Neuroanatomical Review of Visceral Pain

Abstract

Visceral afferent information is processed centrally by the nervous system. The central connections of these afferents are widespread. Although the encoding of visceral pain is still creating much debate, evidence exists for mechanisms of central sensitization and mechanisms of referred pain to somatic structures, leading to possible trophic changes in these structures.The autonomic nervous system innervates the viscera. As with the somatic nervous system, it too is vulnerable in certain areas to compromise, within the thoracic, abdominal and pelvic cavities for example. If the sympathetic nervous system is sensitized then alterations in sympathetic outflow could lead to trophic alteration in target tissue, as well as the maintenance of pain states.If, at a physical level, manual therapists are to evaluate these central and sympathetic changes that may take place due to sensitized visceral and sympathetic input in the generation and maintenance of pain, then a physical assessment of the visceral and supporting fascial network must be made in the management of chronic pain states.