Diane Jacobs, PT:

There is no such thing as a pain receptor.”
True. There are (in the body) only nociceptors. Nociception and pain are two different things.

“The brain does not receive pain signals.”
True. The brain generates the perception of pain.

“Pain is created by the brain as a protective response to perceived threat.”
Exactly. See neuroscience. Period.

Boris, if you think you can fix broken tissue with your bare hands, through a thick layer of cutis/subcutis, full of neural array, there to protect the brain’s thermoregulatory organ (Where Mrs. Jacobs found such new organ? by JMS) and everything beneath it from external deformation, without engaging the brain itself, especially since epidermis, sensory receptors, nerves and brain all come from ectoderm, then, my friend, you are well and truly self-deluded and are going about blithely deluding others.

If you admit you are treating a person’s pain with your hands, then join the club – that’s all anyone else does, either. Via the perfectly scientifically acceptable mechanism of stress reduction.

Tim Irving, DC, LMT:

I am also a massage therapist… If you’re stopping at Melzack’s gate control theory, regarding your understanding of pain, you’re 40 years behind the curve, Melzack himself updated his thoughts in the 1990’s to the neuromatrix theory which supersedes the gate control theory and is much more in line with current pain biology evidence.

There are no such things as “pain impulses”. Melzack and Wall DID NOT substantiate the gate control theory, they moved past it with the neuromatrix theory.

Jason Erickson:

4 things every therapist should know:

* There is no such thing as a pain receptor.
* The brain does not receive pain signals.
* Pain is created by the brain as a protective response to perceived threat.
* Pain science is a subdiscipline of neuroscience that has its own peer-reviewed journal(s), its own international association and conferences, and a massive amount of ongoing research and clinical work being done.

Alicia Sanvito, LMT:

Are you aware of what’s going on it modern pain science? Remember Gate Theory by Melzack and Wall? Are you aware of their more recent pain theory, the Neuromatrix Theory of Pain? Do you still think that pain comes from the tissues? Do you understand what is meant when it is said that pain is a sensation generated by the brain?

This paper, titled simply Pain, by Melzack and Katz, covers the history of our understanding of pain up to the present and describes current thinking on pain. It’s not easy reading but don’t be intimidated by it. Really, if you take it just a little at a time, it’s not that difficult. And there’s so much in it that if you only understand 1% the first time, you’ll still get a lot because there is so much in it.

If you work with clients in pain, this will help to update your understanding of how pain works and the role of the brain in the experience of pain.

The mislabelling of nociceptors as “pain receptors” is not my opinion. It’s what the pain scientists say. You’ll have to take it up with them. Patrick Wall is one of the leading pain scientists in the world. Patrick Wall and Ronald Melzack were the authors of the Gate Theory of Pain.

There are many times, for instance, that soldiers get shot in battle and don’t even know they are wounded until they are off the battlefield. Everyone has examples in their lives of times when they got cut or injured and didn’t realize it until they saw blood. Why? Because their brain ignored it.

Rob Haddow, LMT:

Understanding that the pain as perceived is based on a series of correlated messages and not pain specific receptors has actually fundamentally changed how I look at a number of problems.

Dianna Linden, LMT:

Pain is conceptual. It is an interpretation by the brain.

Meaghan Anderton:

The topics of argument:

1. “All pain is generated by the brain” I agree
2. “The brain does not receive pain impulses” I agree, the body sends signals to the brain, and the BRAIN decide what we feel is painful or not.
3. “There is no such thing as a pain receptor” I agree, it’s an over simplification that hasn’t done us any good. The terms nociceptor and pain receptors should not be used interchangeably.

Dear JMS,

I really enjoyed your 4-part article on Trigger Point Therapy, back in one of the 2009 issues. In the 3d part I noticed that the Neuromatrix Theory of Pain wasn’t even mentioned, instead all the information in the article talked only about the Gate-Control Theory of Pain.

From what I have read in other sources, the Gate Control Theory of Pain is an outdated concept. Even its authors cancelled it in favor of the more modern Neuromatrix Theory. I was surprised that I didn’t find this information in your Journal. Was there a reason for this?

Cathy Tanning, LMT

Hello there,

I am wondering what JMS thinks regarding the Neuromatrix Theory of Pain in relation to the original Gate Control Theory of Pain? Thank you for your publication! I enjoy your articles 🙂

J. B.


I am curious about JMS‘s opinion on Neuromatrix Theory of Pain.

R. Dawling, CMT

Dear JMS!

My physiology teacher mentioned that according to the latest research, our pain is generated by the brain itself. His words resonated with me because I have always believed in the brain’s healing powers. Would JMS be interested in reviewing the project paper I wrote for my physiology class on this topic? Looking forward to hearing from you!


Category: Medical Massage