Reappraisal of a proposed neurophysiological mechanism for the relief of joint pain with passive joint movements

Abstract

Selective stimulation of large diameter joint neural units is a neurophysiological mechanism advanced for the diminished perception of pain obtained with therapeutic methods of passive movement of painful joints. Evidence from electrophysiological studies of normal joints of animals, indicates that passive movements are unlikely to selectively excite a significant proportion of large diameter joint afferents. Within range passive movements of inflamed joints are likely to stimulate predominantly small fibre joint nociceptors. In these respects, this method of peripheral nerve stimulation would be theoretically inappropriate for ‘closing the spinal gate’ to joint pain.