Research has provided us with an increased understanding of nociception-motor interaction. Nociception-motor interaction is most often processed without conscious thoughts. Hence, in many cases neither patients nor clinicians are aware of the interaction. It is aimed at reviewing the scientific literature on nociception-motor interaction, with emphasis on clinical implications.
Chronic nociceptive stimuli result in cortical relay of the motor output in humans, and a reduced activity of the painful muscle. Nociception-induced motor inhibition might prevent effective motor retraining. In addition, the sympathetic nervous system responds to chronic nociception with enhanced sympathetic activation. Not only motor and sympathetic output pathways are affected by nociceptive input, afferent pathways (proprioception, somatosensory processing) are influenced by tonic muscle nociception as well.
The clinical consequence of the shift in thinking is to stop trying to restore normal motor control in case of chronic nociception. Activation of central nociceptive inhibitory mechanisms, by decreasing nociceptive input, might address nociception-motor interactions.
*Department of Human Physiology, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel
†Division of Musculoskeletal Physiotherapy, Department of Health Care Sciences, Artesis University College Antwerp
‡Department of Physical Medicine and Physiotherapy, University Hospital Brussels
§Department of Neurology, Faculty of Medicine, University of Antwerp
∥Department of Neurology, University Hospital Antwerp, Belgium
¶Research Centre of Allied Health Sciences, Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, The Netherlands
The authors declare no conflict of interest.
Reprints: Jo Nijs, PT, MPT, PhD, Artesis University College Antwerp, Van Aertselaerstraat 31, B-2170 Merksem, Belgium (e-mail: Jo.Nijs@vub.ac.be).
Received May 31, 2010
Accepted May 24, 2011