24/10/2025
Massage therapy interacts with several mechanisms described in the gate control theory.
First, massage stimulates large, fast-conducting A-beta afferents that respond to touch and pressure signals. These signals compete with the smaller, slower afferents (A-delta and C fibers) at the first synaptic gate in the spinal cord.
Of course, this would depend on the type of massage and the receipient's expectations and experience with massage.
When non-painful stimuli dominate, they “close the gate,” reducing the amount of nociceptive input that is passed to the brain. (This goes back to why rubbing or touching an injured area can dull the pain.)
Beyond the spinal cord, massage influences descending pathways from the brain that regulate pain. Pleasant touch and relaxation activate the periaqueductal gray, nucleus raphe magnus, and other brainstem regions are involved in descending inhibition. These areas release serotonin, noradrenaline, and endogenous opioids, which suppress nociceptive transmission.