Spinal Cord Gates: Unlocking Pain's Secrets - Essay Sample

Introduction

The Gate control theory of pain claims that the spinal cord has neurological gates that either allow or block pain signals from reaching the brain. Notably, when an individual is injured, pain signals are transmitted more readily to the mind causing pain, or they are inhibited, reducing the sensation (Mendell, 2014). All pain signals from the body are passed to the dorsal horn of the spinal cord via the peripheral nervous system. The small and large nerve fibers carry information to two distinct regions of the dorsal horn (Treede, 2016). The small or pain nerve fibers transmit pain signals, while the larger nerve fibers are responsible for the passage of normal stimuli such as touch, skin senses, and pressure (Mendell, 2014). The larger nerve fibers send signals to the inhibitory interneurons, which prohibit the transmission of sensory pain information.

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In this case, the Gate theory claims that the activity of large nerve fibers activates the inhibitory neurons, which reduce the transmission of the pain information to the brain-the gate is closed. Notably, if the activity of large fiber nerves is higher than that of small nerve fibers, an individual will experience less pain (Mendell, 2014). On the other hand, high pain fiber activity inactivates the inhibitory interneurons allowing the passage of pain signals to the brain. In the brain, nociception takes place-gates are open (Mendell, 2014). Additionally, mental factors affect how the gates are opened and controlled. For instance, if an individual anticipates an injury to cause pain, they will be hurt to a significant extent. Therefore, the theorists Ronald Melzack and Patrick Wall concluded that emotions, thoughts, and expectations influence pain perception (Treede, 2016).

Examples of How Pain Is Blocked According to Gate Theory

One example of how gates theory controls pain is when an individual tends to rub their toe when they bang it against a chair or door. In this case, when a person rubs the injured part, they increase the activity of the large nerve fibers, which aid in inhibiting the pain fiber activity minimizing pain inception (Treede, 2016). The enhanced sensory touch closes the gates. Secondly, pain theory is utilized to numb pain during childbirth. In this scenario, mothers are massaged, creating an inhibitory effect concern the pain sensations.

Furthermore, stressful emotional conditions influence the opening of the gates, causing more pain (Ropero Pelaez & Taniguchi, 2016). For example, if a person believes they have stomach upset due to cancer, they are likely to experience more pain than those who think it is because of food poisoning even if they both have a similar condition (Treede, 2016). Additionally, psychological feelings control the opening and closing of the gates in such a way that a player who injures his or her ankle in a rugby game is likely to experience less pain since he associates the pain to his interests.

Application of Gate Theory to Pharmacological and Nonpharmacological Measures

Pain Gate theory applies to pharmacological and nonpharmacological measures to control pain in various ways. Firstly, in pharmacology, narcotics that are derivatives of opiates are used to numb pain. In this case, opiate receptors in the spinal cord are located in the nocineurons' presynaptic ends, and the interneuron layers of the dorsal horn (Treede, 2016). Therefore, activation of the opiate receptors by narcotics causes polarization at the interneuronal level, inhibiting the release, and firing of neurotransmitters concerned with pain transmission. As a result, the gates are closed, numbing an individual's pain.

Secondly, in non-pharmacological measures to control pain aims at modulating pain by inhibiting nociceptive signal inputs by activating the large nerve fibers. The Gates Control theory claims that high activity of normal nerve fibers inhibits pain transmission (Ropero Pelaez & Taniguchi, 2016). For example, the transcutaneous electrical nerve stimulation (TENS) procedure is an example of a nonpharmacological method is based on inhibition of pain neurotransmitters to inhibit transmission of pain signals to the central nervous system. In this technique, low-voltage electric electrodes are placed on the injured body site to allow electricity to travel through the nerve fibers. The situation increases the activity of the normal nerve fibers inhibiting pain transmission to the brain. Gates theory can be utilized in other nonpharmacological methods such as massage, acupressure, physical therapies, and psychological interventions.

Prompt 2

The patient ordered naxalone since it is an excellent antinarcotic antagonist agent vital in minimizing the abuse of opioids. Notably, persons receiving narcotics to relieve pain are at a high risk of abusing them for recreation, especially those suffering from drug and substance abuse. Morphine is an example of opioid a derivative of opium, which is often abused by patients beyond doctor's prescriptions (Kim & Nelson, 2015). The phenomenon makes it indispensable for individuals taking morphine to combine it with naxalone to minimize abuse of the opioid. The drug can also be used for a partial or complete reversal of opioid depression caused by narcotic overdose.

Indications

According to Kim & Nelson (2015), naxalone is used for complete or partial; reversal of opioid and respiratory depression caused by prolonged use of narcotics. Synthetic and natural opioids such as propoxyphene, butorphanol, cyclazine, nalbuhphine, and methadone can induce depressions (Kim & Nelson, 2015). Notably, the drug is often used in emergency cases where patients are suffering from respiratory distress to the use of opioids. Individuals with extreme drug overdose have symptoms such as breathing problems, dizziness, reduced heartbeat rate, and low blood pressure (Kim & Nelson, 2015). Physicians are advised to administer the dosage when a person shows severe symptoms after taking narcotic prescriptions to avoid brain damage. For instance, I once observed a patient having breathing difficulties being rushed into the ED. The patient had overdosed morphine and was experiencing a seizure, which prompted the nurses to administer a naxalone injection, which stabilized him. The effects of the drug last up to an hour; therefore, patients should be rushed taken to the hospital to seek more medical intervention after its application (Kim & Nelson, 2015). Additionally, naxalone may be administered to patients suffering from septic shock to increase their blood pressure.

Comparison of Naxalone With Other Narcotic Antagonists

Naxalone is one of the best narcotic antagonists available today. The drug is preferred for people under narcotic prescription since it does not have severe side effects as compared to others such as levallorphan (Wiegand, 2015). Additionally, naxalone is a pure opioid antagonist compared to the others since it is capable of producing both partial and complete reversal effects while others such as nalorphine reverse respiratory depressions partially (Wiegand, 2015). Naxalone dosage can also be administered to pregnant women and people suffering from long-term opioid addiction (Wiegand, 2015).

Application of Gates Theory

The Gates theory plays an essential role in this scenario concerning the pharmacodynamics of naxalone. Naxalone is a competitive antagonist that competes with other narcotics to bind to the opioid receptors in the dorsal horn. When it binds with the receptors, it inhibits the transmission of opioid into the brain, limiting their effects (Kim & Nelson, 2015). In this case, it closes the neural gates, which prevents the brain from responding to endorphins and opioids. A patient taking morphine is administered naxalone to limit the effects of the narcotic, which may surpass the medical prescription.

References

Kim, H. K., & Nelson, L. S. (2015). Reducing the harm of opioid overdose with the safe use of naloxone: a pharmacologic review. Expert opinion on drug safety, 14(7), 1137-1146. https://doi.org/10.1517/14740338.2015.1037274

Mendell L. M. (2014). Constructing and deconstructing the gate theory of pain. Pain, 155(2), 210-216. DOI:10.1016/j.pain.2013.12.010

Ropero Pelaez, F. J., & Taniguchi, S. (2016). The gate theory of pain revisited: modeling different pain conditions with a parsimonious neurocomputational model. Neural plasticity, 2016. http://dx.doi.org/10.1155/2016/4131395

Treede, R. D. (2016). Gain control mechanisms in the nociceptive system. Pain, 157(6), 1199-1204. DOI: 10.1097/j.pain.0000000000000499

Wiegand, S. L., Stringer, E. M., Stuebe, A. M., Jones, H., Seashore, C., & Thorp, J. (2015). Buprenorphine and naloxone compared with methadone treatment in pregnancy. Obstetrics & Gynecology, 125(2), 363-368. DOI: 10.1097/AOG.0000000000000640.