The University of West Alabama

Athletic Training & Sports Medicine Center

        AH 330 Therapeutic Modalities
               in Athletic Training

             Pain Control Theories

Gate Control Theory                  Opiate Pain Control
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Parameters                                                                    Parameters


Intensity--Sensory (low)
Pulse Duration--75-150usec
On/Off Time--None
Treatment Time--15-20min as needed
Pad Placement--Quadrapolar-Crossing
Current Type--any
Special Instructions--Treatment should correspond with fluctuations in pain
Intensity--Sensory (high)
Pulse Duration--200usec-10msec
On/Off Time--None
Treatment Time--15-30min as needed
Pad Placement--Bipolar, cathode distal, and anode proximal (if possible)
note: in an ideal situation, the anode pad should be a large, dispersive pad
Current Type--any
Special Instructions--Stimulation should be applied over trigger points
The Gate Control Theory is explained as follows:

A modality (electrical stim, cryotherapy, thermotherapy, etc.) is applied to or around the area of pain.  The body now senses the effects that are produced from this modality (warmth, cold, electrical impulses, etc.) instead of sensing the pain that is present in the area.  In effect, the modality's impulses are sent through the "gait" to the CNS, thus blocking the pain impulses from passing through the "gait" to the CNS.

The Opiate Pain Control Theory is explained as follows:

A modality, such as a TENS unit, is applied to the point of pain for an extended amount of time (30 min on, and 30 min off during waking hours).  This long duration of treatment causes the release of enkephalin from local sites in the CNS and -endophin from the pituitary gland into the spinal fluid.  The pain relief from the release of these chemicals will usually last for approximately 6 to 7 hours.



Central Biasing Theory

Intensity--high, approaching a noxious level, no muscle contraction
Pulse Duration--10msec
On time--30sec-1min
Pad placement--over trigger points
Modality type--low frequency, high intensity generator
*If this treatment is successful, pain will be relieved shortly after the treatment.
The Central Biasing Theory is explained as follows:

The body uses past experiences with pain to judge the intensity/severity of current pain.  It is used on sharp chronic pain or severe pathological pain.