Visceral pain occurs during the activation of pain receptors known as nociceptors in the forensic abdominal and pelvic cavities. This is felt as an aching or cramping sensation that is diffused and difficult to localize. Often this pain is later felt on the surface of the body, a principle known as referred pain in which the pain is felt a lot sharper and easier to localize. The diffused localization of the pain is thought to be due to the relatively low density of nociceptive innervation in the viscera.
Visceral pain usually originates in places like the gallbladder, the cardiac muscle, the spleen, or the appendix. All of these places can have tissue damage and all of that can lead to a type of pain that feels dull in sensation and very poorly localized in the body. Also, it’s poorly localized in time which means it doesn’t have a sharp onset or a sharp offset.
How To Localize Visceral Pain?
The poor localization of visceral pain begins with a convergence between a deep visceral nervous structure (which can be any internal organ tissue) and a more superficial nervous structure such as skin.
You have virtually no ability to localize the pain but there is a basic topography. Take the thoracic for example. The thoracic viscera are going to end on neurons that are much higher in the spinal cord than the abdominal viscera. This is very important because a person cannot tell which organ it is that is injured. If there is any sort of amorphous, deep, and blunt pain, it can mean that there’s an instance of internal tissue damage and the person may need medical attention.
Visceral pain usually undergoes two phases –
- True visceral pain – Initially visceral sensations can present as true visceral pain. This first phase is different because the pain is not felt on the surface of the body, rather this often is described as a dull sensation localized deep in the body regardless of the origin of the pain. The perceived location is consistently in the mid line, mostly at lower sternum and upper abdomen. This mid line localization is thought to be due to the organs receiving autonomic response from both sides through the sympathetic nerves. In most cases, true visceral pain is accompanied by autonomic phenomenas including nausea, vomiting, profuse sweating, changes in heart rate, fluctuations in blood pressure and body temperature and diarrhea.
- Delayed visceral pain – When the pain gets more acute, it triggers referred pain. This pain is felt at the surface level and often needs instant medical attention. furthermore emotional responses such as anxiety and anguish also can be experienced at this level.
When it comes to visceral pain, certain kinds of movements, lifestyles of illnesses can trigger visceral pain. As this kind of pain is generated internally, there is no way of knowing exactly what can be a trigger until it happens. Some common triggers include –
- Blockage – It can happen when an internal organ gets hurt, damaged or somehow swollen. Inflammation can cause blood clot, tissue or nerve damage which can lead to severe pain and organ claustrophobia.
- Menstrual cramps – Women are the most affected by visceral pain and the most common cause of it is menstrual cramps. During periods a prolonged pain can be caused by internal hemorrhage or clotting in the uterus region. Sometimes the pain feels unbearable and needs physician consultation.
- stretching of the organs – Sometimes an organ can be overly stretched over time or due to a sudden movement. This can lead to tearing of the muscles, nerves or arteries.
- Decreased blood flow – This happens when a blood vessel is clogged by fat or the volume of blood present in the body decreases over time. Decrease blood flow can cause heart attack, severe headache, senselessness, dizziness or stroke.
These causes are sometimes the result of an underlying physical or mental disorder such as:
- Inflammatory bowel disease (IBD) – It results in persistent diarrhoea, abdominal pain or rectal bleeding.
- Tumors – There are some benign and malignant tumors which can cause organ swelling, stretching or failure, particularly when it is concentrated in the pelvis or abdomen.
- Irritable bowel syndrome (IBS) – In this phenomena, patients are often not in control of their bowel movement. Sometimes it can cause internal bleeding or swelling.
- Cancer – This needs no introduction as it is life threatening. Cancer originates from malignant tumors or narcotic tissues which can lead to agonizing pain.
- Pancreatitis – Pancreas is the source of pain in this scenario. Pancreatitis affects the lower part of pancreas. Often times it gets swollen and a burning sensation in felt in the tummy.
- Indigestion – It happens because of many reasons, but the effect is the same. Pain in abdomen, difficulty during bowel movement and swelling of rectum are some of the effects of it.
- Interstitial cystitis (IC) – It is often mistaken for Urinary Tract Infection (UTI) whereas in this case there is no infection. It is also known as painful bladder syndrome and the symptoms rightfully justify the name.
- Peritonitis – This is another life threatening disease and very infectious. It happens when the abdominal wall or the covering outer layer of intestine gets damaged, holed or leaked. This is very painful and requires immediate intensive medical care.
Final words :
In conclusion, visceral pain is caused in the internal organs and a diffused, dull sensation is felt in the midline of the upper abdomen. Most of the time this pain is unrecognized and often mis-linked with somatic pain. Usually, visceral pain is discovered along with autonomic phenomena that accompany this visceral sensation. On the other hand, if the pain is persistent, it will often be referred to the surface of the body for the phenomenon of referred pain and will resemble somatic pain. In both of the cases this problem can never be diagnosed properly, so which effects are triggering the pain is very important because they can be immensely helpful in diagnosing the source of the pain.
PainPathways is the first, only and ultimate pain magazine. First published in spring 2008, PainPathways is the culmination of the vision of Richard L. Rauck, MD, to provide a shared resource for people living with and caring for others in pain. This quarterly resource not only provides in-depth information on current treatments, therapies and research studies but also connects people who live with pain, both personally and professionally.
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