Superficial and Deep Somatic Pain

The term "somatic pain" sounds like a complicated thing, but you probably know it well. If you cut your skin, the pain you experience is called a somatic pain. You also experience somatic pain if you stretch a muscle too far, exercise for a long period of time, or fall down onto the ground and hurt yourself. 

Somatic pain is a type of nociceptive pain that is also referred to as skin pain, tissue pain, or muscle pain. Unlike visceral pain (another type of nociceptive pain that arises from internal organs), the nerves that detect somatic pain are located in the skin and deep tissues.

These specialized sensory nerves, called nociceptors, pick up sensations related to temperature, vibration, and swelling in the skin, joints, and muscles — basically any painful stimuli. When they detect some kind of tissue damage, nociceptors then send impulses to the brain, which is how you feel or experience pain.

Somatic pain can be either superficial or deep.

Superficial pain arises from nociceptive receptors in the skin and mucous membranes. For example, if you cut your lip, this pain is called superficial somatic pain. Superficial somatic pain is the type of pain that happens with common everyday injuries and is characterized as pricking, sharp, burning, or throbbing pain.

Deep somatic pain originates from structures deeper within your body, such as your joints, bones, tendons, and muscles. Like visceral pain, deep somatic pain is usually dull and aching.

Deep somatic pain can either be experienced locally or more generally depending on the degree of trauma. For example, if you bump your knee, the pain that you experience is localized to your knee. However, if you break your kneecap (called your patella) you likely experience pain throughout your entire leg.

Somatic pain is treated in a variety of ways. It depends on the severity and extent of the injury or trauma, as well as the quality of pain a person is experiencing. For instance, if you're feeling a spasm rather than a throbbing pain, a different treatment will be used.

Most minor cases of somatic pain respond well to over-the-counter medications such as Tylenol (acetaminophen) or NSAIDs like Aleve (naproxen) or Motrin (ibuprofen). A big difference between Tylenol and NSAIDs is that Tylenol offers no anti-inflammatory effects. So, Tylenol won't help with associated swelling. That being said, some people cannot take NSAIDs due to underlying health conditions like a history of gastrointestinal bleeding, kidney disease, or heart disease.

This is why it is important to always consult your doctor before taking any medication, even those available over-the-counter.

With deep somatic pain or musculoskeletal pain, muscle relaxants like Baclofen or Flexeril (cyclobenzaprine) may provide relief. Opioids, or medications like oxycodone and hydrocodone, are best reserved for severe pain that is not relieved with Tylenol or NSAIDs alone. Please keep in mind that opiods carry a great risk of substance misuse and dependence. This is why opioids are typically prescribed for only short periods of time.

Depending on the pain, your doctor may also recommend other therapies like a heating pad or cold pack on the painful area. Even activities like physical therapy, massage, or relaxation can help. 

The good news about somatic pain is that it usually fades once the underlying injury or insult heals. However, somatic pain that lasts longer than expected (more than 3 months) can become chronic pain, which requires a more rigorous treatment plan.