In planning pain reduction interventions, which pain theory provides information most useful to nurses?
A. Specificity theory
B. Pattern theory
C. Gate-control theory
D. Central-control theory
Correct Answer: D. Central-control theory
No one theory explains all the factors underlying the pain experience, but the central-control theory discusses brain opiates with analgesic properties and how their release can be affected by actions initiated by the client and caregivers. In central-control theory, the master control mechanism directs the muscle movement based on linguistic goals. The gate-control, specificity, and patter theories do not address pain control to the depth included in the central-control theory.
Option A: Specificity theory is one of the first modern theories for pain. It holds that specific pain receptors transmit signals to a “pain center” in the brain that produces the perception of pain. Von Frey (1895) argued that the body has a separate sensory system for perceiving pain—just as it does for hearing and vision.
Option B: This theory ignored findings of specialized nerve endings and many of the observations supporting the specificity and/or intensive theories of pain. The theory stated that any somesthetic sensation occurred by a specific and particular pattern of neural firing and that the spatial and temporal profile of firing of the peripheral nerves encoded the stimulus type and intensity.
Option C: According to his theory, pain stimulation is carried by small, slow fibers that enter the dorsal horn of the spinal cord; then other cells transmit the impulses from the spinal cord up to the brain. These fibers are called T-cells. The T-cells can be located in a specific area of the spinal cord, known as the substantia gelatinosa. These fibers can have an impact on the smaller fibers that carry the pain stimulation.