Ascellus Blog

Close the Pain Gate to Shut Off Chronic Pain

October 15, 2018

Close the Pain Gate to Shut Off Chronic Pain


Chronic pain is annoying. Unlike acute pain, which alerts us to potential bodily harm, chronic pain serves no good purpose and only distracts those affected from doing other things. Actually, chronic pain is just that: a distraction. When people can learn to distract their brains to something else, the chronic pain has much less intensity or ability to take over a person’s life.

Pain is all about perception. That’s why some people have ‘higher pain thresholds’ than others. Or why two people with the exact same injury report different levels of pain. Much more than just a physical sensation, pain is an intricate combination of thoughts, emotions, environmental factors and, yes, physical stimuli. We have the ability to control our perceptions of pain. Injured workers in chronic pain simply need the tools to understand and utilize various strategies to take back control of their bodies — and their lives.

The ‘Pain Gate’

To get an idea of how to help injured workers in chronic pain, it’s helpful to understand what happens with pain signals, the spinal cord and the brain. Here’s a quick exercise that demonstrates how pain functions in the body.

Bite your bottom lip with your top teeth — not too hard, just a ‘5’ on the 10-point pain scale. Now hold up one hand in a closed fist. Count from 1 – 5 as you hold up each finger, and with each one bite your lip just a little harder. Now shake that hand vigorously; then stop shaking it. What happened to the pain in your lip? It seems to have disappeared. What happened was your brain became more focused on your hand movement than on your lip pain and the pain signal from your lip sensation was blocked by the signal sent to the brain from the hand movement.

Our bodies have two sets of nerve fibers that go from the body to the brain. One, the small nerve fibers, is where pain travels. The other, the large nerve fibers set, is used for movement, like shaking your hand or active walking. Imagine both sets of nerve fibers heading toward the brain and converging at the same point on the spinal cord — a gate, if you will. Only one set of nerve fibers can get through the gate at a time.

In our exercise, the hand shaking motion became the more important because it alerted our brains to the possibility of a danger more pronounced than the lip pain. Our survival instincts kicked in and said, ‘hey, it’s more important to run away from that proverbial tiger than to feel that lip pain.’ The large nerve fibers set becomes more predominate and basically let those, not the other nerve fibers through the gate in the spinal cord. The gate was closed to the smaller nerve fibers, where the pain signals were.

Closing the Pain Gate

The important point to understand from the exercise is that movement and activity can be instrumental in helping to close the pain gate. We see this constantly in our work with injured workers who have chronic pain. Those who spend their days sitting on a couch may be in excruciating pain, even though the injury itself healed long ago. With movement and activity, they can close the pain gate; their pain levels decrease and may even disappear completely.

Just as you saw with the hand shaking exercise, simple movement can close the pain gate. Other physical movement or stimulation such as massage or acupuncture can help many people as these also create activity in the large nerve fibers.  

While physical activity is key to helping injured workers with chronic pain it is certainly not the only strategy. As explained earlier, thoughts, emotions and environmental factors all play a significant role in pain perception. In addition to using movement to close the pain gate, injured workers also need to learn how to change their thoughts and emotions. In our next blog, we’ll offer various exercises to do just that.

Ascellus – Integrated Medical Case Solutions – is the premier behavioral medicine network for pain and trauma response with evidence-based outcomes and a proven track record for transforming workers’ compensation cases. Ascellus makes intervention efficient with a national network of 1,500+ psychologists and psychiatrists in all 50 states.

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Ascellus bridges the gap between mental and physical health to accelerate recovery for our nation's workforce. By connecting the workers' compensation industry with our expert behavioral care and evidence-based treatments, we deliver high-quality outcomes, helping injured workers reemerge with increased strength, purpose and resilience in the workplace.