Pain Control by Proprioceptive and Exteroceptive Stimulation at the Trigeminal Level

Abstract

The Gate Control Theory of pain, published more than half a century ago to explain nociceptive modulation of peripheral sensory input, assumes inhibition of incoming nociceptive (pain) information produced by mechanical stimulation. To verify the presence of such a gate control mechanism at the level of the human trigeminal system, we evaluated the effects on pain sensation of a proprioceptive trigeminal stimulation induced by mandibular extension. We found that such a stimulation, applied for 7 min, was effective in increasing both the threshold and tolerance of tooth pain induced by electrical activation of dental nociceptors. Moreover the antinociceptive effect lasted for several minutes after the proprioceptive stimulus had ceased. We also tested whether an exteroceptive palatal stimulation superimposed on the proprioceptive stimulation would increase the effects on tooth pain perception of human volunteers. We observed that the exteroceptive stimulation significantly increased the antinociceptive effect induced by the sole proprioceptive stimulation. The physiological mechanisms and the possible implications of these observations are discussed.

The effect of joint position sense therapy on chronic shoulder pain with central sensitization

“…[27] Owing to complex neurological pathways, proprioception, and pain can interfere with each other through neurophysiological processing. [28] A previous study observed the effect of proprioception on pain control and found a significant increase in the antinociceptive effect induced by proprioceptive stimulation, [29] consistent with our study's findings, where the JPST group showed lower PPT values than the control group. Although pain management cannot directly result in improved motor performance in some respects, our study suggests that JPST could significantly improve shoulder motor function according to the DASH assessment by enhancing proprioception input of shoulder joints.…”

Mechanism, application and effect evaluation of nerve mobilization in the treatment of low back pain: A narrative review

“…[35][36][37] Most experts in the field agree that pain is regulated by the gate control theory, which is also supported by a diverse range of evidence, including animal studies, clinical trials, as well as physiological and biochemical experiments. [38][39][40] The gate control theory of pain was first proposed by Melzack and Wall in 1965 and has been widely accepted by the scientific community. [41] According to Melzack and Wall's gate control theory of pain, pain signals are transmitted from the periphery to the spinal cord via fine fibers, mainly A-delta and C-fibers.…”

Somatosensory Cortical Signature of Facial Nociception and Vibrotactile Touch Induced Analgesia

“…Thus, vibrotactile stimuli applied around the noxious stimulus-sensitive center reduce WDR neuronal responses to the nociceptive inputs through inhibition ( 2–4 ). In humans, touch mediated pain relief has been demonstrated for both the body parts innervated by dorsal root ganglia (DRG) neurons, as well as for orofacial regions innervated by trigeminal ganglion (TG) neurons ( 5 ). A quantitative study in humans, in which a painful laser stimulation was flanked by two touch stimuli at varying distances, showed that concurrent application of touch caused the subjects to rate the laser stimuli as less painful in a distance dependent manner, consistent with the receptive field properties of spinal WDR neurons ( 6 ).…”