Referred Pain

Referral (or superficialization) is one of the fundamental classifications of visceral pain. If a visceral sensation recurs or intensifies the pain evolves and will not be felt at a common location. The pain often is perceived in superficial somatic structures (i.e., skin, subcutaneous tissue, and muscle) of areas that differ according to the viscus and that are often remote from the primary source of the stimulus (Fig. 24.1 - right). Now, the sensation becomes sharper, qualitatively more similar to pain of somatic origin, much better defined and localized, and is no longer accompanied by marked autonomic phenomena. Two types of referred pain from viscera have been described: (1) without hyperalgesia and (2) with hyperalgesia.

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