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A physical therapist attempts to explain to a patient how electrical stimulation can help decrease the perception of pain. Which of the following descriptions would be used to explain the gate control theory of pain?

1. The threshold for stimulating peripheral nociceptors is decreased.
2. The threshold for stimulating peripheral nociceptors is increased.
3. Nociceptive signals are inhibited by stimulating non-nociceptive sensory nerves.
4. Nociceptive signals are inhibited when endorphins bind to opiate receptors.

Transcript

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A physical therapist attempts to explain to a patient how electrical stimulation can help decrease the perception of pain. Which of the following descriptions would be used to explain the gate control theory of pain?

1. The threshold for stimulating peripheral nociceptors is decreased.
2. The threshold for stimulating peripheral nociceptors is increased.
3. Nociceptive signals are inhibited by stimulating non-nociceptive sensory nerves.
4. Nociceptive signals are inhibited when endorphins bind to opiate receptors.

Gate Control Theory
The gate control theory of pain modulation explains how nociceptive signals to the brain can be overridden by the stimulation of other sensory nerves. Pain sensation is determined by input to T cells within the spinal cord. The T cells receive excitatory input from nociceptors (e.g., A-delta and C fibers) and inhibitory input from non-nociceptor sensory nerves (e.g., A-beta fibers).

It's important to remember that the question is not asking about pain in general, rather it is asking specifically how the gate control theory decreases the perception of pain.

Let’s explore each of the options:

Option 1 - The threshold for stimulating peripheral nociceptors is decreased
The peripheral sensitization theory explains why individuals experience chronic pain. The peripheral nociceptors become more responsive since the threshold for stimulating them becomes decreased over time. 

This theory would explain an increase, not a decrease, in the patient’s pain.

Option 2 - The threshold for stimulating peripheral nociceptors is increased
An increase in the threshold for stimulating peripheral nociceptors would result in less pain since it would take a larger amount of input to stimulate the nerve fibers.

However, this is not the explanation that the gate control theory is based on.

Option 3 - Nociceptive signals are inhibited by stimulating non-nociceptive sensory nerves
The gate control theory states that nociceptive signals to the brain are inhibited through the stimulation of non-nociceptive sensory nerves. 

Massage, electrical stimulation, and traction are interventions that stimulate non-nociceptive sensory nerves, thereby reducing the transmission of nociceptive signals to the brain.

Option 4 - Nociceptive signals are inhibited when endorphins bind to opiate receptors
Nociceptive signals can be inhibited by the release of endogenous endorphins which bind to opiate receptors in the nervous system and block the transmission of nociceptive signals.

However, this is not the explanation that the gate control theory is based on.

The correct answer is Option 3

Let’s explore the all student data:
6% of students selected Option 1, The threshold for stimulating peripheral nociceptors is decreased.
20% of students selected Option 2, The threshold for stimulating peripheral nociceptors is increased.
64% of students selected Option 3, Nociceptive signals are inhibited by stimulating non-nociceptive sensory nerves, the correct response
10% of students selected Option 4, Nociceptive signals are inhibited when endorphins bind to opiate receptors.

System Classification
This question is a Neuromuscular and Nervous Systems question which represents approximately 24% of all exam items.

Content Outline Classification
This question is a Foundations for Evaluation, Differential Diagnosis, and Prognosis question which represents approximately 33% of all exam items.

Level Classification
This question is a Level 1 question since the question requires students to possess basic foundational academic knowledge. Remediation of Level 1 questions occurs through academic review of entry-level content using textbooks, review books, Basecamp, and flash cards.

Academic Focus Area
Looking to review related academic content? Check out pages 74-77 in PTEXAM: The Complete Study Guide.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!