Pathophysiology · Pain · Week 4

The Gate in the Spinal Cord

Pain is not a fixed signal on a one way wire. At the dorsal horn it meets a gate. Big touch fibers and the brain’s own brake can close that gate. Move the controls and watch how much of the signal gets through.

The dorsal horn circuit line widths follow the live numbers

Thin C fibers carry pain in. Thick A beta fibers carry touch in and switch on an inhibitory cell. The brainstem sends its own brake down. What is left climbs to the brain.
The dorsal horn gate with live widths

Repeated firing over a minute press fire fast volleys

Fast repeated C fiber firing makes each volley land harder than the last. That is wind up. When the brake is weak it settles into central sensitization, and the line keeps climbing.
Pain score and sensitization over a minute

Right now

0.0pain score out of 10 quiet
Pain score bar

The controls

What the gate is doing

Chemistry at this gate

Chemicals opening and closing the gate