Motor consequences of experimentally induced limb pain: A systematic review
Article first published online: 20 JUN 2012
© 2012 European Federation of International Association for the Study of Pain Chapters
European Journal of Pain
Volume 17, Issue 2, pages 145–157, February 2013
How to Cite
Bank, P.J.M., Peper, C.E., Marinus, J., Beek, P.J. and van Hilten, J.J. (2013), Motor consequences of experimentally induced limb pain: A systematic review. European Journal of Pain, 17: 145–157. doi: 10.1002/j.1532-2149.2012.00186.x
This study is part of TREND (Trauma RElated Neuronal Dysfunction), a Dutch Consortium that integrates research on epidemiology, assessment technology, pharmacotherapeutics, biomarkers and genetics on complex regional pain syndrome type 1. The consortium aims to develop concepts on disease mechanisms that occur in response to tissue injury, as well as its assessment and treatment. TREND is supported by an unrestricted grant from the Dutch Ministry of Economic Affairs (BSIK03016).
Conflicts of interest
There are no conflicts of interest.
- Issue published online: 9 JAN 2013
- Article first published online: 20 JUN 2012
- Manuscript Accepted: 17 MAY 2012
- Dutch Ministry of Economic Affairs. Grant Number: BSIK03016
Compelling evidence exists that pain may affect the motor system, but it is unclear if different sources of peripheral limb pain exert selective effects on motor control. This systematic review evaluates the effects of experimental (sub)cutaneous pain, joint pain, muscle pain and tendon pain on the motor system in healthy humans. The results show that pain affects many components of motor processing at various levels of the nervous system, but that the effects of pain are largely irrespective of its source. Pain is associated with inhibition of muscle activity in the (painful) agonist and its non-painful antagonists and synergists, especially at higher intensities of muscle contraction. Despite the influence of pain on muscle activation, only subtle alterations were found in movement kinetics and kinematics. The performance of various motor tasks mostly remained unimpaired, presumably as a result of a redistribution of muscle activity, both within the (painful) agonist and among muscles involved in the task. At the most basic level of motor control, cutaneous pain caused amplification of the nociceptive withdrawal reflex, whereas insufficient evidence was found for systematic modulation of other spinal reflexes. At higher levels of motor control, pain was associated with decreased corticospinal excitability. Collectively, the findings show that short-lasting experimentally induced limb pain may induce immediate changes at all levels of motor control, irrespective of the source of pain. These changes facilitate protective and compensatory motor behaviour, and are discussed with regard to pertinent models on the effects of pain on motor control.