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Nociception Affects Motor Output: A Review on Sensory-motor Interaction With Focus on Clinical Implications

Nijs, Jo PT, MPT, PhD*,†,‡; Daenen, Liesbeth PT, MSc*,†,§; Cras, Patrick MD, PhD§,∥; Struyf, Filip PT, MSc*,†; Roussel, Nathalie PT, MPT, PhD†,§; Oostendorp, Rob A.B. PT, MPT, PhD

doi: 10.1097/AJP.0b013e318225daf3
Review Article

Objectives 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.

Methods Narrative review.

Results 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.

Discussion 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:

Received May 31, 2010

Accepted May 24, 2011

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.