Objectives: To review literature that pertained to the Johansson/Sojka hypothesis that positive feedback loops in the gamma-motor system are responsible for chronic muscle pain and increases in muscle tone.
Data sources: Articles were selected from MEDLINE searches and from manual library searches.
Results: Normal, static, and ischemic muscle contractions and/or chemical mediators of inflammation excite intramuscular groups III and IV chemonociceptors. In groups III and IV, afferent firing stimulates gamma-motorneurons, which causes the firing of Ia and II muscle spindle afferents and increased extrafusal resistance to stretch (muscle tone). Some criticism of the involvement of the gamma-motor system in muscle tone was found to be dated or based on data from noncomparable research. Most of these studies (pro and con) were performed on prepared test animals, and the results may or may not translate to human subjects.
Conclusions: There exists a sizable body of research that establishes a link between the activation of intramuscular chemonociceptors, increased gamma-motor activity, and increased Ia and II spindle output, as proposed by the hypothesis of Johansson and Sojka. However, because of the lack of sufficient data on human subjects, their hypothesis should not be considered proved. Further research into the effects of metabolites of muscle contraction and their effects on muscle tone is recommended. Research into subluxation/joint dysfunction in light of the Johansson/Sojka hypothesis is recommended.