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Somatic Pain vs. Visceral Pain

Overview

Fast facts

  1. Somatic pain is the pain you feel when you superficially injure yourself. For instance, you feel somatic pain when you cut yourself, burn your skin, or break a bone.
  2. Visceral pain is the pain you feel when your internal organs are injured or inflamed. This a deeper pain that is harder to pinpoint.
  3. Both types of pain can be treated by treating the underlying condition causing the pain.

Pain refers to perception of the body’s nervous system that tissue damage is occurring. Pain is complex and varies a lot from person to person. Doctors and nurses often classify pain into different categories, with two of the most common being somatic and visceral. Read on for some of the common symptoms, treatments, and underlying causes of each type of pain.

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Symptoms

Symptoms and identification

Somatic pain

Somatic pain occurs when pain receptors in tissues (including the skin, muscles, skeleton, joints, and connective tissues) are activated. Typically, stimuli such as force, temperature, vibration, or swelling activate these receptors. This type of pain is often described as:

  • cramping
  • gnawing
  • aching
  • sharp

Somatic pain is often localized to a particular area. It is constant and stimulated by movement. Pain in the pelvis, headaches, and cuts to the skin all fall under somatic pain.

Somatic pain is often divided into two forms. The first, called superficial pain, occurs when pain receptors in the skin, mucus, and mucous membranes are activated. Common, everyday injuries usually cause superficial somatic pain.

The second form of somatic pain is known as deep somatic pain. Deep somatic pain occurs when stimuli activate pain receptors deeper in the body including tendons, joints, bones, and muscles. Deep somatic pain usually feels more like “aching” than superficial somatic pain.

Additionally, somatic pain can be confined locally or spread across larger areas of the body depending on the extent of the injury.

Visceral pain

Visceral pain occurs when pain receptors in the pelvis, abdomen, chest, or intestines are activated. We experience it when our internal organs and tissues are damaged or injured. Visceral pain is vague, not localized, and not well understood or clearly defined. It often feels like a deep squeeze, pressure, or aching.

Causes

What are some causes for each type of pain?

Somatic pain

Because somatic pain occurs from a variety of sources, it has many different potential causes. These include:

  • a small or large injury to joints or bones
  • any trauma or cut to the skin
  • a fall or collision that damages connective tissues
  • a strained muscle due to excessive use
  • a bone fracture
  • diseases that affect connective tissues such as osteoporosis
  • cancers that affect the bones or skin
  • arthritis that leads to swelling in the joints

Visceral pain

Visceral pain occurs when there is damage or disruption to internal organs and tissues. Causes include the following:

  • injuries to internal organs, such as the gallbladder, intestines, bladder, or kidneys
  • damage to the core muscles or abdominal wall
  • spasms in the core muscles
  • acid indigestion
  • other digestive problems such as constipation
  • infections in the digestive and renal systems
  • problems in specific organs such as the pancreas or liver
  • cancer that affects internal organs such as stomach cancer
  • endometriosis
  • menstrual pain
  • prostate damage
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Risk factors

Risk factors

Generally, women are more likely to experience both types of pain. This is due to two main reasons. First, women generally have higher sensitivity to pain than men do. Second, females have a higher likelihood of developing conditions such as fractures, osteoporosis, and issues with the reproductive organs that cause these types of pain.

Genetics may also play a role in the perception of both of these types of pain. Typically, if you have more pain receptors, you will experience more pain. Mental health conditions such as depression and stress may contribute to a higher perception of pain as well.

Factors associated with specific painful conditions are also risk factors for pain. Examples include low calcium intake for somatic pain caused by osteoporosis and increased smoking for visceral pain caused by stomach cancer.

When to see a doctor

When should you see a doctor for pain?

Typically, both somatic and visceral pain will subside within a few days. However, if you experience severe pain or persistent pain for at least week, you should see your doctor. They will ask you about your symptoms, where the pain is, how bad it is, how often it occurs, and what affects it. When seeing your doctor, it is important to provide them with the following information:

  • how long you have had the pain
  • when you started experiencing the pain
  • the intensity of the pain
  • where you feel the pain
  • your medical history

They will then put your symptoms in the context of your medical history and other health problems you may have. Oftentimes, a doctor will also run objective tests such as lab analyses and physical exams.

After reviewing your symptoms and other factors, a doctor will provide you with a treatment plan. This may include seeing a specialist to deal with the underlying cause, such as orthopedist for joint pain or gastroenterologist for a stomach issue. They may also recommend that you see a pain management doctor.

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Treatment

Treatment

Pain is complex and highly subjective. Therefore, treating pain can be a bit tricky. Doctors treat both somatic and visceral pain by addressing the underlying cause(s) of pain. For example, if someone is experiencing osteoarthritis, a doctor might prescribe one of several medications to reduce symptoms.

Somatic pain

Doctors will often use drugs to treat somatic pain. Over-the-counter medications you can take include:

More severe forms of pain can be treated using prescription medications. Your doctor may prescribe medications like:

It is important to be very careful with these medications as they are addictive. Doctors, especially orthopedists and rheumatologists, may use injections to treat pain in the joints and bones.

Visceral pain

Doctors sometimes use pain-reliving drugs to treat visceral pain as well. However, because visceral pain is less defined and more spread out, it is harder to pinpoint the exact medication that will help. Additionally, some medications such as NSAIDs can cause stomach issues. As researchers learn more about visceral pain, new methods will be developed to treat it.

Lifestyle changes

Medication and treating the underlying source of pain is not the only way to manage symptoms of pain. Oftentimes, you can couple traditional medical methods with the following lifestyle changes to manage pain:

  • doing relaxing activities
  • good nutrition, especially for visceral pain
  • yoga
  • meditation
  • tai chi
  • physical therapy
  • keeping a journal where you can express your thoughts
  • low-impact exercises, such as swimming and walking
  • high-intensity exercise (with reasonable limits)
  • behavioral therapy
  • getting enough sleep
  • reducing or stopping smoking and drinking
  • acupuncture (with mixed evidence)
  • osteopathic manipulation therapy (OMT)

Remember: it is important to check with your doctor before engaging in some of these activities. For example, if you have knee pain caused by an injury, some exercises may not be wise.

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Takeaway

Outlook

Most visceral and somatic pain isn’t severe and will go away within a few days. If your pain is severe and or persistent, you should see a doctor. They will be able to give you a treatment plan that reduces pain by both treating the underlying cause and directly reducing the sensation of pain. Additionally, you can supplement your doctor’s treatment with a variety of home methods, assuming they do not negatively impact your health.

Article resources
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  • Ilicki, J. (2015). Safety of epinephrine in digital nerve blocks: A literature review. The Journal of Emergency Medicine49(5), 799-809. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/26254284
  • Rosenquist, R. W., & Vrooman, B. M. (2013). Chronic pain management. Morgan and Mikhail's Clinical Anesthesiology. McGraw-Hill Medical, New York. Retrieved from http://accessmedicine.mhmedical.com/content.aspx?bookid=564&sectionid=42800580
  • Sikandar, S., & Dickenson, A. H. (2012). Visceral Pain–the ins and outs, the ups and downs. Current Opinion in Supportive and Palliative Care6(1), 17. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22246042
  • Wesselmann, U., Baranowski, A. P., Börjesson, M., Curran, N. C., Czakanski, P. P., Giamberardino, M. A., ... & Traub, R. J. (2009). Emerging therapies and novel approaches to visceral pain. Drug Discovery Today: Therapeutic Strategies6(3), 89-95. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3020100/
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