Chapter 2 Clinical approach to visceral sensation

Procacci, Paolo; Zoppi, M.; Maresca, Marco

doi:10.1016/s0079-6123(08)62753-3

Cited by 54 publications

(37 citation statements)

References 9 publications

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“…Examples in which there is an interaction of the viscera with somatic tissues include somatic hyperalgesia [50,51] and trophic changes in tissue [52,53]. In the rat, intense stimulation of the intrauterine cavity is associated with neurogenic extravasation of administered dye in the region of the dermatomes innervating the pelvic [54].…”

Section: Visceral Causes Of Myofascial Painmentioning

confidence: 99%

Endometriosis and Abdominal Myofascial Pain in Adults and Adolescents

Jarrell

2011

Curr Pain Headache Rep

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Endometriosis and myofascial pain are common disorders with significant impact on quality of life. Increasingly, these conditions are being recognized as highly interconnected through processes that have been described for more than a century. This review is directed to this interconnection through a description of the relationships of endometriosis to proposed mechanisms of pain and chronic pain physiology; the clinical assessment of myofascial representations of this pain; and an approach to the management of these interconnected disorders.

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Section: Visceral Causes Of Myofascial Painmentioning

confidence: 99%

Endometriosis and Abdominal Myofascial Pain in Adults and Adolescents

Jarrell

2011

Curr Pain Headache Rep

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“…After a transitory phase in which visceral pain is perceived as a direct symptom, in fact, (the so-called "true visceral pain," always felt along the midline, whatever the viscus in question, accompanied by marked neurovegetative signs and emotional reactions), the sensation is "transferred" (and called übertragener Schmerz, ie, transferred pain, by the German authors) to somatic areas of the body wall, which differ according to the specific viscus and which are generally located within the relative metameric field [17,33,34]. In these areas, a condition of secondary hyperalgesia most often arises, especially if the algogenic condition of the internal organ reoccurs frequently or is prolonged; this may involve all three somatic tissues of the body wallskin, subcutis, and muscle-but is most often localized at the muscle level (referred muscle pain with and without hyperalgesia) [4,35•].…”

Section: Referred Muscle Pain From Visceral Structuresmentioning

confidence: 99%

Referred muscle pain: Clinical and pathophysiologic aspects

Vecchiet

Giamberardino

1999

Current Review of Pain

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Referred pain, that is, pain perceived in an area other than that in which the noxious stimulation takes place, is very frequent in the clinical setting. There are various forms of referred muscle pain from viscera and from somatic structures. Examples of the latter are referred pain from one muscle to another muscle (as in myofascial pain syndromes) and referred pain from joints (as in osteoarthritis of the knee). Whatever the origin of the symptom, a condition of secondary hyperalgesia very often takes place in the referred zones, together with trophic tissue changes. Referred muscle pain from viscera without hyperalgesia is explained on the basis of the convergence of visceral and somatic afferent fibers on the same central neurons. Referred muscle pain from viscera with hyperalgesia is not completely understood; it is hypothesized that it is due to both central (sensitization process) and peripheral (intervention of reflex arcs) mechanisms. Referred muscle pain from other muscles or from joints is not easily explained by the mechanism of "central convergence" in its original form, because in dorsal horn neurons there is little convergence from deep tissues. It has been proposed that convergent connections from deep tissues to dorsal horn neurons are not present from the beginning but are opened by nociceptive input from skeletal muscle, and referral to myotomes outside the lesion is due to a spread of central sensitization to adjacent spinal segments.

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“…Referred pain from visceral organs is the most important from a clinical point of view [9][10][11]. This type of pain is observed especially when an algogenic process affecting a viscus is intense and long-lasting or recurs frequently.…”

Section: Visceral Versus Deep Painmentioning

confidence: 99%