Pain Theories Essay, Research Paper

Pain has been experienced by everyone regardless of age, gender or economic

status. Pain is usually described as unfavorable experience that has a lasting

emotional and disabling influence on the individual. Theories that explain and

assist in understanding what pain is, how it originates and why we feel it are

the Specificity theory, Pattern Theory and Gate theory. In this paper I will

attempt to demonstrate my understanding of the theories and also will be

critically analyzing the theories about the experience of pain by incorporating

relevant concepts from literature and relating it to psychology. Pain has been

described with a wide range of different words. McCaffery (cited in Adams and

Bromley, p192, 1998 ) simply states that the experience of pain as being ?what

the experiencing person says it is, existing when he says it does?. This

definition by McCaffery strongly indicates that pain is conceived and

experienced differently in an individualized manner .McCafferys?s definition

of pain suggests experiences of pain depends only on the person experiencing the

pain and that no other person is fully capable to understand how he/she may be

feeling as the result of pain. McCaffery does not actually state in his

definition what pain is and what causes the discomfort, how and why pain

arises(Adams and Bromley,1998). Bond (1984) describes pain as being a personal

and unique experience which arises in the brain due to injury to the body

tissue, disease or due to biochemical changes in our bodies. There are two main

types of pain, acute and chronic. Acute pain is experienced for a short time and

usually has a specific cause and purpose such as injury to body tissue (Adams

and Bromley, 1998). Acute pain can be treated using drugs such as aspirin or

other method of pain relieve. Chronic pain has no time limit therefore, can last

for months and years, and serves no obvious biological purpose. Chronic pain can

have a significant impact on the quality of person?s life as chronic pain can

trigger psychological as well as physical and emotional problems that leads to

feelings of helplessness and hopelessness as most chronic pain can not be cured

(Goleman and Gurin ,1993). Pain theories that I will discussing in this paper

are specificity , pattern and gate control theory as these are the major

theories that assist in explaining the concepts of pain . The modern perspective

sees the concept of pain from a view that includes psychological factors but the

earlier theories such as Specificity theory and Pattern theory were more focused

on tissue damage as the cause of pain. The Specificity theory was originated in

Greece .This theory was highlighted by Descartes in 1664 who expressed that the

pain system as being like a ?bell – ringing mechanism in a church?(Melzack

and Wall , p196,1984) .Descartes (cited in Melzack and Wall ,1984) explained

that when someone pulls the rope to ring the bell, the bell rings in the tower.

Hence, specificity theory suggests that pain is caused by injury or damage to

body tissue. The damaged nerve fibres in our bodies sends direct messages

through the specific pain receptors and fibres to the pain center, the brain

which causes the individual to feel pain (Adams and Bromley ,1998). This theory

suggest that there is a strong link between pain and injury and that the

severity of injury determines the amount of pain experienced by the person

(Brannon and Feist , 2000). The Pattern theory was incorporated into the

specificity theory which added more concepts to explain and extended its

hypothesis of pain .The pattern theory states that nerve fibres that carry pain

signals can also transmit messages of cold, warmth and pressure can also

transfer pain if an injury or damage to body tissue occurs (Adams and

Bromley,1998).The Pattern theory claims that pain is felt as a consequence to

the amount of tissue damaged (McCance and Huether, 1990). Both Pattern theory

and Specificity Theory are part of Linear model of pain which simply

demonstrates that noxious stimulus such as tissue damage or injury results in

the nerve tissues being stimulated which causes painful sensation which causes a

response or painful behavior (Adams and Bromley, 1998). The Specificity theory

and Pattern theory are not sufficient in explaining the experience of pain as

the theorists fail to include any psychological aspects of pain. Adams and

Bromley ,(1998) felt that the specificity theory does not see the individual

difference in how pain is perceived by people. Brannon and Feist (2000) also

emphasize that this particular theory declines to incorporate how pain is felt

throughout the society. Melzack and Wall, (1984 )claims that soldiers who were

severely injured during the wars reported experiencing little or no pain for

days after the injury while people with chronic pain show unbearable amount of

pain even though they have no detectable injury to body tissue. Adams and

Bromley (1998) illustrates that if severity of injury was seen as amount of pain

experienced then pain relief would be given according to the amount of injury ,

not according to the person who had sustained the injury , regardless of how the

person conveys their pain . Hence clients with chronic pain would be seen as

?crocks? as they have no visible injury or damaged tissue and will not

treated with analgesics and would be rejected by doctors (Bond, 1984). Melzack

and Wall proposed the idea of Gate Control theory in 1965. This new theory was

against the idea of Liner model as the theorist believed that pain perception is

influenced by a number of factors which begins in the spinal cord. Melzack and

Wall highlighted that pain messages are carried by the specific nerve fibres

that can be blocked before reaching the brain by the actions of other nerves and

psychological factors (Brannon and Feist, 2000, Polnik 1999, Goleman and Gurin,

1993). Melzack and Wall suggested that when pain signals first reach the nervous

system, the pain messages are sent the thalamus and the ?gate? opens to

allow the pain messages to be sent to superior centers in the brain(Brannon and

Feist, 2000).However, the gate may remain closed if neurons come in contact with

pain signals , the neurons has the ability to overpower the pain signals which

results in the gate remaining closed(Brannon and Feist, 2000). Pain signals can

also be stopped if the hypothetical gate remains closed as our natural

painkiller, endophins, blocks the pain signals from getting to the brain(Goleman

and Gurin , 1993). Melzack and Wall (cited in Bromley and Adams ,1998)

highlights that previous memory of how the prior painful situation was handled ,

supportive support members, positive thinking of pain , distraction, prior

conditioning , cultural values, boredom, stress, negative thinking, poor pain

coping skill may allow the gate to open or to remain closed by affecting the

central control system.This concept can be explained by Beecher (cited in

Brannon and Feist, 2000) who noticed that the soldiers during World War II

reported slight pain even though they had sever damage to tissue due to the

battle. These soldiers had positive thinking and were distracted because injury

meant that the soldiers would be allowed to go home or sustain no further injury

( Beecher cited Brannon and Feist , 2000). The gate control theory states that

non painful stimulus such as distraction competes with the painful impulse to

reach the brain. This rivalary limits the number of impulses that can be

transmitted in the brain by creating the hypothetical gate (Plotnik ,1999). The

Gate control theory is the first and the only theory to take into account

psychological factors of pain experiences. Experiences of pain are influenced by

many physical and psychological factors such as beliefs , prior experience,

motivation , emotional aspects, anxiety and depression can increase pain by

affecting the central control system in the brain. The specificity theory and

the pattern theory suggests that pain occurs only due to damage to body tissue

while the gate control theory claims that pain may be experienced without any

physical injury and individuals interpret pain differently even though the

extent of injury is the same.

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