Montreal pain researcher joins Canadian Medical Hall of Fame

Martin C. Barry

June 2009

Dr. Ronald Melzack’s interest in studying pain started off as a scientific problem, much like studying vision or hearing. “It was just plain curiosity about pain,” he said about his recent induction into the Canadian Medical Hall of Fame.

It wasn’t until he was a postdoctoral fellow in medical school at the University of Oregon and “met all kinds of people in terrible pain that could not be treated” that the study of chronic pain became his lifelong passion.

Last month during a ceremony in Montreal, Melzack was inducted into this country’s medical hall of fame along with four other individuals recognized for winning their place in Canadian medical history. Located in London, Ont., the hall of fame is dedicated to honouring Canadians who have changed the world’s health care landscape.

“I’m thrilled,” Melzack said of becoming a member of the Hall of Fame that has honoured such medical pioneers as Banting and Best, known for their discovery of insulin. Melzack’s pioneering research into pain mechanisms and pain control spans more than a half century and has had a major impact on every field of medicine dealing with patients who suffer from pain, in particular chronic pain.

Ronald Melzack is “thrilled” with his induction into the medical hall of fame Photo: Martin C. Barry

Born in Montreal, Melzack first became interested in the connection between pain and environment at McGill when he studied the reactions of dogs to pain stimulus. For the first six months of their lives, one group of dogs was raised in kennels while the others were raised in homes with small children. The dogs who had no interaction with children reacted more to “being pinched.”

A leader and visionary in his field, Melzack made four major contributions in the field of pain.

With the support of Dr. Joseph Stratford, Melzack co-founded the first pain clinic in Canada known as the McGill University Montreal General Hospital Pain Center where he served as research director from 1974 to 2000. The clinic is known to be one of the best organized centres for pain treatment in the world.

In 1965, Melzack developed the gate-control theory of pain in collaboration with neurophysiologist Dr. Patrick Wall.

The theory produced an explosive growth in research and resulted in experimental and clinical psychology becoming an integral part of pain research and therapy. Then in 1968, Melzack published an extension of the gate theory, proposing that pain is a subjective, multidimensional experience produced by parallel neural networks.

Another breakthrough was the development in the mid-70s of the McGill Pain Questionnaire, now the most widely used method worldwide for measuring pain in clinical research. It was developed during Melzack’s postdoctoral years, when he recorded more than 100 words to describe pain. Then with the help of a statistician, he obtained quantitative measures for each descriptor.

His fascination with phantom limb pain led to the publication in 1989 of the “neuromatrix theor y of pain.” In it 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.

The world’s knowledge of pain might be a different today if Melzack had chosen to pursue a different path. While working toward his postgraduate and doctoral degrees during the early 1950s, his brother, Louis, was establishing the foundations of the Classic Book Shops chain that would eventually become one of Canada’s leading retailers of paperbacks.

“They wanted me to go into the book business and I didn’t want to,” he said. “By this time I was really hooked on psychology. Louis thought an academic life was nice, but I would never really earn a living.”

That’s when Dr. Victor Goldbloom, who was then a young pediatrician and a regular customer at one of the book shops, advised the family that they should give the future Dr. Melzack their full support. Goldbloom remains in touch with him to this day.

Mrs. Hull, whom Melzack had met in the course of his postdoctoral research, was instrumental in developing the McGill Pain Questionnaire. A diabetic, she experienced phantom pain following the amputation of her legs. “She would get throbbing pain, burning pain, crushing, all these adjectives,” Melzack said. “And then I began to write down all these adjectives. And then other patients would use other adjectives – a variety of them.”

Pain researchers are getting a better understanding of a condition known as fibromyalgia, according to Melzack. “The stress system is highly involved in it,” he said. “We know that there are trigger points, sensitive areas in the body where you’re likely to find the same pattern in virtually everybody, which means that these muscles seem to be under some strange tension for reasons not known. It produces depression and is activated by depression. But now there’s so much more research on it and it’s become so prevalent.”