It Hurts Where? Ron Melzack reckoned the pain is in your mind


Where does it hurt?  You sure?   “It’s all in your mind."


That’s what Ron Melzack was trying to explain 35 years ago, but the revolutionary gate-control theory of pain he developed while at MIT with neurophysiologist Patrick Wall was met with scorn and derision.

"People didn't like the idea at all,” recalls Melzack, now one of the world’s leading authorities on pain.  “The papers that came out about our work for the first year or two set out to destroy the theory.”

The theory was deceptively simple. Melzack and Wall put forward that pain is not strictly cause and effect: how the brain perceives an injury, is less dependent on the stimulus than on past experience and other inputs in the brain itself.  The pain, in other words, is not in our nerves but in our heads.

The theory ultimately produced an explosive growth of research and resulted in experimental and clinical psychology becoming an integral part of pain research and therapy. 

That original paper in 1965, and a subsequent extension of the theory three years later, went on to be among the most cited neuroscience articles of all time.

Dr. Melzack equally went on to become one of the most widely recognized authorities in the neuroscience of pain.   He has been honoured with a Killam Prize and is an Officer of the Order of Canada and l'Ordre du Quebec. 

In April last year (2009), he was inducted into the Canadian Medical Hall of Fame, in recognition of his “outstanding contributions to medical science and the improved health and well-being of people everywhere.”

The gate-control theory is one of four major contributions in the field of pain made by Melzack, a native Montrealer. He also co-founded one of the world’s leading pain centres, developed a universally used process for measuring pain, and published a “neuromatrix theory of pain.”

A professor of psychology at McGill University, Melzack founded Canada’s first pain clinic at McGill in the 1970s, with the support of Dr. Joseph Stratford. 

In the four decades since, the clinic and Melzack’s career have both helped to establish McGill as a world centre for pain research and the high concentration of pain researchers and clinicians at McGill led to the creation of an expanded Pain Research Centre in 2002. 

This was renamed the Alan Edwards Centre for Research on Pain five years later to acknowledge the extraordinary contribution of the late Montreal businessman and philanthropist Alan Edwards to the funding of the centre.

Back in his post-doctoral days, Melzack recorded over 100 words to describe pain and, with the help of a statistician, he was able to obtain quantitative measures of each descriptor.

This led to his development in 1975 of the McGill Pain Questionnaire, now the most widely used method for measuring pain in clinical research worldwide and translated into over 20 languages.

By 1989, Dr. Melzack’s fascination with phantom limb pain led to a publication in 1989 of the “neuromatrix theory of pain”.  

He proposes that we are born with a genetically determined neural network that generates the perception of the body, the sense of self, and can also generate chronic pain, even when no limbs are present.

Today, Ron Melzack is a professor emeritus at McGill, still actively researching pain, and the honours continue. 

He is the recipient of the 2010 Grawemeyer Award in psychology and in late August, most fittingly on the eve of the 13th World Congress on Pain held in Montreal, he was honoured by his colleagues from around the globe.

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