Notes taken from Physiology for Nursing Practice (1999) Hinchcliffe, S. Montague, S. Watson, R. 2nd Edition, London; Harcourt Brace and Company Ltd and Pathophysiology The Biologic Basis for Disease in Adults and Children (2010) McCance, K.L., Huether, S. E., Brashers, V., Rote, N. S., Missouri; Mosby Inc
Pain is transmitted to the spinal cord by large A Delta and smaller C fibres
These fibres terminate on inhibitory interneurons in the
substantia gelatinosa (laminae in the dorsal horn or the
spinal cord)
Cells in the substantia gelatinosa act as a
gate, regulating transmission impulses to the
CNS
Stimulation of the non-nociceptive A fibres, such as
touch, vibration or thermal stimuli, cuase the cells in
the substantia gelatinosa to 'close the pain gate'.
This diminishes pain perception
Small fibre input inhibits cells in
the substantia gelatinosa to
'open the pain gate'
This enhances pain perception
The CNS through efferent pathways, may also close, partially close or open the gates
GCT is inadequate to explain some chronic pain
problems such as 'phantom limb pain' instead the
Neuromatrix theory was proposed to explain
this.
The perception of pain is called
nociception and depends on
specifically dedicated receptors and
afferent pathways that detect and
transmit noxious or damaging
stimuli
The experience of pain by Gate Control
Theory emphasises the activation of
non-nociceptive afferent input coming into
the dorsal horn of the spinal cord to inhibit
pain signals as well as the dynamic role of
the brain in modulating the pain process