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The Gate Control Theory of Pain: What It Is and Why It Matters

Medical science knows a lot about pain. But truth be told, there is a lot more we don't know. We do not know why people perceive pain differently, for example. No doubt we have some educated guesses. But we can't offer a concrete explanation. One possible explanation is known as the Gate Control Theory of Pain (GCTP).

The GCTP's origins go back nearly 60 years. It was first posited in 1965 as an explanation for how pain signals make it to the brain. The theory focuses on two different types of nerve fibers referred to as “gates.” Opening and closing these gates is the key to reducing pain sensations.

We still call the GCTP a theory nearly six decades later because it has never been scientifically proven. However, there is value in considering its merits. Even if the actual gates discussed by the theory don't exist, the principle behind it is worth further attention.

Pain Isn't a Static Thing

We tend to think of pain as a static mechanism that remains consistent across the board. If you touch your hand on a hot stove, nerves in the skin sense danger and send pain signals to the brain. Those signals are designed to get you to pull your hand away. They act as a mechanism to protect you.

That said, there are other types of pain that do not offer the same benefit. The pain caused by osteoarthritis is by no means a safety mechanism. It doesn't protect you from anything. Instead, it lets you know that the cartilage between your joints has worn away to the point that the bones are grinding on one another. It is a different kind of pain that exists for an entirely different reason.

Opening and Closing the Gates

Knowing that pain isn't static leads us to believe that there is more to pain perception than just signals traveling up the spinal column to the brain. That is exactly what GCTP posits. The theory is rooted in two different types of nerve fibers in the human body.

Larger nerve fibers, like those found in the skin, transmit sensory information that may or may not have anything to do with pain. Smaller nerve fibers, located internally, are more likely to send signals related to tissue damage, inflammation, etc. The thinking is that opening the larger gates while closing the smaller ones reduces the perception of pain.

It stands to reason that the larger nerve fibers are more responsive in some people than their smaller counterparts. These types of people would be more sensitive to tactile experiences – like massage, for example. Likewise, other people have more active smaller fibers.

What It All Means

So, what does all this mean from a pain management standpoint? Let us assume the theory is true. People with naturally higher activity in the larger fibers should have a higher tolerance for pain. Those with more activity in the smaller fibers would have a lower tolerance. If we could manipulate both fibers, we could influence pain perception.

It is an interesting theory that demands more research. Until such research is undertaken, we cannot say for sure how legitimate Gate Control Theory of Pain really is. However, we can say for certain that people perceive pain differently. That much is true.

Regardless of your particular pain perceptions, the professionals here at KindlyMD want to help. Our pain clinics are staffed by trained professionals who take a holistic approach to pain management. We don't want to just treat you; we want to be equal partners with you on your journey to feeling better.

6 Tips for Taking Control of Your Own Healthcare Journey

We do things a little bit differently at KindlyMD. For instance, we consider healthcare a journey rather than a service or business. We also believe patients should be able to take complete control of their respective journeys, should they decide to do so. Ultimately, each patient must decide how to utilize healthcare services, advice, treatments, etc.

That is one of the reasons we help patients looking to obtain their Utah Med Cards. Our position on the Med Card is simple: the plant-based medicines they provide access to are an alternative to other treatments for pain, PTSD, seizure disorders, etc.

If you have been feeling like you are not in charge of your healthcare journey, we can help you change that. Make an appointment at any one of our clinics to get started. In the meantime, here are six tips you can put to use right away:

1. Educate Yourself

Education is by far the best healthcare tool. And thanks to the internet age, we have more information at our fingertips than ever before. Take advantage of it. Educate yourself about those health concerns you have. Learn about the conditions that affect your daily life.

There is a caveat here: just because something is on the internet doesn't make it true. The best way to verify accuracy is to look for multiple sources (reputable sources, by the way) that agree.

2. Find a Provider Who Gets You

Healthcare providers come in all shapes and sizes, so to speak. There are doctors, nurse practitioners, physician assistants, etc. The key to taking control of your healthcare journey is to find a provider who gets you. Look for a provider who is on the same page and is willing to work with you as an equal partner. When you find such a provider, don't just “see” him or her. Establish a relationship with that person.

3. Keep Your Own Records

Records are a big part of taking control. We advise keeping track of everything. For example, you might come to us for assistance obtaining your Utah Med Card. Keep a record of that assistance. But in addition, also start tracking your use of plant-based medicines. Write down every product you buy with your Med Card. Write down every time you use it, how much you use, and how it makes you feel.

4. Be an Active Communicator

Whether you are looking to get your Med Card or you need help with an unrelated issue, make a point of being an active communicator. Your healthcare provider can only help you if you are willing to be open and honest about everything. The better you communicate, the better that relationship with your healthcare provider will be.

5. Learn to Be an Advocate

We always say that patients are their own best advocates. It's something we believe in very passionately. If you want to take control of your own healthcare journey, learn how to be an advocate for yourself. Speak up for yourself. Make your desires and goals known. Insist on being heard, because you should be.

6. Practice Prevention

Last but not least is practicing prevention. Take control of your journey by making healthy lifestyle changes. Take advantage of preventative screenings and regular checkups. Being proactive with prevention is all about avoiding as many problems as you can by being as healthy as you can.

We can help you begin taking control over your own healthcare journey by assisting you in getting your Utah Medical Card. If you would like to know more information, do not hesitate to reach out.

How Taking an Active Role in Your Healthcare Visits Can Help | Pain management physicians

Pain management physicians and their patients ideally work together to come up with treatment plans and follow through on them. The Kindly MD way is to work with our patients as partners in better healthcare. We invite them to take active roles in their healthcare journeys. Taking an active role starts with routine visits.

Regardless of where you are on your particular journey, taking an active role in your healthcare visits can help a lot. If you are not sure why, keep reading. The remainder of this post offers invaluable information.

What Taking an Active Role Looks Like

Let us start by discussing what taking an active role in healthcare visits actually looks like. Bear in mind that a “visit” is any interaction you have with a pain management physician. It could be an annual physical, a routine maintenance visit, or any other type of interaction.

Taking an active role is characterized by several things:

Think of taking an active role in terms of establishing a relationship. For any relationship to work, both people need to be present. They need to communicate freely, being willing to be open and honest about everything. Both need to be willing to engage in questions and answers, problem-solving, coming up with new ideas, etc.

Your Provider Relies on You

As for how all of this helps, remember that your healthcare provider relies on you as a guide. Whether it is a doctor, physician's assistant, or nurse practitioner, your provider can only offer advice based on available information. Your being an active participant in your visits gives your provider much more information to work with.

If your doctor is trying to help you better manage chronic pain, for instance, he needs to know how you feel. He needs to know your level of pain today as compared to when you saw him last month. The same is true for any condition. We aren’t limiting ourselves to pain management here.

Your Expectations Matter

Taking an active role in your healthcare visits helps your provider understand your expectations. Again, let us use chronic pain as an example. A nurse practitioner may wonder why you're not responding to a particular treatment. She may ask all sorts of questions designed to better understand your expectations. Why? Because maybe the biggest issue you're having is a misunderstanding of how a particular treatment helps.

Maybe your expectations don't match up with treatment realities. And if that's the case, your pain management physician would want to know what your expectations are so that she can make appropriate recommendations. Perhaps your current treatment isn't the best option based on your expectations. Maybe there is something else you can try.

It Is Ultimately Your Journey

If we could drive home just one point here it would be this: the healthcare journey you are on is ultimately your journey. Pain management physicians can only help you along that journey. We cannot travel it for you. That's why we want you to be an active partner in determining where it goes.

If you've never tried it before, we encourage you to take an active role in all your healthcare visits. Ask questions. Talk about your concerns. Let your provider know your expectations for treatment. By becoming an active participant rather than a passive patient, you can help direct your healthcare journey to a more positive outcome.

5 More Things About Chronic Pain Most People Do Not Know

We recently published a post discussing five things about chronic pain most people don't know. We couldn't discuss everything we wanted to in that post, so we decided to publish a follow-up. We hope you get a better understanding of chronic pain after reading them.

Below are five more things about chronic pain you might not be aware of. As you read, remember that KindlyMD exists to help Utah pain patients feel better. We offer tailored treatments, plant-based medicines, help to obtain a Utah medical card, and additional services. You can contact us at any time to make an appointment at one of our clinics.

With the preliminaries out of the way, here are five more things about chronic pain most people do not know:

1. Chronic Pain Can Be Felt Anywhere in the Body

Given that pain is almost always a symptom of another condition, it is not limited to specific parts of the body. It can be felt anywhere. Even more interesting is the fact that some types of pain can be felt in one part of the body while the root cause is found elsewhere.

Take sciatica. It occurs when a nerve in the lower back is pinched. A patient can feel sciatica pain through the hip and all the way down the leg. Hip and leg pain can be felt even if there is no sensation of pain in the patient's back.

2. The Number of Causes Is Nearly Limitless

Unfortunately, the number of possible causes of chronic pain is nearly limitless. Nerve damage can cause neuropathic pain that lasts a lifetime. Arthritis can cause pain in the joints. Fibromyalgia can cause body-wide pain that never goes away. The list goes on and on. Hopefully, you get the point.

3. Chronic Pain Impacts Quality of Life

This next point is one that many people who have never experienced chronic pain have trouble wrapping the brains around: chronic pain affects quality of life. For starters, trying to maintain a normal routine when pain is always present is challenging – even on the best days.

Just getting through the day can be hard enough. And when this is the case, patients have a tendency to limit their activities. They stop doing the things they love. They stop spending time with friends and family. They might not get out of the house very often. Losing such things can ultimately lead to depression or other mental health concerns.

4. The Treatments Are Many and Varied

Possible treatments for chronic pain are many and varied. Doctors will consider the root causes, the severity of the pain, how often the pain is experienced, and other factors when treating a patient. Treatment options run the gamut from prescription medications to physical therapy to plant-based medicines.

5. A Cure Is Not Always Possible

A general rule says that pain must persist for at least three months to be considered chronic. This further suggests that some cases of chronic pain can be cured along with the underlying condition. Unfortunately, a cure is not always possible. There is no cure for fibromyalgia, for example. Fibromyalgia pain can be managed for the most part, but it never fully goes away.

Chronic pain is a complex condition, to say the least. We are here to help you find relief if you live in Utah and traditional treatments haven't helped you. Contact us to learn more about services related to plant-based medicine and Utah Medical Cards. Our number one priority is helping you feel better in a safe and manageable way.

5 Things About Chronic Pain Most People Do Not Know

Chronic pain affects just over 20% of the U.S. adult population. That works out to about 50 million people. It has been our experience that many people know very little about chronic pain, especially those who have never experienced it. But even many chronic pain patients know little about their condition other than that it hurts.

Pain clinics like ours specialize in helping chronic pain patients feel better. They are staffed by pain management physicians with access to a variety of treatments not normally available through GPs and family doctors. Anyone suffering from chronic pain and unable to find relief through standard treatments is a good candidate to visit a pain clinic.

While you think on that, here are five things about chronic pain most people do not know:

1. How It's Defined

From a medical standpoint, chronic pain is not arbitrary. We define it as pain that is felt either daily or on most days, for a period of time longer than would otherwise be normal for the condition behind it. As a general rule, chronic pain persists for at least three months.

2. Pain Can Be a Symptom or a Condition

In the majority of chronic pain cases, pain is a symptom of something else. Cancer patients experience pain related to both the disease itself and its treatments. Diabetics are known to experience neuropathic pain as a direct result of nerve damage in their limbs.

However, there are cases when pain cannot be traced to some other condition. Test after test indicates an otherwise healthy person. In such cases, pain is the only condition. Science doesn't quite understand how this is possible, but it cannot be denied in the face of so many patients who exhibit this sort of pain.

3. Pain Can Be Specific or Nonspecific

Playing off the previous point, pain can be specific or nonspecific. Specific pain can be traced back to a verifiable condition. Arthritis pain is specific; we know what is causing it. On the other hand, nonspecific pain is pain for which we have found no root cause. This does not necessarily mean there is no root cause. It just means that testing hasn't revealed it.

4. Chronic Pain Is Often Accompanied by Other Symptoms

People who have no experience with chronic pain often think of it in isolation. Their own experience with temporary pain doesn't allow them to make the connection between pain and other symptoms. But truth be told, chronic pain is almost always accompanied by other things, including:

The thing about chronic pain is that it is physically and mentally draining. A patient doesn't just hurt; the constant battle of trying to live a normal life wears them down when pain is always present.

5. Chronic Pain Is Challenging to Diagnose

From a clinical perspective, chronic pain is often challenging to diagnose. We know chronic pain is an actual condition. What we are not quite sure about is why it persists in so many cases. Not having a full understanding of chronic pain makes things difficult for medical providers who sincerely want to help.

There is a lot more about chronic pain we have not discussed in this post. Perhaps a second post will follow. At any rate, chronic pain is as much a mystery as it is a reality. If you are living with it and haven't found adequate relief yet, consider visiting one of our clinics. KindlyMD specializes in helping chronic pain patients feel better.

Pain Management Contracts: There Is a Better Way

It is hard to imagine that a medical clinic or individual clinician would require patients to sign a contract before receiving care. Unfortunately, contracts are pretty common in pain medicine. Pain clinics around the country establish contractual relationships with their patients, with the understanding that such relationships can be terminated for breach of contract. Here at KindlyMD, we believe there is a better way than pain management contracts.

In fairness to those clinics that choose the contract route, they do so for a reason. The primary thing they are attempting to avoid is misuse of prescription medications. Not only is medication misuse unhealthy for patients, but it could also expose a clinic to liability. Basing care on a signed contract ostensibly minimizes both.

Sometimes It Takes Time

In a Medical News Today post published in March of 2023, contributor Mary West posed an intriguing question: "how many chances do you get at pain management?" Her point is well taken. Pain management isn't a simple thing. Sometimes it takes quite a bit of time to achieve the desired results. Effective pain management is often a process of trial and error.

A pain management physician might prescribe a particular medication after an initial consultation. If it doesn't work, it's back to the drawing board. The back-and-forth between doctor and patient might eventually hit on an effective treatment, but it could take months or years. In the meantime, the patient won’t necessarily follow the doctor's advice to the letter.

That could result in breach of contract. When that happens, the patient gets dropped, and they are out of chances – at least with that clinician. Then it's on to the next. It all seems pretty strange given the fact that healthcare is supposed to be altruistic at its core.

Patient Guided Healthcare

As we said at the start of this post, we think there is a better way to handle pain management. That better way is to let the patient be the guide. No one knows a patient's body better than the patient themselves. No one knows but them how they truly feel. Most importantly, no one but the patient has to live their life. Clinicians should always remember that.

Part of our approach to patient-guided journeys is to explore alternative treatments. We are not so quick to write prescriptions. If there are other ways to manage pain, we want our patients to know about and use them. We are especially fond of plant-based medicine due to its widespread use in Eastern practices for millennia.

We believe plant-based medicine is a more natural way to treat chronic pain. We feel it is more organic and more closely aligned with how the human body works. We realize that not all pain clinics share our beliefs or agree with letting patients guide their healthcare journeys. But we can confidently say that we have had remarkable success over the years.

Chances Should Be Unlimited

We believe letting the patient guide their healthcare journey is a better approach than establishing a contractual relationship between doctor and patient. It is a better approach for many reasons, not the least of which is the fact that a patient's opportunities to find relief ought to be unlimited. No one should be condemned to a life of chronic pain because a contract was violated.

We understand why some pain clinics go the pain management contracts route. What they do is their business. At KindlyMD, we think that a patient-guided approach is the better way to go. Please don't hesitate to get in touch if you would like to know more about how we treat chronic pain.

Should Patients Guide Their Own Healthcare Journeys

The healthcare journey is one with multiple juxtapositions. On the one hand, healthcare should be based in scientific fact and reliable evidence. On the other hand, how a patient feels doesn't always line up with science. Likewise, doctors and nurses are trained clinicians well versed in how the human body works. But no one knows a body better than the person who lives in it. We say all this to pose the following question: should patients guide their own healthcare journeys?

KindlyMD patients live with a full range of medical conditions including chronic pain, PTSD, depression, and anxiety. We operate on the philosophy that they should be the primary decision makers. They should be encouraged to guide their treatments with help from prescribers and clinicians. When all is said and done, they are in charge.

Like Building a House

A good way to think of the KindlyMD approach to healthcare is to compare it to building a house. The builder and general contractor are trained professionals with the knowledge and experience to make sure the actual construction is done correctly. But they are not the primary decision makers.

They sit down with buyers to have frank discussions about what the finished product should look like. Builders and contractors rely on buyers to make architectural decisions, design decisions, budgetary decisions, and so forth. The buyer guides the journey while the paid professionals make it happen.

If builders and contractors built what they wanted without regard to their buyers, they would have a tough time selling houses. That's why they don't do it. Should healthcare be any different? We don't think so. We think patients should be the primary guides. They should lead us along their healthcare journeys while we provide the know-how to get them from one point to the next.

Not Always Black-and-White

Some types of healthcare services are more black-and-white than others. That said, many of the conditions we treat can be pretty fluid from patient to patient. We work with patients experiencing chronic pain in different ways and for different reasons. We treat PTSD patients who experience a range of symptoms that are not always identical.

In terms of mental health conditions like anxiety and depression, there are some basic things common to most cases. But the details of each case are unique to the individuals they pertain to. No two mental health patients are exactly alike.

Patients Know How They Feel

We have learned a lot about the practical aspects of pain medicine over the years. One of the big things is that pain clinics can offer treatment options and sound advice. We can offer recommendations to patients who desperately want relief. But we cannot truly know how they feel. They know how they feel, and it is up to us to listen to what they say.

Patients visiting KindlyMD for the first time discover that our clinicians love to ask questions. Questions are important to helping us understand what a patient is going through. We rely on answers to understand patient experiences as best we can. We are also genuinely interested in what a patient feels is the best direction for treatment.

Should patients guide their healthcare journeys with prescribers and clinicians in support? We believe so. That is the position we take. Patients are in a unique position to know where they were, where they are, and where they think they are going. It's not up to us to dictate what that journey looks like. Our role is to provide support, sound advice, a full array of treatments, a listening ear, and an open mind.

Pain Medicine Needs an Open Mind to Move Forward

As a medical specialty, pain medicine tends to be more open minded than more traditional approaches to handling chronic pain. But even within the specialty we can be close-minded at times. We can get set in our ways. We can fail to consider that even pain medicine evolves over time. The solution is for the specialty to adopt a more open mind toward everything from diagnoses to treatments.

KindlyMD believes that a more open mind leads to discussions about alternatives, including applying for a Medical Card. Here in Utah, a state-issued Medical Card gives chronic pain patients access to a particular form of treatment they may have never tried before. It is a treatment that works very well for thousands of our patients.

Of course, a Medical Card isn't the only avenue for alternative treatments. There are many others. The point is to not be locked into a single way of thinking. Chronic pain is very personal. It requires an equally personal approach from pain clinics, pain medicine practitioners, and patients.

More Plant-Based Medicine

As a Utah pain clinic, KindlyMD serves patients from all walks of life. We work with professionals and blue-collar workers. We work with men and women. Virtually anyone struggling with chronic pain is a good candidate to visit KindlyMD. At the heart of what we do is plant-based medicine.

Plant-based treatments are actually not new. Eastern medicine has taken tremendous advantage of plants throughout human history. Western medicine has historically avoided them. We feel it is time to change that. We could use more plant-based medicines in Western healthcare.

For the record, this is what the Utah Medical Card is all about. Receiving a card means opening the door to plant-based treatments as an alternative to the more traditional approach to pain management. A treatment rooted in plant-based medicines just works better for some people.

Good Health Isn't Static

One of the things we have been learning in pain medicine over the last two decades is just how much healthcare relies on static diagnoses and treatment options. But we have also learned that good health isn't static. What do we mean by that? We mean that there is no uniform standard for everyone.

Pain management is the perfect example. Not all patients experience pain in the same way. Not all patients exhibit the same pain threshold. Not all doctors interpret responses to the pain scale the same way. There is so much variation that it is impossible to come up with a static diagnosis and treatment applicable to every patient.

We can establish general guidelines. We can establish basic recommendations based on established facts. But when push comes to shove, healthcare needs to be flexible enough to accommodate the many differences between patients and their experiences. That's something Western medicine hasn't done very well throughout history.

Pursuing Whatever Works

A more open-minded approach to Western medicine recognizes that it is possible to pursue whatever works for patients, within reason. From our point of view, Medical Cards and plant-based medicines are well within reason. Plant-based medicine has thousands of years of history behind it. Medical Cards give patients access to it.

Throughout human history, we have treated injuries and illnesses through a variety of means flexible enough to accommodate individual needs. Somewhere along the way, Western medicine lost much of its flexibility. It's time to change that. Specifically, where pain medicine is concerned, we need more pain clinics adopting a more open-minded approach. The more we open our minds to new treatment possibilities, the better we will be at offering genuine pain relief.

Do You Feel Like Your Doctor Doesn't Listen to You

Do you feel like your doctor doesn't listen to you? If so, you're not alone. There is growing sentiment among patients that our healthcare system isn't responsive to their needs. When patients feel that way, obtaining healthcare services can seem frustrating. It can make patients feel both helpless and hopeless.

For the record, none of this is a knock against doctors, nurse practitioners, physician assistants, etc. Unfortunately, most of them are locked into a system that doesn't allow them to pay as much attention to patients as they would like. They must walk that fine line between providing adequate care and keeping things moving. We can empathize with them.

Nonetheless, it is never good when a patient feels as though their doctor doesn't listen. That's why we take a different approach at KindlyMD. Our approach is a holistic one designed to treat the whole patient in body, mind, and spirit. We avoid focusing exclusively on symptoms alone.

A Different Way of Thinking

The holistic approach to medicine isn't necessarily a new approach, per se. Rather, we like to describe it as a different way of thinking. It is different in the sense that the goal is the same as traditional medicine – to help patients feel better – but the journey to reaching that goal tends to be anything but traditional.

The typical Western approach to medicine seeks to make the patient feel better by addressing symptoms. If something hurts due to inflammation, we prescribe a medication designed to reduce that inflammation. But what about the root cause of the problem?

Another important aspect of holistic care is the fact that it addresses both the mental and physical. At KindlyMD, we combine mental health services with alternative medicines for a more thorough and comprehensive treatment. We want patients to feel better physically and experience better mental health at the same time.

You Can Change Doctors

Getting back to the main premise of this post, know that you can change doctors. Your health is important to you. It is too important to continue working with a medical provider in whom you don't have confidence. So if you don't feel like your doctor listens and you have unsuccessfully tried to resolve the issue, perhaps it's time to start looking for a new provider.

We actually see this quite a bit in pain medicine. It is very common for pain management doctors to take on new patients who feel as though their GPs are unable to help them. Again, we are not knocking GPs. They have their hands full dealing with everything from allergies to colicky babies and the common cold.

Chronic pain is something that GPs and family doctors do not always address well. Switching to a pain medicine doctor is a better option for many patients. And that's okay, by the way. Seeking out a new doctor capable of helping you doesn't make you unappreciative or disloyal. It makes you smart.

We Are Here to Listen

If you feel like your doctor does not listen to you, we understand. We get you. We also want you to know that we are here to listen. KindlyMD practices a holistic form of medicine that seeks to treat the whole patient rather than just symptoms. Our specialty is chronic pain management.

We have multiple clinics ready to serve you here in Utah. Check out our Clinics page to find the one nearest to you. Whether you need help with medication management, mental health, or obtaining a Utah Medical Card, we are ready to work with you to help you feel better.

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