There are times, however, when pain signals aren’t reliable or useful. An injury may have already healed. There may be a stable, ongoing cause of pain - such as arthritis or low back pain. In these cases, we don’t need to get the message every waking minute - but the alarm keeps sounding. How can we stop this neurological noise and get on with our lives?
That’s where gate control theory of pain comes in.
One way to close the pain gate is by bombarding it with different signals. For instance, a weak electrical current can cause a tingling sensation that replaces the pain. To do this, a person wears a small transmitter on adhesive patches on the skin. If this doesn’t work, or if the nerves aren’t working well enough to receive signals, it’s possible to transmit electrical signals directly to the spine.
There also are medications that decrease pain signals to the brain. Most of these work by:
• Quieting the nerves, so the signal is decreased.
• Increasing chemicals that contribute to blocking pain signals.
• Stimulating opiate receptors, part of the body’s natural system for blocking pain.
Most importantly, the brain can send signals that close the pain gate. Think about how much information your brain receives all the time: the feeling of your clothing, of the chair you’re sitting on - everything you see, hear, touch and taste. No one can pay attention to all of these things all the time. Our brains direct our attention to what’s important at the moment. If that’s not pain, the pain gate closes. This is why distraction is so effective in relieving pain.
Because the focus of attention is important in pain, learning to meditate is another way to close the gate. Scientists are learning that meditation actually changes the way the brain functions. It’s a powerful tool against chronic pain.
We also produce natural opiates that decrease pain signals. These opiates increase when we’re doing something we enjoy and with regular exercise. Because of this, the last thing a person with chronic pain should do is give up enjoyable activities and exercise.
It’s easy to understand how people with chronic pain can avoid doing many of the things they enjoy - especially if they involve physical activity. This leads to stressful relationships and depression, which can make pain worse. This cycle of decreasing activity and increasing pain affects every part of a person’s life.
That’s why many people with chronic pain are asking how they can get their lives back. The answer is different for everyone - but all people with chronic pain should take careful stock of what they want to be able to do, why they’re not doing it, and how to take gradual steps to meet achievable goals. To do so, it’s helpful to work with a health care provider - often in a chronic pain program - to develop an individualized recovery plan.
There are many ways people with chronic pain can stay active and involved. It’s helpful to think of these ways as tools in a toolbox. Not every tool is good for every situation, but, over time, we can assemble the right set of tools to control the pain gate.
Gail Trenfield-Joyner is a nurse practitioner at the Montana Spine and Pain Center.
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tami buckallew wrote on Oct 6, 2008 7:15 PM:
i have been struggling to get help for 8 yrs and finely have gotten a refferal. and just knowing i will be dealing with DR.s that won't treat me bad and who will help me figure out why i feel so hurt all the time is a relief.THANK YOU TB. "