The gate control theory is an attempt to describe the mechanism of pain transmission. The dorsal horn of the spinal cord contains a gate mechanism that alters the transmission of painful sensations from peripheral nerve fiber to the thalamus and cortex of the brain. The thalamus and the cortex is where painful sensations are recognized as pain.
The transmission flows through the gate mechanism. The gate is closed by large diameter, low-threshold afferent fibers and is opened by small diameter, high-threshold afferent fibers. In addition to these two sets of fibers, the gate is also influenced by descending control inhibition from the brain to close the gate.
When the patient experiences slower-acting painful stimuli, the large-diameter fibers are stimulated. This causes the gate to close, stopping transmission of the painful stimuli.
Nonpharmacological pain relief treatments, such as a massage, are based on the gate control theory to ease the patient's pain.
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