When you feel a sudden pain, how do you know when to wait it out or to seek immediate medical attention? If the pain is bad enough to make you think about going to the hospital, you should go. If you have pain and you’re not sure what’s going on, come to the emergency department and let us evaluate it. We’d rather see someone and send him or her home after determining it’s indigestion than have that person sit at home with a heart attack or other serious problem.

The most common signs of pain that could signal a serious health problem include:

Chest Pain

Heart attack pain can feel like pressure in the center of your chest, which may spread to the jaw, neck and arm. Other possible heart attack signs include pain that gets worse when you exert yourself, shortness of breath, nausea and sweatiness.

The average person waits for about two hours between the time they start feeling chest pain and the time they come to the hospital, often because they think it may be indigestion or will go away. But if you're having a heart attack, the longer you wait, the more of the heart muscle is being damaged.

At the hospital, a person with chest pain will get an electrocardiogram to check for problems with the electrical activity of the heart. An abnormal EKG can indicate a heart attack that needs immediate intervention such as angioplasty. If the EKG is normal, the doctor may order a blood test to look for signs of a heart attack.

Headache

While most headaches are not a sign of a severe medical problem, there’s one exception: pain that comes on suddenly, particularly after exertion, and feels like the worst headache of your life. This could be a sign of an aneurysm, or bleeding in the brain. This type of headache needs immediate medical attention.

At the hospital, a person with a sudden, severe headache may have a CT scan or MRI. Sometimes if the CT scan is normal but we’re still concerned about a possible aneurysm, we will do a spinal tap or lumbar puncture to look for blood in the spinal fluid – an indication of bleeding that can be missed on a CT scan.

Abdominal Pain

Stomach pain is one of the most common complaints we see in the ER. In as many as half of cases, there’s no specific diagnosis. Common causes of abdominal pain include appendicitis, gallstones (hardened deposits of digestive fluid that can form in your gallbladder), pancreatitis (an inflamed pancreas) and diverticulitis (when pouches in the wall of the colon get inflamed or infected).

Appendicitis is associated with pain in the right lower section of the abdomen and is often accompanied by fever, nausea and vomiting. Anyone with these symptoms should go directly to the ER. If the pain is caused by appendicitis, a quick diagnosis is important because if it’s caught before the appendix ruptures, the surgeon often can remove the appendix with laparoscopic surgery. If the surgery isn’t done until after the appendix ruptures, the surgery becomes more complicated, and the recovery is longer.

Gallstones cause pain in the right upper section of the abdomen, often after eating a fatty meal. The pain can be severe and is often associated with nausea. As with appendicitis, removing gallstones early makes surgery simpler, with a faster recovery.

Back Pain

While most cases of back pain are caused by muscle strain, some types of back pain are a sign of a more serious problem. Back pain associated with weakness and numbness in the arms and legs, or accompanied by fever, should be evaluated immediately. This type of back pain could be a sign of a spinal cord infection, which should be treated right away to reduce the risk of permanent damage to the spinal cord.

Severe upper back pain, whether or not it’s accompanied by chest pain, could be a sign of a heart attack or aneurysm.

Leg Pain

If you have leg pain along with swelling of the leg, it could be a sign of a blood clot. The risk of a blood clot is higher after a long period of immobility, such as a long plane ride or after a person has been in bed for a while following surgery. The pain caused by a blood clot feels more like throbbing or aching. A blood clot is diagnosed with an ultrasound.

We want to identify and treat a blood clot as quickly as possible, because an untreated clot could get larger, break off and go to the lungs, where it can cause a life-threatening problem.

Should I Call the Doctor First?

When you’re feeling sudden, severe pain, you may wonder whether you should call your doctor’s office first or head straight to the hospital. If the pain is in your chest, come to the hospital right away. For other types of pain, you’re often better off coming straight to the hospital. If you’re not sure, you can call your doctor, but most of the time they’ll tell you to go to the ER. We are set up to do whatever diagnostic testing is needed, and you’ll save valuable time in case you really are experiencing a serious medical emergency.