Factors that influence how you experience pain

Gate control theory of pain

We used to think that the amount of pain someone felt matched the amount of damage to tissues. Now, thanks to the gate control theory of pain, we know that is not the case.

The gate control theory proposes that a complex “gating system” in the spinal cord controls the strength of pain signal that travels from the site of an injury to the brain. The circuit works like a gate that opens or closes. How much the gate opens depends on a number of factors, including signals that arrive there from the brain. The more the gate opens, the stronger the pain signal that gets through and the more pain someone will experience.

The signals from the brain can be affected by a range of factors. These include:

• internal factors such as your emotions (stress or anxiety, feeling happy or sad), your thoughts, your physical health (exercise, sedentary time), your behaviour and your previous experiences with pain

• external factors such as responsibilities at work or school and relationships.

Together, all these factors can make your pain better or worse.

Situational factors of pain

The illustration above summarizes the different factors that can influence your pain experience. In the following sections, you will also learn about the things you can do to reduce your pain by applying the 3Ps (physical, psychological, pharmacological) approach to therapy. When these factors are working against you and letting more pain signals through the gate, the level of pain may remain high even though the injury is healed.

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