The symptoms of hypothyroidism can be quite varied from person to person; some may even seem unrelated to thyroid problems and therefore dismissed as irrelevant. However, if a connection to the thyroid is overlooked, any treatment with medication can be ineffective.
Many thyroid patients do not realize that the persistent low back pain may be related to hypothyroidism. Often, it becomes chronic because the source of the pain has not been correctly identified.
To know how to deal with low back pain effectively, it’s important to understand the 3 major causes of low back pain in thyroid patients:
1. Vitamin D Deficiency
A person’s vitamin D level is most accurately determined through a 25-hydroxyvitamin D blood test. A vitamin D deficiency will be indicated by a level of less than 40 nmol/L.
A lack of vitamin D can predispose to poor bone and muscle health and therefore result in lower back pain. If left untreated, even mild to moderate vitamin D deficiency deficiency may contribute to bone loss and muscle weakness resulting in increased predisposition to fracture and fall and can be especially dangerous for older people.
Various studies have been made on several groups of patients, and these have revealed certain facts about the occurrence of vitamin D deficiency. It has been found to be common among patients with hypothyroidism and autoimmune conditions including Hashimoto’s disease. Furthermore, the severity of vitamin D deficiency correlates with duration of Hashimoto’s, size of the goiter and levels of thyroid antibodies (1).
Vitamin D serves not only as a nutrient but also as a steroid hormone, which aids in maintaining balance of the immune system. Unfortunately, 90% of patients with Hashimoto’s disease have a genetic defect that affects their vitamin D cell-receptors preventing the nutrients from entering into the cells (2).
Other study (3) has determined that a significant part of the North American population have low levels of vitamin D. Mild forms of vitamin D deficiency are in fact quite common, but often remain undetected. This widespread condition is partially caused by an imbalanced modern diet – an average North American’s regular daily intake often lacks food rich in vitamin D like seafood, egg yolks, organ meat and butter.
Other factors which contribute to the deficiency include physical conditions such as aging, bowel inflammation, adrenal problems and obesity. It’s also affected by stress or insufficient exposure to sunlight.
A six-year research was conducted in Saudi Arabian spinal clinics, revealing how vitamin D deficiency is one of the causes of low back pain. It has been found that over 80% of patients who suffered from chronic low back pain with no apparent causes had significantly low levels of vitamin D. After these patients were given vitamin D supplements, they were all reported to experience noticeable improvements. Based on these findings, the authors suggest that screening for vitamin deficiency in patients with low back pain should be mandatory.
To provide more effective solutions to lower back pain, testing for serum 25-hydroxyvitamin D concentrations and appropriate vitamin D supplementation as well as adequate sunlight and diet rich in vitamin D foods in people with deficiency should be a part of current clinical guidelines for managing chronic low back pain.
The objective is to restore and maintain high normal levels of vitamin D for patients who experience lower back pain, particularly for those with hypothyroidism and Hashimoto’s disease. This can be successfully done with supplementation of vitamin D in emulsified form (cholecalciferol).
2. Adrenal Fatigue
Adrenal glands are responsible for regulating the body’s energy and stress levels. Any form of chronic stress that exceeds body’s ability to handle it can cause adrenal fatigue.
The most common sources of stress include:
- Lack of sleep
- Strenuous physical activity (including exercise)
- Prolonged or serious illness
- Chronic and acute infections
- Root canal repair
- High-sugar diet
When a person is consistently under stress for long periods of time, the adrenal glands become fatigued and eventually decrease in efficiency; as a result, this hampers the production of major hormones. It must be noted that any hormonal imbalance in the body can contribute to much larger problems.
The function of the adrenal glands are related to the work of the thyroid gland, so when one begins to fail, the other is sure to follow. Hypothyroidism almost always occurs with hormonal imbalance resulting from malfunctioning adrenal glands. It is one of “protective mechanisms” when our body cannot handle outperforming thyroid gland compared to low adrenal function, and slows down by reducing the output of thyroid hormones.
One of the most common warning signs of severe adrenal fatigue is a sudden, penetrating pain in the lower back. The vast majority of patients remain symptomatic and their treatments usually fail until the adrenal fatigue is diagnosed and treated accordingly.
3. Myofascial Trigger Points
Many of the daily aches and pains we commonly experience in hypothyroidism are caused by small, sensitive knots in the muscle tissue. These are called myofascial trigger points, or simply trigger points. Trigger points are formed over time due to strenuous physical activity,or can be caused by metabolic factors.
The most common metabolic factors are:
- Subclinical or mild hypothyroidism and especially low levels of metabolicaly active thyroid hormone T3
- Low iron, B12, B1, B6, folic acid, vitamin C and other nutritional deficiencies that are aslo very common in thyroid patients
- High levels of uric acid
- Estrogen dominance
- Low blood sugar (hypoglycaemia)
- Chronic viral or bacterial infection
Back pain of any kind usually involves trigger points. After other causes such as spinal arthritis, herniated disc and dislocated vertebrae are ruled out, one of the most common causes of low back pain are trigger points. The sensation is often referred pain from these tender areas.
When a person has myofascial pain syndrome, the pain may often be diagnosed incorrectly because the trigger points are similar to the symptoms of other diseases like fibromyalgia or hypothyroidism. Unless this is identified, any treatment given for the pain will be ineffective.
Overworked muscles and intensive physical activity can lead to knotting and pain in the muscle tissue, though this may subside within a few weeks if the affected tissue is not exposed to too repeated stress.
Trigger points massage is also very effective for immediate pain relief that works instantly. The costs vary from $80 to $130 per hour by a qualified massage therapist and investing into Trigger Point Self-Treatment System can save you a lot of money. Most people can feel trigger points and learn how to reactivate them. The system is easy to use and can help you to completely relax your muscles and eliminate trigger points while you apply only the amount of deep therapeutic pressure needed to your tolerance level.
If contributing metabolic factors remain unidentified and not corrected the positive effects of trigger point massage usually are only temporary. The trigger points can be reactivated again by the same stress and the patient can develop chronic myofascial pain. The most effective treatment for low back pain that was caused by trigger points is a combination of a specialized massage and correction of underlying metabolic imbalances and physical stressors.
A proper treatment of hypothyroidism and nutritional deficiencies is the best way to ensure long-lasting results of the trigger points massage therapy. Instead of reaching to pain medication, it’s necessary to understand the causes of low back pain. It’s beneficial to consider the possibility of vitamin D deficiency, adrenal fatigue or trigger points, because a proper solution to any ailment always depends on a precise diagnosis.
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1. The Association Between Severity of Vitamin D Deficiency and Hashimoto’s Thyroiditis. Endocr Pract. 2013 Jan 21:1-14.
2. Polymorphisms in the vitamin D receptor gene and risk of autoimmune thyroid diseases: a meta-analysis.Endocrine. 2013 Apr;43(2):318-26.
3. Vitamin D insufficiency in North America. J Nutr. 2005 Feb;135(2):332-7.
4. Vitamin D deficiency may have role in chronic low back pain. BMJ. 2005; 331(7508):109.