Why Am I in So Much Pain?
- Kim Atherton
- 7 days ago
- 6 min read
Pain affects everyone at some point, but its complexity can make it feel like a lonely battle. If you find yourself asking, "Why am I in so much pain?" understanding the reasons behind pain can bring hope and insight.
One compelling way to look at pain management is through the 'Gate Control Theory of Pain'. This theory sheds light on how pain signals travel through our bodies and how we might control those signals.
Understanding Pain
Pain is more than just a physical sensation. It is a multifaceted experience shaped by emotional, psychological, and social factors. For instance, studies show that individuals dealing with anxiety as well as pain, often report a 20% increase in pain perception compared to those with more positive emotional states. This variation helps explain why two people with the same injury can have widely different experiences of pain.
The Basics of Gate Control Theory
At the center of the Gate Control Theory is a "gate" mechanism in the spinal cord. This gate can either allow pain signals to reach the brain or block them. When the gate is open, we feel pain. When it is closed, pain signals are inhibited, leading to relief.
Several key factors influence whether the gate is open or closed:
Physical stimuli: Non-painful sensations like touch or pressure can help close the gate. For example, applying ice to a sprained ankle can ease pain not just through cold therapy, but also by stimulating surrounding nerves thorugh touch and pressure.
Emotional state: Negative emotions such as anxiety and stress can open the gate. Research indicates that stress can amplify pain perception by up to 50%. Meanwhile, positive emotions or relaxation methods can help to close this gate.
Attention and distraction: When we concentrate on pain, it often feels worse. Engaging in other activities can distract us and help close the gate on pain.
The Gate Control Theory reshaped our understanding of pain. It shows that pain does not arise solely from injury; rather, it is influenced by how our nervous system interprets and processes pain signals.
Types of Pain
1. Nociceptive Pain – pain that arises from actual or threatened damage to non-neural tissue (not nerves) and is due to the activation of certain receptors in our body called nociceptors. There is continuous damage and inflammation of bodily tissues present. The pain is described as aching, throbbing, tender, and sore.
Examples include sports injuries, external injuries.
2. Neuropathic Pain – pain from nerve damage caused by a lesion or disease of the part of the nervous system that feels sensations (somatosensory nervous system). Described as burning, tingling, shooting, stabbing, and electric.
Examples of peripheral neuropathic pain include diabetic nephropathy, and phantom limb syndrome, while examples of central neuropathic pain include multiple sclerosis, and spinal cord injury post-stroke.
3. Nociplastic (Psychogenic) Pain – it can be defined as chronic pain leading towards an altered nociceptive function despite no clear evidence of actual or threatened tissue damage. This type of pain comes from a malfuntioning pain system that needs retraining.
Examples include Fibromyalgia, chronic lower back pain, Irritable Bowel Syndrome pain, bladder pain syndrome.
The Role of the Nervous System
The nervous system is instrumental in the Gate Control Theory. It uses two primary pathways to transmit pain signals, the ascending pathway (bottom up - how we feel pain like touching something sharp), and descending pain (top down pain modulation after inhibition or stimulation by neurotransmitters - why some people can tolerate the same pain as others are intolerant to).
Pain is sent up to the brain to be processed to accentuate the possible perceived pain (gate is open), or
Pain stimuli is attenuated at the spinal cord, and restricted from travelling to the brain to perceive pain (gate is closed).
The spinal cord is therefore a ”pain control box” modulating pain signals.
If the gate is open, pain signals can pass through and will be sent to the brain and pain will be felt.
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.
What Opens and Closes the Pain Gate?
You may well be very interested now in what opens and closes the gate for your own pain perception.
The gate opens through stress, lack of activity, mental health concerns.
The gate closes through relaxation, mental health factors, and activity.
The secret with pain relief is controlling the neurotransmitters that govern the opening and closing of the pain gate.
What Can Help with the Pain?
Understanding how the Gate Control Theory works can lead to effective pain management strategies. Here are some actionable methods to help 'close the gate' and lessen discomfort:
1. Physical Therapies
Physical therapies such as massage, vibration, acupuncture, and chiropractic care stimulate non-painful sensory pathways, closing the gate. For instance, many patients report a decrease in pain intensity of around 40% after a few sessions of acupuncture. A TENS machine (Transcutaneous electrical nerve stimulation) is very useful here.
2. Mindfulness and Relaxation Techniques
Practices like meditation, deep breathing, and yoga can foster relaxation and ease stress. These techniques allow individuals to shift their focus from pain, effectively helping to close the gate.
3. Distraction Techniques
Participating in enjoyable activities—be it reading, painting, or socialising—can distract us from pain. Research shows that distraction can decrease pain perception by over 30%, making it a valuable tool in pain management.
4. Cognitive Behavioural Therapy (CBT)
CBT helps individuals reshape their thoughts and reactions concerning pain. By addressing negative thinking and promoting effective coping strategies, CBT can close the gate and significantly improve pain management. There are even Apps that can help you especially with chronic, unresolved pain.
4. Natural Therapies
There are some natural supplements that you can take that are specifically designed to help with different types of pain. Specifically, they address nerve pain, joint pain, inflammation, muscle aches, reduce transmission of pain, reduce neurotransmitters involved in transmission, creams and homeopathic options.
Describing how you feel pain is key to helping with the most appropriate pain relief for your individual circumstances .
The Importance of a Holistic Approach to Pain Management
While the Gate Control Theory provides invaluable insights, a holistic approach is vital for successful pain management. Pain is a complicated experience, influenced as discussed by physical, emotional, and psychological factors.
If you find yourself grappling with the question, "Why am I in so much pain?" remember you are not alone. Effective methods are available to help you manage pain and enhance your quality of life. With the right strategies and support, pain management is possible.
Developing a personalised plan that meets your unique needs is critical, and can take some time to determine what is best for you, but it would be time well invested.
By combining various methods like physical therapies, mindfulness practices, psychological support and natural therapies, you can create a robust pain management strategy.
If you’re experiencing unresolved pain and you would like to discuss your current circumstances, then please feel free to make a booking to discuss.
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