title: Chronic visceral pain secondary to ventral disc herniation: Development of visceral complex regional pain syndrome.
abstract: When an organ disease is ruled out as the origin of pelvic pain, the superior hypogastric plexus (SHP) injury and consequent dysfunction could be the mechanism of visceral chronic pain perpetuation. As much as a dorsal discus herniation may harm the dorsal or ventral roots, a ventral discus herniation at L4-L5 or L5-S1 may result in direct physical trauma to the SHP, maintaining chronic visceral pain mediated by sympathetic dysfunction, conceivably also afferent fibers dysfunction. We propose that similarly to nociceptive somatic dysfunction named complex regional pain syndrome, the maintained sympathetic pelvic pain secondary to straight physical damage to the SHP characterize in fact the same disease, but in nociceptive visceral tissue, named visceral complex regional pain syndrome, a concept constructed based on the International Association for the Study of Pain criteria (1994).
authors.affiliation: Department of Biomechanics Medicine and Rehabilitation of Locomotor Members, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
authors.forename: Gabriela Rocha
authors.initials: GR
authors.lastname: Lauretti
authors.affiliation: Teaching Hospital, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
authors.forename: Raquel
authors.initials: R
authors.lastname: de Oliveira
keywords: Complex regional pain syndrome; ventral herniation; visceral pain