You can't let every ache, soreness or twinge worry you to the point you have your health care provider or local hospital on speed dial. But there are pains that come on suddenly or accompany fever that you should never ignore. Abby Cuffey of Woman's Day and pain management specialist Dr. Houman Danesh of Mount Sinai Hospital in New York explain how to recognize when some pains, even if they seem small, need immediate attention.
1. A sharp ache between your shoulder blades
Could be: A heart attack
About 30 percent of people who have heart attacks don't get the classic chest pressure. Pain between shoulder blades is common in women, as is jaw pain, shortness of breath and nausea. If you have these symptoms (you'll likely have more than one), you need care ASAP.
A muscle pain is like a dull ache. A heart attack is more like a sharp sudden onset. Call 911. Do not drive yourself to the hospital. It's better not to have someone drive you to the hospital. Wait for the ambulance because they are set up to do triage immediately.
2. A 'thunderclap' headache
Could be: An aneurysm, which is a balloon-like area in an artery
Most of us have experienced mild or moderate headaches — usually an over-the-counter pain medication makes the pain go away. But if you have the worst headache of your life and it comes on suddenly, call 911. Again, do not drive the hospital yourself.
How do you know it isn't a migraine? With a migraine, you feel nauseous, are sensitive to light and sound and it's a gradual progression.
Bleeding in the brain due to a ruptured aneurysm isn't all that common, but when it does happen, swift action is key. Surgeons can save your life by sealing off the weakened spot. If you aren't treated right away, you could die. The biggest risk is, if it does rupture, and you are bleeding into your brain, it becomes difficult to treat, if it can be treated at all.
Don't take aspirin for such a sudden, intense headache — it can increase the bleeding.
3. Dull stomach pain to the lower right of abdomen
Could be: Appendicitis
The pain usually starts at the center of your stomach and gradually moves to the right. If the appendix does rupture, that can be a dangerous complication, with bacteria bursting into your bloodstream and infecting your entire body. If you feel this sensation, go straight to the ER. (Usually, it gets more intense over a 24-hour period as it shifts location.)
Usually with appendicitis, when pressing down on your stomach it doesn't hurt as much as when you let go quickly. Another test is where you use the muscle underlying the gall bladder: Bring your knee to your head and have someone push down with resistance. If that hurts, that's a sign of an irritated appendix, which would need to be evaluated further.
4. Tooth pain that wakes you up
Could be: Teeth grinding
Frequent clenching can cause the nerve within the tooth to become inflamed and the protective enamel to wear away. You might even end up cracking teeth down to the root, which leads to extraction. Call your dentist so he or she can figure out the problem. The complications from grinding, which is often brought on by stress, can be prevented by wearing a night guard.
There are a lot of people who grind their teeth at night. At your annual checkup, your dentist can tell you if you need a night guard, for example, as an intervention.
5. Mid-back pain with fever
Could be: A kidney infection
Don't assume that your temperature, nausea and back pain are just a stomach bug. This condition develops when bacteria that infiltrate the urinary tract spread to the kidneys, making the infection much more severe. You might start with urinary tract infection symptoms, like pain during urination, but some people don't notice anything until later. You'll likely need antibiotics ASAP, so call your doctor.
Women are more susceptible to getting UTIs, which is precursor to kidney infection. If a kidney infection is untreated, your kidneys can shut down. But it's usually so painful, people don't ignore it.
6. Menstrual cramps that don't get better with medication
Could be: Endometriosis
If over-the-counter meds aren't helping, this condition — in which the lining of the uterus grows somewhere else — might be to blame. Endometriosis impedes fertility, and it's common. Forty percent to 60 percent of women whose periods are very painful may have it.
Unless you're trying to conceive, your doctor can start you on oral contraceptives. If pain persists, you may need to have the tissue surgically removed.
7. A tender spot on your calf
Could be: Deep vein thrombosis (DVT)
If one small area of your leg is painful, you could have DVT, a blood clot in the deep veins. The spot may also be red and warm to the touch. DVT is more likely if you use birth control pills or recently took a long car or plane ride. Unless your leg is very swollen or the pain is getting worse rapidly, you can probably wait a day to see your doctor instead of going to the ER, but don't delay any longer. The clot could increase in size or break off, move toward the lungs and stop blood flow.
It can go to your heart and give you a heart attack. It can go to your brain and give you a stroke.
As a preventive measure, if you're on a long car ride or plane:
- get up every 1 to 2 hours and stretch or move around.
- write out the alphabet with your toes on the floor. Take your toes up and down, left to right. As you write the alphabet you squeeze the muscles, the veins, and pumping the blood back up, so it won't clot.
- drink fluids and stay hydrated.