Nearly everyone experiences a headache or leg cramp on occasion. Typically, these and other seemingly minor pains are waited out or treated with over-the-counter medicine. But when do these aches warrant a visit to the doctor’s office, or even hospital?
Emergency room physician Leigh Vinocur paid TODAY a visit on Thursday to explain five different pains that could be symptoms of serious conditions, and when they require immediate medical attention.
A good rule of thumb? "Trust your gut," Vinocur said. "People have a sense that this isn't the usual ache and pains."
1. Leg or calf pain
Could be: Deep vein thrombosis, a blood clot in a leg vein
People at risk for Deep Vein Thrombosis, or DVT, include recent surgery patients, anyone on bed rest or women on birth control. The condition is sometimes called “economy class syndrome” because it affects car or plane travelers who have been sitting long hours in cramped spaces.
If you have a pain in your leg that feels different than a cramp, “get to the emergency room," Vinocur said. "They will do ultrasounds. If it’s positive, they’ll give you blood thinners because we don’t want the clot to travel to your lungs and cause pulmonary embolism."
2. Severe upper back pain
Could be: Aortic dissection, a tiny tear in the aorta that allows the blood to create a false passage
“People will describe it as a ‘tearing pain’ and they’re incapacitated,” Vinocur said of the severe pain that may be a sign of aortic dissection, or a small tear in the aorta.
People at risk for aortic dissection include those who already suffer from high blood pressure or connective tissue disease like Marfan's syndrome. An aortic dissection can close off branching arteries, and may cause a stroke, paralysis or kidney failure.
3. Severe abdominal pain
Could be: Ruptured ectopic pregnancy
An ectopic pregnancy is one that has settled outside of the womb. If it ruptures, it can cause severe bleeding in the abdomen. Women at risk include for a ruptured ectopic pregnancy include those on birth control, individuals with tube scarring from sexual transmitted diseases, and those under going fertility treatments.
“No birth control is 100 percent,” Vinocur said. That's why any woman of child bearing age who comes into the emergency room with abdominal pain will get a pregnancy test, she said.
4. Severe dental pain
Could be: Ludwig's angina, a tooth abscess that has traveled down your neck.
Severe pain that spreads from your mouth to your neck could be the sign of Ludwig's angina, an infection on the floor of your mouth that spreads down your neck. "You notice your neck is getting swollen, the skin looks red, your voice sounds funny, you’re drooling because you can’t swallow your own saliva, it can actually track down to your airway and cause airway obstruction” Vinocur said, adding: "Don’t let a tooth ache get that bad.”
5. Severe headache
Could be: A bleeding stroke
A headache that could indicate a bleeding stroke, Vinocur said, will be a "thunderclap headache," or a headache that is both sudden and severe, reaching maximum intensity within seconds or minutes. "Suddenly people know something is wrong," she said. "They're grabbing their head, rolling on the ground. They can be unconscious."
Typically, there is a family history of bleeding strokes. But other conditions including severe high blood pressure can also lead to the condition.
This story was originally published in March 2015. For more health and wellness tips, sign up for our One Small Thing newsletter.