There are two different types of pain that we experience in our bodies: visceral and somatic. Visceral pain is one that you feel in a specific organ, like your stomach, bladder, uterus, etc. Somatic pain mainly arises from the skeletal system, including bones, muscles, joints, skin, and mucous membranes (inside of your mouth).
Somatic and visceral nociceptive pain signals travel through different pathways to reach the spinal cord. Furthermore, visceral and somatic pain receptors differ in the central nervous system and are activated by different triggers.
Somatic pain is the most common type of pain people experience. It originates from stimulating pain receptors in skin tissues, muscles, joints, connective tissues, and bones. These connective tissue areas are usually affected by an underlying cause such as injury or pressure, which primarily causes somatic pain.
What Is Somatic Pain?
Somatic pain is pain stemming from tissue injury. It manifests in sensations ranging from aching to sharp, localized discomfort. While visceral pain results from damage to internal organs damage, somatic pain results from the activation of nociceptors in the peripheral nerves. It is more identifiable regarding location and is often characterized by its association with physical activity or injury.
Types of Somatic Pain
Somatic pain is classified as superficial, deep, acute, and chronic. Here’s what each of them means:
Superficial Somatic Pain
Superficial somatic pain occurs when pain receptors are in the body’s outer (superficial) layers. It is typically associated with injuries like cuts, scrapes, burns, and conditions like dermatitis and sunburn. The pain is often described as sharp or stinging and is usually localized to the injury site. Given the association, this kind of pain usually occurs in the common sites we injure or burn, such as the skin on our hands or feet or our knee joints.
Deep Somatic Pain
Deep somatic pain arises from the activation of pain receptors in deeper tissues. This includes areas affected by serious injury or strains. It involves deeper structures such as the muscles, tendons, ligaments, joints, and bones. This type of pain is often characterized by a persistent, dull ache or gnawing sensation of pain. Common causes include fractures, sprains, strains, and osteoarthritis. Unlike superficial pain, deep somatic pain may radiate or refer to adjacent areas of the body.
Acute Somatic Pain
Acute means something that lasts for a short duration. So acute pain is short-term pain that lasts from a few hours to 3 months. It usually occurs suddenly. This is the pain you suffer from a sudden injury like a pin prick or a burn. Acute pain usually remains localized to the area of injury but may extend in case of extensive injury.
Chronic Somatic Pain
Chronic conditions refer to something with a longer duration. Medically, a problem is considered chronic if it extends for more than 3 months. Such pain is usually caused by an internal problem like osteoarthritis or a severe injury such as a fracture, causing it to last for days. Chronic pain may involve multiple parts of the body at once or extend to other areas.
Causes of Somatic Pain
Somatic pain can result from a variety of sources, including traumatic injuries, overuse or repetitive strain of a part of the body, inflammatory conditions, and degenerative diseases. Anything that can damage your skin, bones, muscles, and joints can be a potential cause of somatic pain.
Common underlying causes of somatic pain include:
- Traumatic injuries: Falls, sports injuries, and accidents leading to fractures, sprains, or strains can induce somatic pain.
- Inflammatory conditions: Disorders like tendonitis, bursitis, and rheumatoid arthritis trigger inflammation in tissues, causing pain
- Degenerative diseases: Conditions like osteoarthritis and degenerative disc disease cause cartilage and tissues in joints to break down, resulting in chronic somatic pain.
- Repetitive strain injuries: Prolonged or repetitive activities, such as typing or lifting heavy objects, can strain muscles and tendons, causing chronic somatic pain syndromes like carpal tunnel syndrome and rotator cuff tendinitis.
- Burns: Burns can often cause significant damage to skin and cartilage, leading to intense somatic pain.
Diagnosis and Management
Diagnosing somatic pain involves a comprehensive evaluation of a person’s medical condition through a detailed history, physical examination, and diagnostic tests like X-rays, MRI, and CT scans. Management strategies are usually tailored to individual needs.
It can be something as simple as taking an over-the-counter medication or something more intense, such as surgery. Common approaches to somatic pain include:
- Pain medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, and muscle relaxants may provide relief from somatic pain. Sometimes, this can be the only treatment you need.
- Physical therapy: Exercise programs, manual therapy, and modalities like heat and cold therapy can help significantly. They can improve flexibility, strength, and function while reducing pain.
- Interventional procedures: if conservative treatment options aren’t helpful for severe pain, you might need some extra help. This can include injections, such as corticosteroids, trigger point injections, and nerve blocks that target specific areas of pain to alleviate symptoms.
- Lifestyle modifications: Ergonomic adjustments, proper body mechanics, and activity modification help prevent exacerbation of somatic pain and promote healing.
- Psychological interventions: Cognitive-behavioral therapy (CBT), relaxation techniques, and stress management strategies address psychological factors contributing to somatic pain perception.
What Is Psychosomatic Pain?
Psychosomatic pain refers to physical pain or discomfort caused or influenced by psychological factors. These include stress, anxiety, or emotional distress. So, it’s a pain that feels like and closely resembles somatic pain but isn’t caused by an actual physical problem. Rather, the underlying cause is a mental disturbance.
It’s important to note that psychosomatic pain doesn’t imply that the pain isn’t real or that it’s “all in the person’s head.” Instead, it suggests a complex interaction between the mind and body where emotional or psychological factors can contribute to or exacerbate somatic symptoms.
For example, someone experiencing high stress levels might develop tension headaches or muscle pain. Additionally, individuals with certain psychological conditions, such as depression or somatic symptom disorder, may experience physical symptoms without a clear underlying condition or medical reason.
Addressing psychosomatic pain often involves an all-rounded approach that includes medical attention and consideration of psychological aspects. This may include techniques such as cognitive-behavioral therapy, relaxation exercises, stress management strategies, and sometimes medication to manage the physical and emotional components of the pain.
Differentiating Somatic and Psychosomatic Pain
Differentiating somatic from psychosomatic pain is challenging but crucial. Since the treatment options for both types differ, an accurate diagnosis is critical. The health provider must begin by taking a detailed history. They should ask about how often the patient tends to feel pain, the presence of a common noxious stimulus (pain-eliciting factor), what helps relieve the pain, and other health problems. They should then perform a physical examination to check for injury or problematic areas in the patient’s body. Finally, radiographic scans and blood work can help with the diagnosis.
If the history, examination, and tests remain inconclusive in the presence of pain, the diagnosis of somatoform disorder must be considered, and a psychiatrist should be taken on board. Along with a psychiatric evaluation, they may prescribe a dose of SSRIs or tricyclic antidepressants and observe outcomes in terms of pain resolution.
In summary, somatic pain from tissue damage or injury encompasses various types characterized by different sensations and locations. Understanding the nuances of somatic pain and its underlying causes is crucial for effective diagnosis and management. By employing a comprehensive approach tailored to individual needs, individuals experiencing somatic pain can achieve improved pain relief, function, and quality of life.