Visceral Pain

What is visceral pain?

Visceral pain involves your visceral organs — the ones in your chest, abdomen and pelvis — and the tissue that covers them. If something goes awry in your heart, lungs, bladder, reproductive organs or digestive system organs, your body will alert you by causing you to feel pain.

But not all pain feels the same. The pain you feel during a finger prick for a blood draw is different from the visceral pain you experience from a bladder infection, for example.

Visceral pain can feel both deep down and hard to pinpoint, even when there’s no denying the unpleasant feeling that’s there.

What does visceral pain feel like?

Describing any pain is tricky because everyone experiences it differently. Everyone has their own perception of when pain feels “mild,” “moderate,” or “severe.”

Generally, visceral pain feels like it’s deep inside your torso and spread out. Visceral pain is typically more dull than sharp, more aching than stabbing. It’s more vague (and harder to describe) than specific. But this isn’t a hard and fast rule.

Some of the words people use to describe their visceral pain include:

• Deep.
• Spread out (diffuse).
• Crampy.
• Achy.
• Squeezing.
• Gnawing.
• Dull.
• Pressure.
• Persistent.

When it comes to the pain threshold, the experience of visceral pain isn’t always equal to the injury. For example, minor tissue damage may feel excruciating while a major injury may not feel as painful. It depends.

Where is visceral pain felt?

One reason healthcare providers often describe visceral pain as vague is because, although you usually feel it in the trunk of your body, it’s hard to pinpoint the exact spot where the pain is coming from. Instead, your brain may only recognize the general problem area, like your chest or abdomen.

Sometimes, your brain can’t map the pain onto the part of your body where an organ or tissue is damaged or under stress. Pain that’s located in one place but perceived in a different place is called referred pain.

For example, stomach ulcers usually cause a gnawing visceral pain in your abdomen, but some people feel the pain in their chest instead.

When it comes to visceral pain, the sensations may not offer up enough specifics to clue you in on what’s wrong. You may have to “trust your gut” and just know that something (in general) is off — and see a healthcare provider.

What’s the difference between visceral pain and somatic pain?

The nerves in your skin, muscles, joints, bones and subcutaneous tissue (the tissue layer beneath your skin) cause somatic pain. There are more concentrated nerves in this tissue. This means that the pain usually feels sharp and local instead of dull and spread out (as with visceral pain).

Imagine the difference between a stomachache and a paper cut (somatic pain). While a stomachache usually feels like lingering, dull discomfort throughout your belly, a papercut feels like sharpness at the exact spot where the paper tore the skin. Even if you couldn’t see the blood or the cut, your brain would still know where the tissue was damaged.

What symptoms happen alongside visceral pain?

Signs and symptoms that typically accompany visceral pain are what healthcare providers call “nonspecific.” They’re changes in your body that indicate an issue but aren’t especially helpful when it comes to identifying the specific condition causing your pain. Symptoms that sometimes accompany visceral pain include:

• Nausea & vomiting.
• Pale skin (pallor).
• Sweating.
• Changes in your heart rate, body temperature or blood pressure.

Many people with long-term (chronic) visceral pain also have a mental health condition, like anxiety or depression. This doesn’t mean that these conditions cause visceral pain or that visceral pain causes mental health conditions. Researchers continue to study the relationship.

In the meantime, we know that, at least sometimes, there’s a connection. For example, people with anxiety often describe the unpleasant experience of feeling their stomach churn. People with depression may describe sensations they’re carrying deep inside their bodies as “anguish,” an emotion that captures the intersection between physical and psychological pain.

What is an example of visceral pain?

Examples of visceral pain include:

• The painful menstrual cramps you may have during your periods.
• Pain in your abdomen, pelvis, sides or low back when you have a urinary tract infection (UTI).
• The pain or feeling of fullness that happens with Crohn’s disease.

In all cases, your brain perceives changes in your body’s visceral organs — whether from infection, inflammation or even a normal monthly bodily process — as something unpleasant happening deep inside you.

What causes visceral pain?

Think of visceral pain as your nervous system sounding the alarm that there’s been a change that needs attention.

You have pain receptors (nociceptors) throughout your body, including your visceral organs, that detect changes in your body. They notice signs that something’s wrong, including:

• Increased pressure.
• An extreme change in temperature.
• A chemical change (usually a sign of inflammation).

Nociceptors send signals to your brain that you perceive as pain.

Your nociceptors are responsible for the (oftentimes) dull and spread-out feeling that’s associated with visceral pain. You have fewer nociceptors in your visceral organs than in parts of your body where pain feels more pronounced and sharp (for example, your fingertip). They’re more spread out, too. Your brain isn’t as precise in mapping the pain as it is in parts of your body with more nociceptors that are closer together.

What body changes cause visceral pain?

Your body sounds the alarm when a visceral organ has experienced:

• Injury.
• Infection.
• A blockage.
• Inflammation and swelling.
• Bleeding or slowed blood flow.
• Growths (including cancerous and noncancerous masses).

What conditions cause visceral pain?

Most any condition that impacts a visceral organ can cause visceral pain. These include diseases that affect your heart, lungs, GI tract and reproductive organs. Some conditions known to cause visceral pain include:

• Appendicitis.
• Bladder inflammation.
• Bowel obstruction.
• Cancer.
• Cholecystitis.
• Colitis.
• Endometriosis.
• Heart attack.
• Indigestion.
• Inflammatory bowel disease (IBD).
• Irritable bowel syndrome (IBS).
• Kidney infection.
• Pancreatitis.
• Stomach ulcers.
• Urinary tract infection.

How is visceral pain treated?

The most important part of treatment involves addressing the underlying issue that’s causing the pain. Remember that pain is your body’s warning system. It lets you know that you need to act to find out what’s gone wrong and fix it, if possible. Dulling the pain can mask the problem.

Your healthcare provider can recommend ways to eliminate or manage the pain in the meantime.

In some cases — as with functional gastrointestinal (GI) disorders — you have symptoms, but healthcare providers can’t identify a clear cause. In that case, treatment may focus primarily on pain management and relieving other symptoms.

Medications

Medicines for visceral pain include:

• Over-the-counter (OTC) medications. Your healthcare provider may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen or naproxen sodium. They may recommend acetaminophen (Tylenol®).
• Prescription medications. Prescription medications include medicines for nerve pain, like gabapentin and pregabalin. Your healthcare provider may prescribe opioids if your pain is moderate to severe. They’ll work with you closely to prevent the addictive side effects associated with this type of medication.
• Injections. You may need an injection of medicine directly into your tissue if other pain management options haven’t worked. Medications include lidocaine and capsaicin.

Therapy

You may need to work with a therapist who can help with pain relief. Depending on your pain, you may need:

• Physical therapy.
• Osteopathic or chiropractic care.
• Psychotherapy.
• Acupuncture.

A note from Cleveland Clinic

Pain in your torso that’s dull, diffuse and deep down may be a sign there’s an issue with one of your visceral organs — your heart, lungs and reproductive or digestive system organs. Although pain is an unpleasant experience that warrants treatment, it’s even more important to get to the bottom of what’s causing your body to sound the alarm bells. Work with your healthcare provider to learn what’s causing any kind of pain you’re experiencing, including visceral pain.