http://www.painmanagementtheory.homestead.com/index.html
*Pain management* theory has entered a new era. Until now typical chronic pain conditions such as fibromyalgia, myofascial pain syndrome, and diabetic neuropathy have been severely under treated. But new insights to how pain messages change the structure of the nervous system are producing new and better treatments. Professionals now know that it takes more than medication refills to treat chronic pain conditions like fibromyalgia. A program that stresses other modalities, such as *exercise, relaxation therapy, and acupuncture* will be far more successful than one that focuses only on medication.
Legitimate Drug Addicts?
Medications are also better understood. Taboos on opiate medications are being dispelled. Where once it was thought that *opiates* produced "legitimate drug addicts" we now realize that less than 1% of chronic pain patients become addicted.
Unfortunately, the biggest challenge in treating typical chronic pain patients is finding the right *combination* of medicines and alternative treatments. For some patients with fibromyalgia, opiates are not effective or can produce unwanted side effects, where for others they can work wonders. Diabetic neuropathy can be particularly difficult because there are two distinct disorders, diabetes and neuropathic pain. And in some cases of myofascial pain syndrome there is so much myofascial scar tissue that no medicine can reduce the pain, but slow gentle stretching exercises can.
The gate control theory
In 1965 a new pain theory surfaced that has now become the model that most pain management practitioners subscribe to. Ronald Melzac and Patrick Wall, researchers from Canada and England collaborated, and thus fathered the *gate control theory*. Simply stated this theory contends that rather than pain messages starting in an area that may have tissue damage and then being sent to the brain for processing, they are influenced in the spinal cord by other nerve cells that act like gates, either preventing impulses from getting through, or facilitating their passage. In other words the brain is not a passive receiver of pain information but can influence the information received, deciding whether it is important enough to be registered. This theory is now widely accepted and continues to influence the field 35 years after its proposal. It has produced an explosion of research in the field and has led to many new treatments.