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When to Worry About Your Pain: 4 Rules

We all suffer from aches and pains now and then. Sore muscles after a heavy workout, a headache brought on by stress, or perhaps an old injury flares up now and again. But what if that pain doesn’t go away or suddenly becomes worse? There comes a time when pain isn’t just a general ache and needs to be checked out when the pain becomes chronic

What is the difference between acute and chronic pain?


Acute pain is normal pain that warns you that you’ve been hurt when you break your leg, when you hit your thumb with the hammer, when you put your hand on the hot plate and you burn yourself … that’s good pain. It tells you that you have an injury. When you touch that scorching dish, your body will react immediately and you’ll pull your hand away.

 

Acute pain starts suddenly and usually doesn’t last long. When the injury heals, the pain stops. For example, a broken leg will hurt during recovery, but “as time goes on, it gets better and better.

 

With chronic pain, “the pain itself becomes a disease. When the injury heals and you continue having pain beyond the time of expected recovery, that’s chronic pain.

 

Don’t Ignore Pain!

Pain is your body’s “check engine” light.

 

When you feel any sort of pain or discomfort, that’s a signal from your body that an injury has occurred. Sometimes the “injury” is minor muscle tears following an intense CrossFit session. Sometimes, however, it’s something a little more serious.

 

Some of the leading causes are

Past injuries or surgeries

Back problems

Migraines and other headaches

Arthritis

Nerve damage

 

Pain can be like a dull ache, throbbing, burning, shooting, squeezing, stinging, soreness or stiffness

How to Think Like a Doctor

1. Two-Week Rule

Any pain that lasts for more than two weeks should be checked out. A lot of people think that new pain means that they have something serious or critical. Most new pain is due to bones, joints, nerves, and other musculoskeletal structures. Many doctors use the two-week rule because a lot of musculoskeletal pain will resolve within two weeks. Also, a two-week delay in diagnosis is very unlikely to change someone’s prognosis if the pain is due to a serious internal problem. Though the two-week rule applies to most pain, there are times when doctors ignore this rule and become immediately concerned (See Rules 2, 3, and 4).

 

2. Acute-Trauma Rule

Doctors should immediately check all pain associated with acute trauma, such as a car accident or fall off a ladder. Usually, people aren’t overly worried that cancer is causing their pain if they have trauma that results in immediate or even slightly delayed pain. However, all pain associated with trauma necessitates an evaluation; this includes a physical examination and possible imaging tests such as x-rays or MRIs.

 

3. Worst Pain of My Life Rule

Doctors should be alarmed at any new and severe pain that a patient reports. It’s not unusual for a patient to say, “This is the worst pain I’ve ever experienced!” Often, the “worst pain of my life” is not cancer, but maybe the result of something serious, such as a heart attack, appendicitis, or ruptured blood vessel (aneurysm). If the pain is severe but chronic and has been worked up previously, then the “alarm bells” ringless vigorously.

 

4. I Can’t Sleep Rule

 

Doctors should be concerned about any pain that awakens a patient at night. Sometimes, night pain is more serious than the pain that occurs during the day with normal activities. This is because, usually, when you rest, pain improves. Pain that doesn’t improve with rest is sometimes worrisome. However, resting too much with chronic pain leads to weakness and more pain. If you have chronic pain, try and alternate rest with activity to stay strong and keep your overall pain levels down. Cancer pain is one type of pain that often doesn’t improve with rest and will awaken people at night. However, it’s important to know that a lot of musculoskeletal pain problems will bother patients at night. Hip bursitis or shoulder tendinitis can often keep a patient awake if they lie on the affected side and put pressure on the injured part of the body. It’s important not to make assumptions about what is causing night pain, and to identify the cause and treat it appropriately.

  

If pain suddenly becomes worse

 

If pain suddenly becomes worse, is a different type of pain to that normally experienced, or affects your quality of life so that normal activities are impacted or regular painkillers are required then a healthcare professional opinion should be sought.

Just as it’s important to seek medical help for pain that suddenly gets worse, certain types of pain should never be ignored.

  

“An unusually severe headache should never be ignored – especially if it wakes you from sleep, comes on like a ‘thunderclap’ or is a ‘first or worst’ headache (the first time you’ve ever had a pain like this, or the worst headache you’ve ever suffered) – and calf pain can be a sign of a blood clot, especially after a long period of sitting or immobility.

  

An underlying cause

Some pain can be caused by underlying conditions. Arthritis can cause joint pain and bone pain. A trapped nerve can cause shooting pains in the affected area. Endometriosis – a condition that causes the lining of the uterus to grow in areas outside the uterus – can cause severe pain. The list goes on.

 

“Musculoskeletal pain – such as lower back pain, hip and knee pain, and ligament or tendon pains – are an extremely common cause of pain. “Many illnesses or disorders, such as flu, fibromyalgia, and irritable bowel syndrome are well known for causing pain but almost any part of the body can be affected by painful conditions.

 

Changes in pain and other signs and symptoms should be treated with caution and investigated further, particularly in people who have experienced:

 

Cancer.

Long-term steroid use (not asthma puffers).

A recent severe infection.

Physical trauma could have resulted in a fracture.

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