Theories Of Pain


Theories Of Pain

What are the 4 theories of pain?

The four most influential theories of pain perception include the Specificity (or Labeled Line), Intensity, Pattern, and Gate Control Theories of Pain (Fig.1).

What are pain theories?

Clinical Significance – Pain is the result of complex interactions between biological, psychological, and sociological factors that individuals experience, with no two individuals’ experiences being the same. It makes sense that an individual’s treatment approach should align with what it is treating.

An appropriate method of treating pain must be multidimensional and tailored to individual experience. Utilizing the biopsychosocial model to treat chronic pain allows health practitioners to do just that. This model has been proven to have superior outcomes in terms of increased patient satisfaction and a better degree of restoration of functionality.

In addition to this, it also is shown to be a more cost-effective method of treating patients with chronic pain, compared to other commonly used treatment plans. When taking all of this into consideration, it becomes quite evident that an interprofessional biopsychosocial model for the management of chronic pain should be the standard of care for all patients.

  1. Ethically speaking, when a means of decreasing a patient’s suffering exists, it should be utilized to its fullest capacity.
  2. Addressing a patient who is suffering from chronic pain using a biopsychosocial approach provides the physician with the knowledge that is necessary to treat all factors contributing to pain instead of only treating the pain itself.

There are multiple advantages to utilizing this type of model to address pain. One of the most critical benefits seen in clinics when this model is in use is a higher success rate in terms of increased functional capacity and patient satisfaction. This type of treatment focuses not on curing the problem but instead on gaining back maximal functional capacity.

  1. Certain specialties need to be included in a biopsychosocial treatment plan when managing patients with chronic pain to achieve this goal.
  2. These mandatory specialties include a primary care physician, psychiatrist or psychologist, physical therapist, occupational therapist, and sometimes a disability case manager.

Multiple research studies evaluating the effectiveness of this approach have continuously shown that, versus other more traditional methods of managing pain, the biopsychosocial approach to pain allows for greater restoration of functionality. This type of treatment provides the patients with the tools that they need to take control of their pain, as opposed to letting their pain control them.

In addition to better outcomes and increased patient satisfaction, a biopsychosocial approach to pain management would serve to reduce the financial costs associated with caring for chronic pain patients. Research has been conducted comparing an interprofessional biopsychosocial pain management protocol to alternative methods.

All the studies have come to the same conclusion: an interprofessional approach to pain management is 21 times more cost-effective compared to other methods. This reduction in cost can be attributed to a decreased need for pain medication, reduced calls for health care, and emergency room visits, and decreased disability payments.

In a country where 17.5% of gross domestic product gets spent on health care, it would only be logical to implement methods that help to reduce some of this financial burden, and that is why applying an interprofessional approach to pain management is the obvious solution. The Biopsychosocial Model is the only theory of pain that provides the most comprehensive explanation as to why people have pain as well as the unique nature of each patient’s experience.

With chronic pain now considered a public health crisis, clinicians must alleviate suffering by trying all means possible instead of continuously using old methods that have been shown to be ineffective. In proceeding with future research on the concept of pain and its management, clinicians must maintain this biopsychosocial approach and continue to preserve the words of Aristotle, who was ahead of his time, in saying that “pain is quality of all senses.” Even with the availability of these new comprehensive approaches, it remains challenging to effectively manage pain and therefore, will continue to be a topic of future research.

What are examples of pain theory?

Most people think about pain as a simple cause-and-effect process. For example, if you touch a hot stove, you probably assume that the nerves in the skin feel how hot the stove is and signals are sent to the brain to trigger a feeling of pain. Research shows, though, that pain signaling, as well as the sensations the body perceives as pain, can be more complex than this scenario.

Read on to learn more about why we feel pain and gain a greater understanding of the gate control theory of pain. Acute pain serves a purpose: In small doses, it functions as a warning that keeps us from harming ourselves. Whether you touch that hot stove or push your body past its limit during a strenuous workout, your body’s reaction is communicating to you that you should stop doing whatever it is that’s causing the pain.

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Severe pain, like a broken arm or a heart attack, signals to our conscious brain that there is something very wrong. Pain that’s an obvious response to a pain-causing stimulus is called nociceptive pain. This type of pain may not be simple to fix, but it’s obvious where the problem is coming from.

Nociceptive pain can also occur after an injury when there’s an inflammatory response in the injured area. In contrast, chronic pain isn’t always connected to external stimuli, and many people who live with it find it difficult to describe. In fact, there are many different types of pain. Think about hitting your head on the sharp corner of an open kitchen cabinet.

This would be an acute, inflammatory type of pain. You might also feel a dull pain in your head if you were getting a tension headache, or you might feel a burning, tingling sensation in your neck and head if you have a pinched nerve in your cervical spine,

Visceral pain: This type of pain occurs when the internal organs are damaged or sick. It can be difficult to know which organ is causing the pain because internal organs have different pain pathways than the outside of your body does. Neuropathic pain: This pain occurs when your nerves aren’t functioning correctly. It might feel “electric,” and you might experience extreme sensitivity to touch and temperature. Nociplastic pain: This type of pain is one of the potential end results of nociceptive pain that lasts for a long time. In cases of chronic pain conditions like fibromyalgia and recurring tension headaches, a person might have persistent pain even if the body doesn’t show any signs of damage.

Few researchers want to dull the human response to injury, because this pain functions as a safety mechanism. What about the many people who live with chronic pain, though? Some experts think that these people can be helped with the gate control theory of pain — or, the idea that you can simply close the gates to unhelpful pain.

The gate control theory of pain was formulated in 1965 by a neurobiologist and a psychologist who wanted to propose that spinal nerves act as gates to let pain travel through to reach the brain — or close these gates and prevent pain messages from getting through at all. Open gates. When the gates are open, you feel too much pain for too long.

People with chronic pain conditions have gates that stay open even when they should be shut. Closed gates. If you’ve ever injured two parts of your body at the same time, you understand that pain signals “compete” for our brain’s attention. It’s difficult for your brain to process pain from both areas at the same time.

  • Other methods of closing certain gates include self-relaxation exercises and medication. Emotions.
  • Have you ever meditated with the hope that you’ll calm down and your stiff, sore muscles will relax? Negative emotions like anxiety, depression, and chronic stress can increase pain.
  • Once you’re in the cycle of depression and pain, for example, it can be difficult to know whether your depression is making your pain worse or whether your pain is worsening your depression.

They may each have an effect on the other. This is why it’s important to acknowledge the link between mental health and chronic pain. Brain disorders. Your brain is the processing center for pain, so if part of the brain isn’t working correctly, you might not process pain in a healthy way.

People with schizophrenia, for example, often don’t perceive pain in the same way as their mentally healthy counterparts. Researchers think that understanding more about this link between schizophrenia and pain sensitivity could help doctors understand the condition as a whole. Stronger signals. As a child, if you bumped your head, a relative might have immediately told you to rub the affected spot.

This isn’t an old wives’ tale — it’s actually a great example of “closing the gates” of pain. When your brain perceives another, stronger signal coming in, it doesn’t pay as much attention to the first, painful signal. Drug use. Both illegal and prescription drugs have a reputation for affecting example how the body processes and perceives painful stimuli.

Opioids in particular are prescribed for pain, and they have a strong “gate closing” effect — usually, at least. Overusing opioids can lead to an increased sensitivity to pain over time. Central sensitization. People with chronic pain often experience a heightened pain response to nearly everything. When a person lives with chronic pain on a daily basis, their nervous system develops an abnormal response to everyday stimuli,

Clothing may hurt, and walking around may be too painful to bear. In other words, things that shouldn’t be painful are being processed as if they are. While this sounds dramatic, it’s the reality for many people with conditions like rheumatoid arthritis or fibromyalgia.

  1. In this situation, the body’s gates are left wide open and often need medical assistance to shut again.
  2. If you live with chronic pain, it can be discouraging when your current treatment isn’t working or when the pain returns time after time.
  3. The gate control theory of pain example offers insight into the causes of pain and why certain experiences are more painful than others.
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Closing these gates through relaxation exercises, taking appropriate medications, and using treatments like acupuncture to distract the body from the origin of the pain might provide some relief. Get in touch with your doctor if you have questions about your personal pain management plan.

What is the great theory of pain?

Introduction – The Gate Control Theory of Pain is a mechanism, in the spinal cord, in which pain signals can be sent up to the brain to be processed to accentuate the possible perceived pain, or attenuate it at the spinal cord itself. The ‘gate’ is the mechanism where pain signals can be let through or restricted. One of two things can happen, the gate can be ‘open’ or the gate can be ‘closed’:

  • If the gate is open, pain signals can pass through and will be sent to the brain to perceive the pain.
  • If the gate is closed, pain signals will be restricted from travelling up to the brain, and the sensation of pain won’t be perceived.

If someone experiences a painful (noxious) stimulus, the application of a non-noxious (soothing or light rubbing) stimulus can help activate the gate control mechanism, and reduce the pain. There are also other factors which can help facilitate the pain gate mechanism in reducing the perceived pain. These will be further outlined below.

  • Gate closed
  • Gate open

What is the Von Frey pain theory?

Specificity Theory (Von Frey, 1895) – Specificity theory is one of the first modern theories for pain. It holds that specific pain receptors transmit signals to a “pain center” in the brain that produces the perception of pain Von Frey (1895) argued that the body has a separate sensory system for perceiving pain—just as it does for hearing and vision.

This theory considers pain as an independent sensation with specialized peripheral sensory receptors, which respond to damage and send signals through pathways (along nerve fibers) in the nervous system to target centers in the brain. These brain centers process the signals to produce the experience of pain.

Thus, it is based on the assumption that the free nerve endings are pain receptors and that the other three types of receptors are also specific to a sensory experience.

Is the pain real or psychological?

Is psychogenic pain serious? – Even when pain isn’t severe, it can still be a serious problem. Over time, chronic pain can seriously impact your health and well-being. In addition to how pain changes the way your nervous system functions, it can take a toll on your mental health in other ways.

  1. Anxiety and depression are common complications of chronic pain.
  2. All these factors combined mean chronic pain is ultimately serious over time and needs diagnosis and treatment.
  3. A note from Cleveland Clinic “Psychogenic pain” is an outdated term that healthcare providers no longer use.
  4. This term once described pain that happens when your body’s pain processes work incorrectly, activating because of a mental health condition that disrupts the way your nervous system works.

Today, experts know that pain involves many processes and factors. While it might not happen for a specific physical reason, the pain is real and feels no different from pain from an injury or illness. This term fell out of use because of misunderstandings over its meaning and the potential for people to feel ignored or invalidated.

What is behavioral theory of pain?

According to behavioral theory, ‘sensory’ pain is a reflex (a respondent) while ‘psychological’ pain is an instrumental act (an operant). Behavioral theory claims that neither kind of pain is an internal process — that both are overt behaviors.

What is the biopsychosocial theory of pain?

This model argues that pain emerges from a dynamic interplay between biological, psychological, and social factors that vary from individual to individual. These factors are not mutually exclusive. From Rankin, Linda. (2020). Chronic pain: from the study of student attitudes and preferences to the in vitro investigation of a novel treatment strategy.

What are the two types of pain psychology?

There are two main types of pain, of which include nociceptive pain and neuropathic pain. Psychogenic pain is another term that is sometimes used to describe cases of pain, although this is not an official diagnostic term. Alternatively, pain can be classified according to the duration of the pain, as acute, chronic, or breakthrough pain. Image Credit: staras /

What is the Buddhist theory of pain?

I have been pondering how to use my Buddhist practice to work with suffering when my chronic pain flares up. The Buddha’s teachings on The Four Noble Truths came immediately to mind. These teachings provide a roadmap for living a life free from suffering.

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Experiencing my pain directly, without judgments or resistance, has allowed me to use the Buddha’s roadmap on my journey from suffering to liberation. The Four Noble Truths In his first teaching after attaining liberation, the Buddha taught The Four Noble Truths: the truth of suffering, the truth of the origin of suffering, the truth of the cessation of suffering, and the truth of the path to liberation from suffering.

The First Noble Truth recognizes the existence of suffering. We humans will do everything we can to resist or deny the existence of suffering. Paradoxically, resisting or denying the existence of suffering only increases our suffering. Recognizing the existence of suffering, without additional thoughts or denial, is the first step to letting go of the suffering that accompanies my chronic pain.

The Second Noble Truth, the cause of suffering, is clinging to things – especially ourselves – as real and permanent. My knee-jerk reaction when my pain flares up is self-pity. My self-centered thoughts and negative judgments increase my suffering. When I let go of my thoughts and focus instead on the direct experience of my pain, there is an immediate sense of relief and spaciousness.

Focusing on the pain itself, rather than clinging to it as something unique to myself, leads to the cessation of suffering – The Third Noble Truth, Working directly with the energy of physical pain has become my path out of the suffering that accompanies my pain.

This path is related to the Fourth Noble Truth, the path to liberation from suffering. “Don’t Shoot the Second Arrow” The Buddha’s teachings on the “two arrows” has also been extremely helpful for me. When we experience physical or emotional pain, it is like being shot by an arrow. According to the Buddha, the first arrow is not problem.

After all, we all inevitably experience pain of all kinds in our lives. The problem is that we then shoot ourselves with a second arrow with our thoughts, judgments and resistance to the initial pain. According to Buddhist teachers Jack Kornfield and Donald Rothberg : According to the Buddha, our reaction is equivalent to being shot by a second arrow.

  1. We can call this second arrow suffering.
  2. Suffering arises because when we experience pain we typically react by lashing out, at ourselves and others.
  3. We believe somehow that this will dispel or mitigate the pain.
  4. We act in such a way that a second arrow is shot, at us or others, on account of the pain of the first arrow.

When we act so that the second arrow is shot, we ‘pass on’ the original pain. When I “lash out” at the perceived injustice of having a chronic pain condition, I am shooting myself with a second arrow. My mindfulness practice allows me to notice my thoughts and judgments as they arise, let them go and return to the object of my meditation.

  1. When I’m experiencing pain, I allow that to be the object of my meditation.
  2. As thoughts and judgments arise, I notice them lightly and return to the direct experience of pain.
  3. Working Directly with Physical Pain as a Path to Liberation Here is an exercise for working directly with pain to alleviate the second arrow of suffering that often accompanies it.

This exercise can be used for both physical and emotional pain.

  1. Focus on the pain and breathe into it.
  2. Explore the pain with a sense of curiosity:
    • Where is the pain located?
    • How big is it?
    • What’s its shape?
    • If it had a color, what color would it be?
    • Is it hot or cold?
    • Is it static or does it move or vibrate?
  1. As you explore the pain in this way, notice how it shifts and moves. This is a good reminder that everything is impermanent.
  2. Remember that we all experience pain during our journey on the Four Rivers of Life — birth, old age, sickness and death.

When I work with my pain directly in this way, I am fully in the present moment. My thoughts, judgments and resistance are gone, and so is the suffering that I’ve added to the pain with those thoughts, judgments and resistance. In that present moment, I am liberated from my suffering.

What does Descartes say about pain?

Middle ages and Early Modern Period – In the 11th century, Avicenna theorized that there were a number of feeling senses including touch, pain and titillation, Portrait of René Descartes In a religious context, pain could be seen as a punishment or a trial from God. But this religious conception did not prevent Early Modern Physicians from being concerned by the problem of pain: they tried to cure it with pain-killers called “anodynes” ; they discussed the problem of the phantom-pain, described in the 16th century by the surgeon Ambroise Paré; and they proposed rich descriptions of the signs of pain.

How many theories of pain are there?

The four most influential theories of pain perception include the Specificity (or Labeled Line), Intensity, Pattern, and Gate Control Theories of Pain (Fig.1). The Specificity Theory refers to the presence of dedicated pathways for each somatosensory modality.