There are numerous symptoms you may get that tell you something just isn’t quite right.  Of all of them, pain is probably the one we pay most attention to.  In fact, as much as we don’t like it, sometimes we have to say thank God for it, because if it didn’t hit us, we may never know something is wrong.

Most of us will know that if we overdo it around the house, in the gym or in the garden, some pain may be forthcoming. But we know what this is, so we don’t worry too much. And it’s usually not that bad anyway. It’s when the pain is severe or we don’t know where it’s coming from that we get concerned, and often rightly so. These pains should not be ignored and should prompt you to get medical attention.

Here are seven of them that should not be ignored:

1. WORST HEADACHE OF YOUR LIFE

You obviously need to get medical attention immediately. It could be a sinus headache if you have a cold. But it could be a brain tumor or a brain hemorrhage. It actually is a classic sign of a brain aneurysm, a situation where a blood vessel wall weakens and creates something like a pouch.  It causes pressure on brain tissue, and it may also cause the vessel to rupture. The emergency room is where you should find yourself immediately.

2. PAIN OR DISCOMFORT IN THE CHEST, THROAT, JAW, ARM, SHOULDER, OR ABDOMEN

We could be dealing with a pneumonia or a heart attack.  Of course you’d expect to have at least a cough and fever in the former. But for a heart attack, discomfort is more typical than pain. Heart patients clench their fists and put it over their chest and complain of the pressure of an elephant sitting in the middle of the chest.

The discomfort from heart disease may also be felt in the upper chest, throat, jaw, left shoulder or arm, or abdomen, and might be accompanied by nausea. A 20-year old may not worry too much, but someone who has unexplained persistent discomfort and knows they’re high risk, shouldn’t wait.

Intermittent discomfort should be taken seriously as well. Be careful if there is a pattern, such as discomfort related to excitement, emotional upset, or exertion. For instance, if you experience it while gardening, but not when you sit down, that’s angina, chest pain that results from inadequate blood flow to your heart because of narrowed coronary arteries. It is usually worse in cold or hot water.

In women, heart disease may come as gastrointestinal symptoms, such as bloating, GI distress, or abdominal discomfort. It’s also associated with feeling tired. Risk for heart disease increases significantly after menopause. It kills more women than men even though men are at higher risk at any age. Estrogen, which is no longer produced after menopause, has a protective effect on the heart. I’ve offered many of you Hormone Replacement Therapy (HRT). You really should think about it.

3. PAIN IN LOWER BACK OR BETWEEN SHOULDER BLADES

Most often it’s arthritis. But other possibilities include a heart attack or abdominal problems. One danger is aortic dissection, appearing as either a nagging or sudden pain. In this condition, instead of blood flowing normally in the lumen of the blood vessel, it finds its way between layers of the vessel wall which detach from each other. Risk factors include high blood pressure, smoking, diabetes, and a history of circulatory problems.

4. SEVERE ABDOMINAL PAIN

If you still have your appendix, its rupture is a possibility. Gall bladder and pancreas problems, stomach ulcers, and intestinal blockages are some other possible causes of abdominal pain that need attention.

5. CALF PAIN

By now everybody knows about deep vein thrombosis (DVT), a blood clot that can occur in the deep veins of the leg. The danger is that a bit of the clot could break loose and dislodge in the arteries of the lungs (pulmonary embolism). This can be fatal. Obesity, cancer, immobility due to prolonged rest or long-distance travel, advanced age and pregnancy, are some of the risk factors.

If you have pain AND swelling, warmth and redness in your calf, see a doctor immediately.

6. BURNING FEET OR LEGS

Diabetes is a leading cause of morbidity in our country, and there are many who are still undiagnosed. In many people who don’t know they have diabetes, peripheral neuropathy could be one of the first signs. The sensation is of a burning kind, or pins and needles in the feet or legs that can indicate nerve damage.

7. VAGUE, COMBINED, OR MEDICALLY UNEXPLAINED PAINS

A variety of painful, physical symptoms are common in depression. Patients often have vague complaints of headaches, abdominal pain, or pain in the limbs, sometimes in combination.
The pain may be chronic and not terribly troublesome, so depressed people, their families, and even health care professionals might dismiss the symptoms. In addition, the more depressed you are, the more difficult it is for you to describe your feelings.

I’ll leave the rest for the psychiatrists, but let me just mention that you should get help when you’ve lost interest in activities, you’re unable to work or think effectively, and you can’t get along with people. Depression should be treated aggressively before it causes structural changes in the brain.

See you next week.