What is Pain, Really?

Why do we need pain? One way to think about it is like an alarm system. If you imagine that your body is a house, pain is an alarm system warning you that something is wrong. In your own home or office, if an alarm goes off, you are warned to take action to protect yourself. You try to get out, call 911, etc… Pain motivates you to take care of your damaged body parts. Now imagine if your alarm system in your home or office  was malfunctioning. It went off all the time and you couldn't turn it off. How could you work or live in a place where the alarm was always going off? That’s a challenging question. If the alarm in your house or office kept going off, you might just want to have it removed or you would move yourself out of that building. It’s not so easy with chronic pain. You can't escape your body, you can’t remove the signal… but according to the Gate Control Theory of Pain, you can dull the alarm enough to live your life.


Pain fluctuates, you’ll have some days that are better than others. Have you ever wondered why? The Central Nervous System consists of the brain and spinal cord. According to the Gate Control Theory of Pain, put forth by Melzack and Wall in 1965, there are gates in the Central Nervous System that open and close. Opening the gates make pain more intense, closing the gates makes it less intense.


There are many physical, psychological and behavioral factors that can make gates open and close. Exercise tends to close the gates, improving your experience of pain. Depression and anxiety tend to open the gates, making your pain feel worse. A healthy diet and social life can make pain more tolerable, while consuming drugs and alcohol can make pain worse.  Pain Management is not about eliminating the pain altogether, but having the keys to these gates so that you have more control. When you have more control, you can go do the things that you need to do and be the person you want to be. Pain is always fluctuating, but when you understand your gates and have the keys to them, it can definitely be managed.