Pain: Cognitive and Contextual Influences

Gary B. Rollman

Recent pain research has been greatly influenced by the gate control model of pain presented in 1967 by psychologist Ronald Melzack and neuro-scientist Patrick Wall. They suggested that both physiological and clinical data, as well as everyday experience, run counter to the classical view that pain simply arises from overstimulation of the somatosensory system. Anatomical, physiological, and psychological evidence point to a complex interaction of both peripheral and central information in responding to noxious stimuli. Melzack and Wall also noted that the amount of pain after an injury is greatly influenced by contextual factors. An athlete, soldier, or worker may suffer a severe wound yet not report pain until long after the event, likely because the individual's attention was focused upon some vital task when the injury occurred. The gate control theory, emphasizing parallel ascending and descending effects within the nervous system, suggested that pain is not a single sensation. ...

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