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  • 03Dec

    Hypothyroidism and joint pain – is hypothyroidism the reason for joint pain?

    Thyroid gland is an endocrine gland located in the front of neck. This butterfly shaped gland produces two hormones called thyroxine and triiodothyronine. These hormones are responsible for maintaining the metabolic rate in our body. They stimulate physiological processes in every organ of the body. Their main impact is on the functions like growth, use of oxygen and nutrients by cells, heat production to maintain normal body temperature and normal fertility. They play an active role in cellular metabolism of carbohydrates, fats, proteins, vitamins, electrolytes and water.  

    Features of hypothyroidism

    In hypothyroidism, the thyroid hormone levels fall below normal range which slows down the physiological processes. These patients develop symptoms of tiredness, mental lethargy, hoarse voice, cold intolerance, constipation, menstrual disturbance, carpal tunnel syndrome and weight gain despite reduced appetite. The weight gain is mainly due to fluid retention. They also develop muscle and joint pains. Muscle weakness causes an unsteady gait which further aggravates pain in the weight bearing joints. The joint pain is also aggravated on exposure to cold or during cold weather. Cramps involving calf muscles occur commonly at night and are debilitating.

    Carpal tunnel syndrome occurs due to accumulation of glycosaminoglycans in the wrist. This results in wrist pain and numbness of the fingers. These patients need a complete clinical assessment. The common findings include low pulse rate, cold extremities, dry skin and hair, puffiness of face, hands and feet. They have slow movements and delayed relaxation phase of tendon jerks. They also develop anemia and diffuse hair loss.

    Hypothyroidism is associated with occurrence of myopathy which results in muscle weakness.

    Hypothyroidism is associated with occurrence of myopathy which results in muscle weakness.

    Hypothyroidism and joint pain

    Hypothyroidism is associated with occurrence of myopathy which results in muscle weakness. The muscles attached to larger joints like hip, knee and shoulder are affected more. The swelling of muscles due to accumulation of glycosaminoglycans makes them weaker. This results in an increased strain on these joints. An incoordination of activity of these muscles also adds to joint inflammation and pain. These patients also have weight gain due to fluid retention. An increased load on the weight bearing joints affects their function adversely and results in pain. Deposition of glycosaminoglycans around wrist causes pain of carpal tunnel. Pressure on the nerves, passing through the carpal tunnel may result in numbness of the fingers. Similar features have been reported in ankle and foot also. This is known as tarsal tunnel syndrome.

    Treatment of hypothyroidism

    Treatment of the primary cause results in rapid improvement in pain and other symptoms. Oral thyroxine tablets help in regaining normal thyroid function. The metabolism improves and results in weight loss. This further reduces load on the joints with pain. The pace of improvement also depends on the duration of the disease. The dose should be adequate and is assessed by estimation of blood level of thyroid stimulating hormone (TSH) and free thyroid hormones. Once this is achieved, a lifelong replacement therapy is continued with regular monitoring of blood hormone levels.

      Hypothyroidism is a chronic disease. The onset is insidious and progress is very gradual. Many times it is not even suspected. Once detected, the treatment of hypothyroidism and associated joint pain should be done with thyroxine replacement therapy. A healthy diet and a regular exercise should be added to this treatment plan. Many of these patients have early morning joint stiffness as seen in rheumatoid arthritis. Gentle physiotherapy and movements of all joints improves their lubrication and improves blood flow. This also helps in prevention of any injuries due to stiff joints. If the symptoms persist in spite of normal hormonal levels, opinion of a rheumatologist should be taken.

    Anna L.

    It’s all about health!
    I have academic background in drugs related Chemical Technology, as well as extensive professional experience in pharma and medical companies. My main area of interest is everyday life medicine. The goal of my articles is to give people informative answers to the questions that bother them, to dispel doubts and some common misbeliefs and also to inspire everyone to keep healthy lifestyle.

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