Table of Contents Author Guidelines Submit a Manuscript
Pain Research and Management
Volume 5 (2000), Issue 3, Pages 197-204
http://dx.doi.org/10.1155/2000/586814
Tribute to Ronald Melzack

The Determinants of Pain Revisited: Coordinates in Sensory Space

Kenneth L Casey1 and Jürgen Lorenz1,2

1Department of Neurology, University of Michigan, Neurology Research Laboratory, Veteran’s Affairs Medical Center, Ann Arbor, Michigan, USA
2Department of Physiology, University of Michigan, Neurology Research Laboratory, Veteran’s Affairs Medical Center, Ann Arbor, Michigan, USA
3Institute of Physiology, University of Hamburg, University Hospital Eppendorf, Hamburg, Germany

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ron Melzack recognized that the gate control hypothesis of 1965 was incomplete. This led to the publication of a book chapter that would someday be referred to by some as 'the classical view' of pain mechanisms. However, this paper presented some conceptual problems for research on pain mechanisms by using the term 'motivational-affective' to define a determinant of pain. To facilitate research and eventually improve practice, the determinants of pain need to be identified and quantified more clearly. In the present article, three critical dimensions of sensory experience that define pain and related sensory experiences are identified: sensory salience, affect and motivational dominance. The authors show that each of these dimensions can be measured and are mediated by specific neurophysiological mechanisms. Pain and other somatic sensations emerge from the conjoint actions of these neurophysiological systems and fall within unambiguously defined coordinates of the three-dimensional sensory surface that they form. Pain mechanisms would be better understood if research focused on the physiology and psychology of these fundamental sensory dimensions and included a wider range of sensory systems.