Raj N. Sureja, MD
As an Interventional Pain Management Physician, I treat patients who suffer from chronic pain. Pain is a very complex phenomenon, and it involves not only physiological aspects of the body, but also emotional, psychological and psychosocial as well. As with medical conditions and diseases, there are different types of pain, from different sources and causes, pain that is experienced differently and treated differently. In this article, I am going to discuss visceral pain, what it is, its symptoms, how I diagnose it and how I go about treating it effectively for my patients.
The Oxford Language Dictionary defines the word viscera as “the internal organs in the main cavities of the body, especially those in the abdomen, e.g., the intestines”. The word visceral is defined as “felt in or as if in the internal organs of the body”. Visceral pain (VP) is pain that seems to be either coming from a person’s internal organs, organ cavities, or from deep within their body. Perhaps the patient can pinpoint the pain, pointing directly to their heart, liver, or uterus. Maybe there is only a diffuse visceral pain in the general area of the abdomen. These descriptors are important clues for me to use in order to diagnose the root cause of the pain.
Visceral pain is usually accompanied by certain symptoms, but not always.
Typical symptoms seen along with Visceral Pain:
- Muscle spasms or cramping
- Emotional changes, impending sense of doom
- Feelings of gnawing, squeezing, dull aching, sickening pain
- Changes in vital signs, such as blood pressure and heart rate
- Referred pain elsewhere in the body
Menstrual cramps, giving birth to a child, irritable bowel syndrome and having a heart attack are all symptoms and manifestations of visceral pain, so you can see just how varied and extreme the pain may or may not be. Some diseases or temporary illnesses can produce excruciating pain, and some may cause only dull and irritating aches. Cancer might be to blame for the pain, but an idiopathic reason (meaning we don’t know) could just as easily be to blame for the pain.
Visceral pain is often the pain that sends patients to the physician or ER for diagnosis because it scares them into taking action. Depending on the severity of the pain, it is often treated with medications while a battery of diagnostic tests is run on the patient to determine what is causing their visceral pain. After ruling in or out infection, cancer, disease, poisoning or toxic exposure, myocardial events, etc., the patient will be referred to the appropriate specialist for follow-up care.
I may have patients with chronic visceral pain referred to me for management and treatment who have exhausted other treatments, such as medications, and who are looking for interventions, like nerve blocks, radiofrequency ablation and neuromodulation (spinal cord stimulation). These interventions have been shown effective in helping to reduce the visceral pain of patients who have not had success with opiates or other pain-relieving medications.