An incorrect diagnosis can lead to medical complications.
Pain can signal something is wrong in our body, and it helps physicians diagnose the problem and initiate medical care. But doctors sometimes misdiagnose pain, which can delay or hamper the proper treatment and lead to medical complications. “Incorrect diagnoses can be made and the actual source [of the pain] is never identified,” says Dr. Andrew Elkwood, a plastic and reconstructive surgeon based in Shrewsbury, New Jersey. Misdiagnosed pain that’s left untreated can be debilitating and lead to disability, inability to participate in enjoyable activities, unneeded surgery, over-medication, depression, anxiety and isolation, he says.
There can be many reasons for a faulty diagnosis.
About 12 million people in the U.S. who seek outpatient medical treatment are misdiagnosed annually, according to a meta-analysis of three studies published in BMJ Quality & Safety in 2014. Incorrect diagnoses occur for many reasons. For instance, a physician treating someone suffering from chronic pain might not be trained in dealing with chronic pain; a patient may provide an inaccurate medical history; there could be a problem with the diagnostic test; or a patient may have a psychological disorder that increases his or her pain sensitivity. Sometimes, a rare condition mimics a more common one. “Nerve pain is commonly misdiagnosed,” Elkwood says. “Not many physicians are familiar with every nerve in the body. One of the hardest diagnoses is when the nerve is causing the pain.” Here are seven types of pain that are often or sometimes misdiagnosed:
Pain in your heel
Heel pain is one of the most misdiagnosed musculoskeletal conditions, says Dr. Rock Positano, director of the non-surgical foot and ankle service at Hospital for Special Surgery in New York City. “Physicians often misdiagnose heel pain as plantar fasciitis based on the clinical exam alone or in conjunction with an MRI, without performing an ultrasound to rule out other possible causes,” Positano says. Heel pain can signify rheumatoid arthritis, syphilis and nerve entrapment. “An incorrect diagnosis can lead to unnecessary surgery and inactivity,” which can contribute to cardiovascular disease, Type 2 diabetes and depression, he says.
Back pain
Some conditions are misdiagnosed when the patient doesn’t provide his or her physician all the relevant information, says Sherry McAllister, executive vice president of the Foundation for Chiropractic Progress in San Jose, California. “For example, a patient may present to a doctor with back pain, but the patient won’t mention symptoms they think are unimportant, such as increased urination or that they had on-and-off chills for a couple of days, thinking it’s just a cold.” In such instances, a doctor may diagnose a back strain or something similar when the issue is actually a kidney infection, she says. Such infections require prompt medical attention and are typically treated with antibiotics and may require hospitalization, according to the Cleveland Clinic. If untreated, a kidney infection can cause bacteria to spread throughout the bloodstream, causing blood poisoning; kidney scarring, which can contribute to chronic kidney disease; high blood pressure; and kidney failure. For pregnant women, a kidney infection may lead to an increased risk of delivering a low birth weight baby.
Back pain that’s worse at night
At any given time, 31 million Americans experience back pain, according to the American Chiropractic Association. Common causes of lower back pain include sports injuries, arthritis and poor posture. Sometimes, a physician mistakenly attributes back pain to one of these causes when it’s something more serious — like a spinal tumor, says Dr. Neel Anand, professor of orthopaedic surgery and director of spine trauma at Cedars-Sinai Medical Center in Los Angeles. Back pain that intensifies at night when lying down, pain that increases with activity and decreased sensitivity to pain and heat could be signs of a tumor, he says.
Sharp abdominal pain
The sudden onset of sharp pain in your lower right abdomen could indicate a wide array of conditions, including gastritis, food poisoning, anemia and a peptic ulcer. It could also signal appendicitis, says Dr. Kristine Arthur, an internist at MemorialCare Orange Coast Medical Center in Fountain Valley, California. “If you’re experiencing a sudden sharp pain in your lower, right abdomen that persists over several hours or a day, it may be appendicitis,” she says. “You should be seen by a doctor that day because it often requires surgery, and if left untreated, a ruptured appendix can be deadly.”
Pain in your mid-upper abdomen
If you experience pain in your mid-upper abdomen shortly after eating, you might attribute it to indigestion or food poisoning. It may be those things, but pain in that area, or in the upper right corner of your abdomen, can also be caused by a gallstone, says Dr. Ashkan Farhadi, a gastroenterologist at MemorialCare Orange Coast Medical Center. “It is not uncommon for the diagnosis of gallstone to be overlooked,” Farhadi says. Doctors can diagnose gallstones by obtaining a clinical history, conducting a physical examination and an abdominal ultrasound, he says. Other imaging tests, such as a CT scan, an MRI or an HIDA scan, may also be useful.
Women’s pelvic pain
Pelvic pain in women that signals pelvic floor dysfunction is sometimes misdiagnosed as a pulled groin muscle or sciatica — a painful condition that affects the back, hips and legs and is caused by the compression of a spinal nerve root in the lower back. It’s also sometimes mistaken for piriformis syndrome, says Isa Herrera, a physical therapist in New York City who’s written five books about women’s health. This condition occurs when the piriformis muscle, which is located deep in the buttock, behind the gluteus maximus, and runs from the lower spine to the upper part of the femur, becomes irritated, causing buttock pain and tightness, she says. The pelvic floor refers to a group of muscles in your pelvic area; these muscles support the organs in your pelvis like a sling, according to the Cleveland Clinic. This condition can lead to constipation, a frequent need to urinate, ongoing pain in your pelvic area, genitals or rectum, and pain during intercourse. Herrera says she treats pelvic floor dysfunction by digitally manipulating the vagina to stretch it and release trigger points, deep breathing exercises and meditation.
Shoulder pain
Shoulder pain is sometimes misdiagnosed as a rotator cuff strain or tear, conditions that can be caused by overuse and are common among athletes, Herrera says. These ailments are often treated with anti-inflammatory medication, steroids and in some cases, surgery. But shoulder pain may actually be caused by something less serious — small knots, or trigger points, in your chest, Herrera says. These are similar to the knots you may feel in your back, which can be alleviated with stretching and a massage. Both strategies are also good remedies for chest knots, Herrera says. “All you have to do is stretch your chest muscles and strengthen your back muscles,” she says. Exercises with rowing equipment can help strengthen your back muscles. Practicing yoga can also boost your back strength and flexibility, and doing exercises with flexible bands can help strengthen your back and chest muscles.
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7 Ways Pain Is Sometimes Misdiagnosed originally appeared on usnews.com
