Somatic Pain vs Visceral Pain: What’s the Difference?
The term “Visceral” refers to the physical organs or bodily systems that are directly involved with your body’s functioning. These include, but are not limited to: Heart, Lungs, Kidneys, Liver, Stomach and intestines. The word “Somatic” means pertaining to the whole person; it does not necessarily refer to any one organ or system. The terms “nervous” and “neuropathic” are often used interchangeably, however they have different meanings. Neuropathy is a condition in which there is damage to the nerves themselves. Nerves do not function properly. They may become damaged due to trauma (such as from a car accident), disease (such as multiple sclerosis) or other causes. A nerve injury can cause a variety of symptoms including numbness, tingling, weakness or paralysis. Symptoms may vary depending upon the location where the nerve is injured. Nerves in the arms or legs will cause different symptoms than nerves in other parts of the body. Nerves that are damaged may begin to regenerate on their own or they may not. Medications may help to improve nerve function and sometimes surgery is required to repair specific types of nerve damage in the arms, legs or other parts of the body.
Neuropathic pain vs somatic pain: What’s the difference?
A common misunderstanding is that the terms “neuropathy” and “neuropathic pain” are interchangeable. This is not true. While “neuropathy” does refer to a medical condition in which there is damage to nerves (see above definition), it is also a term used to refer to the pain that results from nerve damage. This is referred to as “neuropathic pain”. True neuropathic pain and its sensations may be difficult to describe or even explain. It is not limited to a specific part of the body (vs. somatic pain, such as arthritis, which is tissue-based pain that is located in a specific part of the body). Neuropathic pain most commonly results from damaged nerves, however it can also result from diseases that affect the brain (central nervous system) such as multiple sclerosis or other degenerative disorders. Other sources of neuropathic pain may result from direct injury or trauma to nerves. In some cases, the cause of the nerve damage is unknown.
What are some common symptoms of neuropathy?
The most common symptoms of peripheral neuropathy (nerve damage that occurs outside of the brain and spinal cord) include numbness and a loss of feeling in the affected body part(s). Less commonly, burning pain, aching, sharp or electric-like sensations may be present. If the autonomic (involuntary) nervous system is involved, symptoms such as dizziness, fatigue, changes in heartbeat, blurred vision or sexual dysfunction may occur.
What are the causes of peripheral neuropathy?
The following are some of the most common causes of peripheral neuropathy:
Diabetes (high blood sugar) is by far the most common cause of neuropathy. This is due to the fact that high blood sugar damages and destroys blood vessels, including those in the nerves. High blood sugar can also cause chemical changes within the nerves themselves.
Poorly controlled high blood pressure is another major cause of nerve damage.
Alcoholism damages the blood vessels, including those in the nerves.
Vitamin B12 deficiency can lead to damage to the peripheral nerves.
HIV and other infectious diseases may directly (or indirectly) damage peripheral nerves.
Genetic disorders such as Charcot-Marie-Tooth disease or Refsum disease may cause peripheral nerve damage.
Following certain surgeries, injuries or other trauma.
Who is at risk of developing peripheral neuropathy?
The following groups of people are most at risk:
Anyone with poorly controlled diabetes or high blood pressure.
People with a family history of diabetes, high blood pressure, peripheral neuropathy or Charcot-Marie-Tooth disease.
People with HIV or similar diseases.
People who have had chemotherapy or radiation treatment.
What is the treatment for peripheral neuropathy?
The specific treatment regimen will be determined by your doctor based on the following factors:
Your age, overall health and medical history.
The severity of the condition.
Your tolerance for specific medications, procedures or therapies.
Expectations for the course of the condition.
Your opinion or preference.
Treatment may include:
Pain medication. This is usually the mainstay of treatment for all types of peripheral neuropathy. The use of anticonvulsant drugs (to control nerve pain) and antidepressant drugs (to control burning pain) are especially important.
Managing any illness, such as diabetes or alcoholism, that may be causing the neuropathy.
Physical therapy to increase strength and range of motion of affected areas.
Occupational therapy to assist with techniques that help improve daily functioning.
Special footwear or other devices that may be helpful.
If you are a smoker, quitting smoking is very important. This is because smoking constricts blood vessels and impairs circulation — both of which are needed in the peripheral nervous system.
When should I call my doctor?
If you are taking any anticoagulant or antiplatelet drugs (such as heparin, warfarin, clopidogrel or dipyridamole), call your doctor immediately if you experience any of the following symptoms:
Bleeding that is unusual for you or that you can’t stop, even with a finger prick.
Pins and needles sensations in the hands or feet.
Changes in walking or other motor skills.
Numbness, tingling or weakness in the hands or feet.
Trouble speaking, swallowing or breathing.
Problems with your eyes (such as blurred vision) that last for more than a few hours.
Also let your doctor know if you have any severe pain in your legs, feet or hands, even if you haven’t been diagnosed with peripheral neuropathy. The cause may be something other than neuropathy.
If your doctor feels that you are at risk of bleeding, they will probably order blood tests on a regular basis to make sure the blood-thinning drugs are kept at an optimal level.
PLEASE NOTE: The information found on MedHelp is intended to enhance awareness of medical conditions and medications for yourself or those you care about. Never substitute information on the internet for professional medical advice. If you think you may have a medical emergency, call your doctor or 911 immediately.
Last updated: September 5, 2013
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Sources & references used in this article:
Myofascial and visceral pain syndromes: visceral-somatic pain representations by RD Gerwin – Journal of Musculoskeletal Pain, 2002 – Taylor & Francis
Visceral pain by F Cervero, JMA Laird – The Lancet, 1999 – Elsevier
The effects of intrathecal neostigmine on somatic and visceral pain: improvement by association with a peripheral anticholinergic by GR Lauretti, ICPR Lima – Anesthesia & Analgesia, 1996 – journals.lww.com
A comparison of visceral and somatic pain processing in the human brainstem using functional magnetic resonance imaging by P Dunckley, RG Wise, M Fairhurst… – Journal of …, 2005 – Soc Neuroscience
Bedside testing for chronic pelvic pain: discriminating visceral from somatic pain by J Jarrell, MA Giamberardino… – Pain research and …, 2011 – downloads.hindawi.com
Attentional modulation of visceral and somatic pain by P Dunckley, Q Aziz, RG Wise, J Brooks… – …, 2007 – Wiley Online Library