Robert Libman of Chicago, Illinois, writes:



Marilyn: I read with interest the letter regarding “chest freeze.” (August 21, 2011) The writer stated that when he eats ice cream too fast , he has “brain freeze,” along with a stabbing pain in his chest. You responded that “swallowing big bites of very cold food (or gulping frozen drinks) may cause “chest freeze.” You further stated that brain/chest freeze results from vessels rapidly constricting and dilating, causing certain nerves to send confusing pain signals to the brain and that the brain “interprets the message as coming from a different place…than the offending one.”



I wish to expand on your answer. Pain may be classified in various ways. One way is to divide it into somatic pain and visceral pain. Somatic pain is also known as musculoskeletal pain and originates in skin, muscles, joints, bones and ligaments. These sites are highly innervated and the pain’s origin is easily localized by the brain.



Visceral pain, on the other hand, originates in the body cavities (thorax, abdomen and pelvis) and comes from the internal organs. These have less innervation than tissue of somatic origin and therefore the pain is more diffuse and difficult to locate. In addition, the brain is less accustomed to receiving pain messages from the internal organs and cannot interpret them as accurately as it can pain from somatic areas.



A good example of somatic pain is the sensation that arises when there is injury to a bone. When a bone is broken, the brain has no trouble localizing the origin of the pain, and the individual can generally point to the precise area where it hurts. On the other hand, visceral pain may be present when an organ such as the gall bladder is distressed. When gall bladder disease is present, the pain is often misinterpreted as being caused by a heart attack.



Applying the above to the question you received, a cold stimulus in the mouth or esophagus may stimulate visceral pain which is not easily localized by the brain, causing what has been referred to as “brain freeze” or “chest freeze.”

Marilyn responds:

Thank you, Dr. Libman!

