Don’t ignore these five types of pain

We all feel achy now and then, but when is pain a sign that something is seriously wrong? 

“Part of it is based on severity and part of it is based on chronicity,” said  Kara Huston, MD, an emergency medicine physician at Falmouth Hospital. “In general, if you have any new onset of a significant or severe pain, you should proceed directly to an emergency department, regardless of the location of that pain. 

“If you have a milder pain that’s new or different, that might be appropriate to call your primary care doctor. If you have a chronic pain that you’ve been dealing with for quite some time, it would also be best to try to go through a primary care doctor or a specialist. But if you have a chronic pain that severely worsens or significantly changes, I would consider seeking emergency care.”

Here are five types of pain that can signal a major medical issue. 

Chest pain

“There are many dangerous causes of chest pain,” she said. “For chest pain, especially if it’s new and you don’t know the cause, you should go to an emergency room.” Chest pain can signify many different dangerous conditions such as a heart attack, a pulmonary embolism or a blood clot in the lung, a collapsed lung, or an aortic dissection, when the big blood vessel that runs down our body rips or tears.

“The more severe the pain, the more concerning potentially it is, but you could have mild to moderate chest pain that could still represent a heart attack,” she said. “If one develops sudden onset of new or different chest pain I don’t think you’d be wrong to call 911.”

Abdominal pain

An onset of abdominal pain is harder to gauge because it could be something bad, but belly pain can be benign, such as from indigestion or constipation she said. “Certainly, a new onset of severe abdominal pain or any abdominal pain associated with a fever, rectal bleeding, or loss of consciousness is cause for concern and you should consider proceeding to the emergency department,” she said.

Headache

An occasional low-level headache is typically no cause for concern, but a severe headache deserves attention. “That could represent a subarachnoid hemorrhage, bleeding in the brain, which is often described as a sudden onset of the worst headache of someone’s life,” Dr. Huston said. “It’s potentially associated with nausea, vomiting and/or an altered mental status. For any sudden onset of a severe headache, you should seek emergency care. In addition, a headache associated with a fever and neck stiffness could represent meningitis, which also requires emergent evaluation.”

Back pain

Back pain can result from sitting at a desk too long or doing some yard work. “But the red flag for back pain is any new, significant pain,” she said. “particularly if it is associated with leg weakness or numbness, difficulty urinating, and/or loss of bowel control, which could suggest something is pushing on the spinal cord or the nerve roots that run down from there.” In addition, “a fever associated with back pain could also represent an infection in your back particularly if you have risk factors such as immunosuppression, diabetes, or IV drug use.” One should seek emergency care if they are experiencing any of these symptoms associated with back pain.

Leg pain

Extremity pain is common but, at times, can represent an emergency. “If you have one-sided calf pain or tenderness, especially if it’s associated with leg swelling, you have to get checked to rule out a blood clot in your leg,” she said. “If it’s associated with a color change to the leg, severe pain, shortness of breath, or chest pain you should go directly to the emergency room. In addition, a severe unexplained leg pain with any color change or coldness to your foot or leg could be due to a blocked artery, which could also be an emergency.”

“The overview for all of these pains is that doctors would rather see someone and send them home than have them sit at home suffering from a serious problem,” said Dr. Huston.