Visceral pain

Visceral pain originates from the internal organs in the thorax, abdomen or pelvis. It represents a major clinical problem and is more common than somatic pain. The internal viscera are innervated by the parasympathetic (craniosacral) and sympathetic (thoracolumbar) nervous systems. The physiology of visceral pain is poorly understood compared to somatic pain; however, it is well established that peripheral and central sensitization and dysregulation of the descending pathways contribute significantly. Pain originating from visceral organs is usually diffuse, dull, poorly localized and can be associated with phenomena such as referred pain, referred hyperalgesia, visceral hyperalgesia and viscero-visceral hyperalgesia. Treatment of visceral pain involves identifying and treating the underlying cause, if identifiable, and symptomatic pain management. Patient education and information play an important role in management in combination with pharmacological and non-pharmacological therapies.