Nerve, Muscle, and Joint Pain in Thyroid Patients

by Mary Shomon Patient Advocate

Thyroid problems are associated with a variety of conditions that cause pain to your nerves, muscles, and joints. Some research estimates that as many as 80 percent of thyroid patients have some degree of myopathy, a weakening of the muscles that sometimes leads to pain, tenderness, cramps, and spasms.

Paresthesia is another thyroid-related condition, and refers to numbness and tingling usually felt in the hands, arms, legs, or feet. It can also occur in other parts of the body. Also common in people with thyroid disease is acroparaesthesia, which involves burning, tingling, or pricking sensations or numbness in your extremities when you haven’t been moving for a while, such as after sleep.

Untreated hyperthyroidism and Graves' disease are not typically associated with pain, but rather a condition known as hyperthyroid myopathy. Hyperthyroid myopathy causes weakness in the muscles and causes your muscles to easily fatigue, making it difficult to climb stairs, hold or grip objects, or reach your arms above the head. In most cases, resolving the hyperthyroidism will resolve hyperthyroid myopathy within several months.

Hypothyroidism and muscle and joint conditions

Hypothyroidism ― a condition of insufficient thyroid hormone ― is linked to a variety of general pain-related muscle and joint symptoms, including stiffness, aches, and pains in joints (known as arthropathy). Fluid retention is also common, which can lead to swelling and pain in muscles, known as hypothyroid myopathy.

Hypothyroid myopathy commonly causes what's called proximal weakness ― a weakness of muscles closer to the body's midline ― which affects an estimated 90 percent of people with hypothyroidism. Distal weakness ― weakness of muscles further out on the limbs ― is estimated to affect 30 percent of people with hypothyroidism.

Signs of hypothyroid myopathy include:

  • Muscle pain/weakness, often made worse when exposed to cold

  • Diffuse aching, called fibrositis

  • Muscle cramps/stiffness

  • Joint pain

  • Difficulty climbing stairs

  • Difficulty holding things with the fingers or hands

  • Difficulty raising the arms over the head

Hypothyroid myopathy can also lead to a number of other muscle and nerve conditions, including:

  • Tendonitis

  • Carpal tunnel syndrome

  • Tarsal tunnel syndrome

  • Frozen shoulder

  • Peripheral neuropathy

Tendonitis (also spelled tendinitis) is an inflammation and pain in tendons, most commonly affecting the elbows, wrists, fingers, arms, feet, and thighs.

In carpal tunnel syndrome, swelling compresses the nerves in the forearm, causing a variety of symptoms including pain, aches, tingling, weakness, and numbness in the wrists, fingers, or forearms, as well as decreased grip strength. It’s estimated that a third of all patients with carpal tunnel have an underlying disease, including hypothyroidism, that is causing the condition.

In tarsal tunnel syndrome, swelling compresses the nerves in the lower leg, causing pain, aches, tingling, weakness, and numbness in the feet, toes, ankles, and lower leg.

In plantar fasciitis, swelling affects a nerve in the foot sole, causing heel pain and stiffness at rest or when standing, walking, or climbing stairs.

Frozen shoulder, also known as adhesive capsulitis, causes pain, limited range of movement, and stiffness in the shoulder. The pain can radiate from the shoulder into the upper arm, and you may find it difficult to raise your arm or move your shoulder.

Hypothyroidism can cause peripheral neuropathy. In peripheral neuropathy, damage to nerves can cause a number of symptoms, including:

  • Pain

  • Burning sensations

  • Numbness and tingling

  • Muscle weakness

  • Loss of muscle control

  • Cramps

  • Muscle twitching

  • Decreased reflexes

  • Shrinkage and atrophy of muscles

Treating thyroid-related nerve and muscle conditions

For the most part, symptoms related to nerve and muscles resolve when the underlying hypothyroidism is properly and effectively treated. In most cases, symptoms lessen and even disappear within six months of treatment.

Some approaches to relieving muscle and joint pain include:

  • Supplementing with glucosamine, chondroitin, and magnesium

  • Using an inflammatory supplement like curcumin, a specialized form of the spice turmeric. (Many doctors like the high-potency form of curcumin called Curamin and Curamed.)

  • Icing or heat therapy

  • Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen (Advil or Motrin) or naproxen (Aleve)

  • Topical non-prescription creams, such as CBD, arnica, or comfrey

  • Braces and splints for carpal or tarsal tunnel

  • Orthotic shoe inserts

  • Anti-inflammatory drugs to minimize swelling

  • Stretches, exercises, and physical therapy

  • Osteopathic manipulation

  • Acupuncture

  • Steroid/cortisone shots into affected joints and muscles

When pain and symptoms continue despite treatment, some patients are referred to a rheumatologist to rule out fibromyalgia or arthritis.

In extreme cases that do not respond to any other treatments, surgery — often performed arthroscopically — is sometimes recommended for frozen shoulder, and carpal or tarsal tunnel syndromes.

The integrative approach

Hawaii-based physician Jacob Teitelbaum, MD, is one of the nation’s leading authorities on integrative and natural approaches to pain management. Dr. Teitelbaum typically recommends avoiding NSAID drugs due to the risks of liver damage. Some of his recommendations include:

  • A prescription for low dose naltrexone (LDN) at 4.5 milligrams at bedtime, to help desensitize against pain

  • A patented form of the anti-inflammatory herb turmeric’s key ingredient, curcumin, called Curamin

  • The herb Boswellia

  • An anti-inflammatory diet

Dr. Teitelbaum shares more of his integrative approaches to resolving pain in his helpful book, Pain Free 1-2-3: A Proven Program for Eliminating Chronic Pain Now.

Mary Shomon
Meet Our Writer
Mary Shomon

Mary Shomon is a patient advocate and New York Times bestselling author who empowers readers with information on thyroid and autoimmune disease, diabetes, weight loss and hormonal health from an integrative perspective. Mary has been a leading force advocating for more effective, patient-centered hormonal healthcare. Mary also co-stars in PBS’ Healthy Hormones TV series. Mary also serves on HealthCentral’s Health Advocates Advisory Board.