Carpal Tunnel Syndrome and Hypothryoidism

How Nerve Pain May Be Linked to Low Thyroid Function

Woman with wrist pain
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According to the Washington, D.C.-based Endocrine Society, hypothyroidism (low thyroid function) affects approximately five percent of women and around one percent of men. It is a condition that can cause fatigue, constipation, cold intolerance, weight gain, hair loss, dry skin, and hoarseness.

One of the lesser recognized symptoms of the disease are those of the nervous system, specifically the peripheral nervous system.

This is the part that extends beyond the brain and spinal cord and is responsible for the sensory and motor functions of the body and limbs.

One of the disorders uncommonly cited as a symptom of hypothyroidism is carpal tunnel syndrome (CTS). While we tend to associate it with a progressive injury of the wrist, many have started to recognize CTS as both an possible symptom of hypothyroidism and an early warning sign of undiagnosed thyroid disease.

How Hypothyroidism Causes CTS

Hypothyroidism is known to cause a condition known as peripheral neuropathy in some people. Peripheral neuropathy is the term used to describe damage to the peripheral nerves, causing abnormal localized sensations and pain such as:

  • Numbness
  • Burning, tingling, or a "pins-and-needles" sensation
  • Muscle weakness
  • Hypersensitivity to touch or temperature

Although the association between thyroid function and peripheral neuropathy isn't fully understood, it is believed that hypothyroidism can cause fluid retention resulting in swollen tissues.

It is this swelling that can exert persistent pressure on peripheral nerves.

One of the areas commonly affected is the wrist where nerves travel through a channel of soft tissue known as the carpal tunnel. If pressure is exerted in this area, it can can result in symptoms of CTS. One of the possible signs of hypothyroidism is when there are no other causes for the disorder, including either a traumatic or overuse injury.

While the vast majority of CTS cases are not related to hypothyroidism, CTS is one of the more common manifestations of hypothyroid-related peripheral neuropathy. Other causes include diabetes and joint disease.


While peripheral nerve pain can be distressing and even debilitating to some, hypothyroid treatment can usually alleviate the symptoms. Central to this is the use of the synthetic hormone levothyroxine standardly used to normalize hormone levels in people with low thyroid function.

Equally important is the need to monitor hormone levels during treatment. There is some evidence that, even among people on hormone replacement therapy, elevated TSH levels may increase the risk CTS simply because the disease is being undertreated.

In addition to levothyroxine, doctors may recommend the following treatment for people with CTS:

A Word From Verywell

While hypothyroidism is a less likely cause of CTS, you (or your doctor) should not assume that an overuse injury is the only cause.

Many doctors today are screening people with CTS for diabetes or hypothyroidism as a matter of course.

By doing so, a person diagnosed with hypothyroidism may be able to avoid surgery and have their condition successfully treated with medications alone.


Azhary, H.; Farooq, M.; Bhanushali, M. et al. "Peripheral Neuropathy: Differential Diagnosis and Management." Amer Fam Phys. 2010; 81(7):887-92.

Endocrine Society. "3. Hypothyroidism." (2015) Endocrine Facts and Figures: Thyroid (First Edition). Washington, D.C.: Endocrine Society.