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In this article: 

  • What is hypothyroidism?
  • Why might it affect your muscles and joints?
  • What about hypothyroidism and nerve pain?
  • How to manage painful feet
  • A note from Paloma

Hypothyroidism is well known for causing muscle and joint discomfort. However, an underactive thyroid gland may also affect your nerves and how you experience sensations in your peripheral tissues. Know that you aren't alone if you have hypothyroidism and frequently suffer from painful feet. And while we don't fully know the extent to which thyroid hormones are involved, you should know that a poorly controlled thyroid may be partly to blame for the pain in your feet.

What is hypothyroidism?

Hypothyroidism is a chronic health condition where the thyroid gland does not produce enough thyroid hormone to support the body's metabolic needs. The thyroid gland is the powerhouse driving our metabolism and dictating how and when energy should be used. When we do not have enough thyroid hormone in our body, it can slow down our systems. On the contrary, when we have too much thyroid hormone, as with hyperthyroidism, it can speed up the metabolism, causing several problematic symptoms.

Why might it affect your muscles and joints?

Problems with the skeletomuscular system are all too common in people with hypothyroidism. Muscle pain or aches, tenderness, and joint stiffness are the most prevalent symptoms affecting this body system.

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Several factors may be behind these symptoms in people with hypothyroidism. Firstly, joint pain, in particular, may be exacerbated by autoimmunity. The leading cause of hypothyroidism in the United States is an autoimmune condition called Hashimoto's thyroiditis. In this condition, the body's immune system attacks otherwise healthy tissues in the thyroid gland, leading to chronic inflammation, dry skin, and eventual failure of the organ to produce thyroid hormone. The inflammatory agents behind this condition can also wreak havoc in other tissues and may even lead to other autoimmune conditions like rheumatoid arthritis. (Autoimmune diseases often come in multiples, referred to as polyautoimmunity.)

Secondly, people with hypothyroidism often suffer from weight gain. Being overweight can place additional weight burdens on your joints, making them prone to stress and inflammation.

Thirdly, other joint and muscular conditions are known to be linked to hypothyroidism. For example, carpal tunnel syndrome and restless legs syndrome are common in people with an underactive thyroid gland. While the exact mechanisms for these syndromes are not well understood, certain theories prevail. With carpal tunnel syndrome, excess fluid in the carpal space can lead to pressure on the wrist's median nerve, resulting in pain and neuropathy. And with restless legs syndrome, several factors may be at play, including genetics and thyroid hormone imbalance affecting the dopaminergic system.

All this to say, why you might be experiencing painful feet with hypothyroidism (and, to that extent, any muscle or joint pain) is highly complex and still being questioned.

What about hypothyroidism and nerve pain?

Nerve pain may also be a factor in hypothyroidism. Neuropathy is a condition where nerves outside the brain become damaged and cause several unpleasant side effects, including pain, numbness, and tingling in the extremities. In general, neuropathy accompanies a lot of chronic health conditions like diabetes.

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Severe and long-term untreated hypothyroidism can result in peripheral neuropathy. One theory as to why this can occur is that fluid retention damages nerves in tight joint spaces. Here again, this may be the reason why hypothyroid patients frequently experience carpal tunnel syndrome.

How to manage painful feet

So many factors can cause pain in your feet. From the type of shoes you wear and the amount of time you spend on your feet to chronic health conditions you may have, the cause behind painful feet can be tough to puzzle together.

However, if you have hypothyroidism or suspect a thyroid problem, an important first step is getting a blood test. A thyroid function test can tell you and your doctor how your thyroid is performing and if any autoimmune processes interfere with proper functioning. Getting a blood test can be complicated sometimes, so you can try an at-home thyroid test kit that only requires a small finger-prick blood sample to detect your thyroid levels.

If you have hypothyroidism, correcting low thyroid hormone with medication like levothyroxine can help restore thyroid hormone levels in your body. It can take some time to find the right dose for you, and if you are currently taking it, you may need to have your thyroid checked to verify you are on the correct dose.

Next, weight loss is key if you are experiencing foot pain. Of course, it can be hard to get moving if standing is uncomfortable. Consider other exercises like stationary biking and swimming to get a jumpstart on weight loss.

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Over-the-counter medications like ibuprofen and acetaminophen can help relieve discomfort as well. It can help to take these about 30 minutes before exercising if you are working towards weight loss. But again, adequate thyroid hormone medication is the best way to treat pain associated with hypothyroidism.

A Note from Paloma

Being mindful and aware of symptoms is crucial for any condition. If you feel that new symptoms have appeared or symptoms seem to be worsening, connect with a Paloma Health doctor to discuss a treatment plan right for you.


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About the Author: Tung Chi