The Challenge of Pain

"No two people have thought more about pain than Ronald Melzack and Patrick Wall. First of all as scientists who revolutionised the field in the 60s when they came out with the Gate Control Theory. The theory rejected the notion of pain as a one-way signal starting with some kind of damage in the body that leads directly to the brain. Instead, there are various points along the way where the signal can be modified. This helps to explain why, for example, certain states of mind might make pain less or more intense. But Melzack and Wall also looked beyond the science of pain. They studied its psychology, cultural determinants, and language. One thing that bothered them was that in medicine, pain was spoken about only in terms of its intensity – it’s a two out of ten or a ten out of ten. But what about the differences in quality of pain? So they went and asked patients in the clinic and hospital and compiled lists of words which they classified into groups and subgroups. This later became the McGill Pain Questionnaire which helps patients qualify the type of pain they have in addition to quantifying it. Is it more throbbing or constant? Hot or cold? Sharp or dull? The greatest part of their efforts was finding out that certain descriptions correlated well with certain diagnoses. So not only did the questionnaire facilitate the communication of pain, it also led to better management of patients."