Chapter 24 Referred pain from internal organs

Publisher Summary

This chapter describes “referred pain” as an expression used to indicate pain perceived in an area other than that in which the noxious stimulation takes place. It intends to provide an overview of the modalities of clinical presentation of referred pain from different viscera, also in relation to factors such as age and sex and to update on current knowledge in pathophysiological mechanisms, based on the outcome of a number of studies on visceral nociception both in humans and animals. It reviews that increased pain sensitivity and dystrophic changes taking place in the referred area may have a significant clinical impact per se, such as irrespective of the primary cause of their generation, as these changes can impair the normo-functionality of the somatic tissues for a long time after the original visceral insult. Finally, the chapter concludes that though the pathophysiology of these referred changes is still incompletely known, the setting up and employment of a number of both human and animal models of the condition in recent decades has allowed a considerable advancement in their understanding and will hopefully lead to a more effective control, mechanism-based rather than merely symptomatic, of visceral pain phenomena in the near future.