Visceral pain: a disturbance in the sensorimotor continuum?☆☆☆★

A painful experience may be brought about by an equilibrium shift in the kinetics of the central nervous system or by the information flow in separate interactive pathways and neural centers. A number of recent studies have addressed the role of spinal pathways, in particular the dorsal column, and other alternative mechanisms in the processing and integration of visceral information into a visceral pain experience. This article reviews newly reported experimental findings and some of the historical clinical evidence that point to a role of the dorsal column in visceral pain. It proposes a shift to a goal-oriented approach to pain issues that defers speculations about the nature of pain and keeps in mind the exigency of pain relief for those who are suffering.