibers, and you feel the pain. But what do you do next? You rub the area vigorously. This floods the large nerve fiber, overloading the brain with normal touch sensations, which then reduces the perception of pain. 

This also helps explain why massaging our sore or painful areas feel so good. We grapple with the soreness and the pain all day long, so combating those pain signals with an overdose of “normal” signals (funneled through the large nerve fiber) is, at a minimum, a temporary relief.

And when it comes to massaging challenging to reach areas, the Backmate is an essential tool. Not only can it reach some of those difficult spots, but it can also provide relief depending on how much pressure you use. 

backmate massage therapy

Connecting the dots

Massage has many great attributes; perhaps the most significant is the ability to distract the nervous system from sensing injury and tricking it back to healthy function. Our goal is to stay ahead of the pain. 

If we do nothing about it or mask it with medication, we invite the pain to return, and in greater intensity due to central sensitization. As we discussed, pain signals travel through paths in the spinal cord to the brain. 

Central sensitization causes these paths to enlarge rather than restrict, causing hypersensitivity to pain. So we want to close the pain gate and erase the memory of a pain path. Hence, A quick massage really can influence a lasting effect on pain.

Concluding Thoughts

I bring up the gate control theory because it aligns with my overall goal of helping us see around the traditional avenues of therapy, healing, and medication.

Though gate control is a theory, it’s both intuitive and proven we have the power to control the pain we experience.  And that can be the best medicine on the planet when it comes to recovering from back pain.

Taken as a holistic approach, understanding the gate control theory and combining it with other natural healing methods – like a massage – becomes one more useful tool on our journey towards wellness. 

Eric Bostrom
Eric Bostrom