The gate control theory of pain (GCTP) is a theoretical approach used to treat different types of acute and chronic pain. This theory states that whichever signal reaches the brain first is perceived, regardless of whether the signal is painful or benign. There are several practical applications of GCTP that are useful for the reduction of acute or chronic pain.
Transcutaneous Electrical Nerve Stimulation
The non-invasive application of GCTP is using transcutaneous electrical nerve stimulation (TENS). These devices were formerly available by prescription, but now similar devices can be purchased at retail outlets. The device is applied over the skin of the affected area and when turned on, sends electrical pulses, which can be felt as tapping, vibrating, or buzzing. TENS may be helpful for musculoskeletal pain and menstrual cramps. The goal of TENS is to close the gate on painful signals so only the electrical pulses are felt.
Spinal Cord Stimulation
Spinal cord stimulation (SCS) involves delivering electrical impulses directly to the spinal cord to stop the sensation of pain from reaching the brain. SCS can be used in a wide array of clinical applications, such as chronic low back pain or pain from a single limb. Before SCS can be done, there must be a trial to determine the appropriate placement of the electrode and whether the surgery would be effective. The trial procedure is also used to help patients determine whether they are comfortable with any abnormal sensations caused by the electrode. Some devices mask the pain with a tingling sensation, which might be intolerable for some people.
Deep Brain Stimulation
Deep brain stimulation (DBS) is a surgical technique where an electrical probe is inserted into the brain. This technique is used in several disorders, such as Parkinson's, but can also be used for chronic pain conditions that have not been alleviated with less invasive options. The electrical impulses are sent directly to the brain in hopes of preventing pain signals from reaching the brain first. The signal emitted from DBS is adjusted and controlled via a pacemaker-like device implanted in the chest. DBS can be an effective option if there is a single area in the brain that receives the pain signals, or in the case of Parkinson's, is responsible for movement disorders.
GCTP is the foundation for several devices and procedures used to improve acute and chronic pain. Depending on the underlying cause of pain, there may be several options to decrease pain, increase function, and improve quality of life.
For more information about pain management through neurosurgery, contact a clinic like Southwest Florida Neurosurgical & Rehab Associates.