If you’re hurting, see a doctor. It’s sound advice that may seem obvious, but older adults in particular sometimes write off pain as a function of aging and may wait too long to get medical attention, says Edwin Leap, M.D., an emergency physician in Southern Appalachia.
He has seen it happen. And the results can be devastating.
“Boomers, especially, are very stoic,” Leap says. “They’re used to things hurting. So they put off chest pain for a day or two, and by the time they come to the hospital, they’ve completed a heart attack. Or they fall off a ladder, get up and say they’re fine. Then it turns out they have an intracranial hemorrhage — a life-threatening situation.”
Any new or unexplained pain should be checked out by a doctor, Leap says, even if it’s not severe.
Of course, some types of pain are more likely to signal something serious. Doctors recommend heading straight to the emergency room if you’re experiencing one of the types below.
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Pain with loss of function
If you hurt your leg but can still walk on it, it may be just a sprain. “But if you can’t move it and you’re having pain, that should be investigated immediately,” Leap says. Loss of function can indicate a fracture, nerve injury, loss of blood flow or a serious infection.
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Eye pain that comes out of nowhere
Sudden or acute eye pain, with or without vision changes, can point to a serious problem that should get looked at right away, says Michael Hanak, M.D., a family medicine specialist and associate professor at Rush University Medical College in Chicago. It could be caused by a blocked blood vessel, a detached retina, internal bleeding or acute glaucoma, a serious eye condition caused by increased pressure inside the eye. Eye pain can also be the first symptom of shingles, a viral infection that causes a painful rash, Hanak says.
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Chest pain
An older adult experiencing any type of chest pain should be evaluated by a doctor right away, says Hanak, who notes that a heart attack doesn’t always manifest as sudden, crushing pain: “A lot of times, it’s pressure, heaviness or tightness with breathing.” Other signs of a heart attack are dizziness, fatigue or shortness of breath while doing ordinary activities like going up the stairs or gardening. Chest pain may also be a signal that a blood clot has moved to your lungs or heart — a life-threatening condition that needs immediate treatment.
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Pain in one or both arms, your jaw or between the shoulder blades
These lesser-known symptoms of a heart attack are more likely to affect women, according to the American Heart Association. Nausea or vomiting, shortness of breath, dizziness and lightheadedness are other heart attack symptoms to look for. Severe pain between the shoulder blades can also be caused by an aneurysm or a tear in your aorta, a major blood vessel.
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The worst headache of your life
An occasional headache is usually nothing to worry about. More concerning is one that feels more severe than usual, Leap says. A headache is worrisome as well if it’s accompanied by neck stiffness, weakness or vision change, or if you recently hit your head. And know that if you’re on blood thinners, simply bumping your head on a door frame can cause dangerous bleeding in your skull.
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Severe abdominal pain
Pain in your abdomen that keeps getting worse — or is associated with vomiting, swelling or a fever — can be a marker of acute appendicitis, a serious infection, or diverticulitis. “You know your body,” Leap says. “If you’ve had this pain on and off for years, that’s one thing. But if it’s new and it doesn’t let up or it keeps getting worse, I want to see you.”
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Calf or thigh pain, especially if in just one leg
Increasing pain in your calf or thigh after a period of inactivity, even if it’s not severe, can be a sign of deep vein thrombosis (DVT). This dangerous type of blood clot is especially common in patients recovering from knee or hip surgery, Hanak says. Patients sometimes describe the pain as feeling like a muscle cramp, and it’s often accompanied by leg swelling or redness. DVTs need to be treated right away because the clots can travel through your bloodstream and block the blood supply to your lungs, a life-threatening condition called pulmonary embolism.
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Severe back pain that lasts more than 72 hours
Back pain is common — affecting about 8 out of 10 people at some point in their lives — and it typically improves on its own with rest, ice and pain relievers. However, intense back pain that lasts more than three days can be a sign of a more serious problem, especially if the pain worsens when you bend or twist, says Douglas D. Dickson, M.D., an assistant professor of orthopedic and spine surgery at the University of Texas Southwestern Medical Center in Dallas. You may have a torn muscle or ligament, a compression fracture or a cancer that has metastasized to the spine, Dickson says.
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Back pain with pelvic numbness and/or incontinence
Pay attention if your back pain is accompanied by numbness in the groin or glutes area, problems using the restroom or incontinence. Those are symptoms of a rare but dangerous condition called cauda equina syndrome caused by nerve compression, Dickson explains. “When that happens, the nerve is extremely compressed,” he says. “If you don’t get help right away, your function may not recover.”
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Pain from a minor wound
Say you’re working in the yard and something sticks you in the hand. Or maybe you get bitten by a dog, or you cut yourself doing a home repair. If the pain from a wound (especially one that is red and swollen) keeps getting worse over a few days, that can be a sign of a serious infection that can turn deadly if not treated. “Organic material causes infections that spread wildly,” Leap explains. “I’ve seen a splinter that got up under a fingernail and the patient said, ‘It’s fine. I’ll deal with it later.’ A few days later, they’ve got red streaks up their arm and a raging infection.”
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Pain after a procedure or injection
Spinal injections, biopsies or other therapies that involve injections can occasionally cause infection or bleeding. If you experience persistent pain or loss of function after one of those, call your provider right away.
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Pain with fever
If you have a high temperature as well as pain, your body may be fighting a dangerous infection. It’s especially important to seek treatment quickly if:
- The pain is in your mouth, throat or neck. Swelling from an infection in those areas can compromise your airway, Leap says.
- The pain is in your lower or upper back. You could have a kidney infection or a spinal infection that could cause paralysis if left untreated.
- The pain is associated with an area of tender, inflamed skin. You may have a deep skin infection called cellulitis that could spread and cause tissue damage. Or you may have a fluid-filled abscess that is infected and needs to be drained.
- The pain is at or around a surgical site. Post-op infections typically appear within 30 days, Leap says. In addition to fever, you may notice an unexpected increase in pain, swelling or drainage (pus) from your incision.
This article, originally published on Dec. 1, 2020 by has been updated with new information.
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