title: Nociception affects motor output: a review on sensory-motor interaction with focus on clinical implications.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Human Physiology, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Belgium. Jo.Nijs@vub.ac.be
authors.forename: Jo
authors.initials: J
authors.lastname: Nijs
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Daenen
authors.forename: Patrick
authors.initials: P
authors.lastname: Cras
authors.forename: Filip
authors.initials: F
authors.lastname: Struyf
authors.forename: Nathalie
authors.initials: N
authors.lastname: Roussel
authors.forename: Rob A B
authors.initials: RA
authors.lastname: Oostendorp
mesh_terms: D000818:Animals; D001921:Brain / Q000503:physiopathology*; D006801:Humans; D008959:Models, Neurological; D009068:Movement; D009119:Muscle Contraction / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D059225:Nociception / Q000502:physiology*; D010146:Pain / Q000503:physiopathology*; D013116:Spinal Cord / Q000503:physiopathology*