Thyroid Disease: Coping With Muscle and Joint Pain

Leg cramp
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Hypothyroidism and hyperthyroidism can cause a variety of muscle or joint-related symptoms. Both hypothyroidism and hyperthyroidism are known to cause what are called myopathies—the medical term for diseases that affect skeletal muscle.

Skeletal muscles are the muscles connected to your bones. An example of skeletal muscles are your biceps in the upper arm, or the quadriceps in the thigh.

Myopathies most often are seen in what are known as the proximal muscles.

These are the muscles that are closest to the center of the body, such as the thigh or shoulder.

In myopathies caused by inflammation or metabolic conditions, such as autoimmune thyroid disease, white blood cells may attack parts of the muscle and the surrounding blood vessels, or abnormal levels of certain biochemical substances end up accumulating in your muscles, leading to weakness or pain.

Different thyroid conditions can also be associated with particular types of muscle and joint problems.

Muscle and Joint Pain With Hypothyroidism

Hypothyroidism can create a variety of muscle and joint-related symptoms. Most commonly, these symptoms are due to swelling of muscles, or swelling muscles that are pressing on nerves. Some of the problems seen include:

  • general muscular weakness and pain, including cramps, and stiffness
  • general joint pain, achiness, stiffness, known as "arthropathy"
  • tendonitis in the arms and legs
  • carpal tunnel syndrome, which involves pain, tingling, weakness, achiness, or numbness in the wrist, fingers, or forearm. It is due to swelling of membranes that compress a nerve in the forearm.
  • tarsal tunnel syndrome—similar to carpal tunnel, with pain, tingling, burning, and other discomfort in the arch of your foot, the bottom of the foot, possibly extending into the toes.

Muscle and Joint Pain With Graves' Disease/Hyperthyroidism

In hyperthyroidism and Graves' disease, you may experience muscle weakness and fatigue, known as hyperthyroid myopathy. Pain in muscles is not as common in hyperthyroidism.

Some people with hyperthyroidism actually lose muscle tone and strength, a process that can be referred to as "muscle wasting." Some common complaints include:

  • difficulty climbing stairs
  • difficulty holding or gripping objects with hands
  • difficulty reaching arms above the head

In some cases, the muscles affected can include those that help you swallow, so you may have some hoarseness or difficulty swallowing.

When the Pain Doesn't Go Away

Typically, the worst of these symptoms and conditions usually resolve with proper treatment of the thyroid condition. When muscle and joint pain does not go away with proper thyroid treatment, however, it's time to ask several questions:

  1. First, if you are hypothyroid, are you getting sufficient and proper treatment? In other words, is your treatment "optimized" or are you undertreated? Insufficient thyroid hormone replacement, or a need for the additional hormone T3, may be required to resolve muscle and joint pain.
  1. Second, if you are receiving optimal thyroid treatment, and still suffering joint and muscle problems, should you get a referral to a rheumatologist, for further evaluation and possible treatment? A trained rheumatologist can provide a more thorough evaluation for arthritis and fibromyalgia. Rheumatologists are experts in joint and muscle problems, and treat arthritis, some autoimmune conditions, various musculoskeletal pain disorders, fibromyalgia and tendonitis. To find a rheumatologist in your area, check the American College of Rheumatology's Doctor Directory.
  2. Third, have you been evaluated for fibromyalgia? Interestingly, on the subject of fibromyalgia, some practitioners actually believe that fibromyalgia is a symptom of or manifestation of hypothyroidism. Fibromyalgia is a syndrome that features specific tender points in the body, with widespread weakness and fatigue.
  3. Fourth, should you look into alternative therapies? Some patients with chronic joint and muscle pain related to their thyroid conditions have had success with therapies, such as massage, acupuncture, and myofascial therapy. In terms of supplements, researchers at the National Institutes of Health's National Institute of Arthritis and Musculoskeletal and Skin Diseases have found that glucosamine and chondroitin "may have some efficacy against the symptoms of [osteoarthritis]."

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