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Pain From Your Internal Organs, Or, How Does Your Liver Say “Ouch”

April 23rd, 2010 · 10 Comments

I came across an interesting article recently about how we experience pain from organs such as the appendix, stomach, and pancreas.

When you injure your pinky finger, messages go to your brain which allows you to pinpoint where the injury is.  You’re able to know that it’s your pinky finger, and not, let’s say, your thumb.  You can also tell pretty clearly what type of injury it is – say, the difference between a burn and a prick.

In contrast, things with our internal organs – stomach, lungs, liver, pancreas – aren’t so clear.  Why is this?

1. The pain message from your internal organs get spread out

The pain message from an organ goes to many different places in the spinal cord, so the brain has a harder time decoding where it’s originally coming from.  The message gets diffuse.  Your brain can decifer in general where the pain is coming from, but not exactly.

2. Your brain receives messages from different places in your body to the same place in your brain.

Pain signals from your organs go to the same places in your brain as pain signals from other parts of your body.  For example, signals from your gallbladder and shoulder end up in the same place.  Or messages from your heart and your lungs can look the same to your brain.  So your brain isn’t sure who sent the original message.  Thus it can look like there’s illness in an area that’s actually healthy.

3. The messages from your organs are closely tied to your autonomic system

Pain signals from your organs also activate your autonomic system.  This then causes nausea, sweating and diarrhea.  You can then wonder why you’re having nausea, etc., without realizing that that’s a secondary symptom.  This can make diagnosis confusing.

4. Chronic pain changes your brain

As in similar in some other pain conditions (CRPS or RSD, back pain), chronic pain can cause changes in your brain which then keep the pain signals going, even if the original injury heals.  There is now evidence that this happens in organ pain, as well.

Visceral (organ) pain is poorly understood, but work like this can help illuminate this area.  This can then lead to better diagnosis and treatment.

The original article is by DM Drewes from Denmark, and appears as an abstract, “Visceral pain: from the periphery to the brain,” in the Scandinavian Journal of Pain, 2009, Vol 1.

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10 responses so far ↓

  • toni // Apr 23, 2010 at 9:09 am

    this is a great message you have sent . having pain and being told the doctors cannot find the cause , what you have said makes sense,also my way of thinking has changed and lowness of mood goes with pain. Thank you Toni

  • toni // Apr 23, 2010 at 9:12 am

    this is a great message you have sent . having pain and being told the doctors cannot find the cause , it has helped me. Thank you Toni

  • Kendra // Apr 24, 2010 at 12:58 am

    Very enlightening for sure. I am a massage therapist and have worked on my mother weekly for 6 years now. My mom has had an emotional life with enduring the pain of the death of several family members in her youth. She was also struck by lightening in the early 70’s and later developed Chronic Fatigue Syndrome, Fibromyalgia….and, you name it! A cyst in her spinal cord (Syringomyelia) was found to be the cause of all of her issues…supposedly. She has what I call Phantom pain, all over her body. I wonder what is real, and what is not? What is the cause? Is it emotions? Is is the mis-firing of her neurological system because of the cyst? She has IBS to boot! Wow! If we could only find out!

  • Banks // Sep 2, 2011 at 5:28 am

    I have pain behind the tail end of my left rib which radiate to my chest back and neck for the past one year.

  • Abazie // May 14, 2013 at 3:32 pm

    Very interesting

  • Steve Mitchell // May 30, 2014 at 7:02 pm

    Yes, I have constant visceral discomfort. Fizzy and burning at times as well as ache and blah like internal sensations. Very odd. I have no clue as to the cause.

  • Cris // Nov 26, 2014 at 7:51 pm

    Pain in my upper right quadrant under rib cage drs not sure whats going on cause all tests come back negative. Only a daily basis it hurts

  • patty // Dec 11, 2014 at 10:05 am

    I feel crazy when trying to tell doc, I have pain both ribs and internal organs and sweats at night and headache. why?

  • Sherri H // Jan 26, 2016 at 4:36 am

    I’ve had back pain for 14 years now, I was told I have DDD and Osteoarthritis. They have operated on my neck an did a fusion with cadaver bone and metal and screws. But the rest of my back is the absolute worst! My Thoracic is the worst! Then my lower back and tail bone. My MD sent me to another doctor for his opinion and I left in tears! He said there’s nothing that he could see to cause me such pain! He was looking at X-Rays, you can’t see soft tissue on those films. My hip is unbearable and they say it’s coming from my lower back? Could they be neglecting to look at my organs an find something there that may cause me these symptoms? They are taking me off of all my pain meds to see how I do! I can tell you what will happen, I will be one of the 50% of people who don’t make it due to chronic pain! Do you have any advise for me to go back with? Thank you very much!

  • How to Cope with Pain // Jan 26, 2016 at 8:52 am


    Sorry you’re having it so tough! My suggestions would be:

    1. Get a pain medicine expert to coordinate your care – someone who understands and treats chronic pain
    2. Here’s an article on: Tips for patients to get good cares
    3. Work with an expert pain management person (psychiatrist, psychologist), who can help you cope. You can also start with the pain management class I offer here: Pain management class
    4. Understand that it may take a while to improve and cope better, and it may take visiting many health providers until you find people who will form a good team to work well with you

    Good luck!

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