Where Does Myofascial Pain Syndrome Most Commonly Occur
Myofascial pain and trigger points can develop in any muscle in the body. However, the most commonly affected muscles are those in the upper back, shoulder and neck. These muscles include the:
- Sternocleidomastoid: This large muscle helps rotate your head to the opposite side and flexes your neck. It is located on both sides of your neck, running from your skull behind your ear area to your collarbone and breast bone.
- Trapezius: This large, broad, flat triangular back muscle tilts and turns your head and neck, shrugs and steadies your shoulders, and twists your arms. The muscle extends from the base of your skull to the middle of your back.
- Levator scapulae: This pair of strap-like muscles help raise and rotate each of your shoulder blades. They run from the first four cervical vertebra to the top edge of your shoulder.
- Infraspinatus: This triangular muscle, located on the back side of each of your shoulder blades, helps rotate and stabilize your shoulder joints. Its one of four muscles of the rotator cuff.
- Rhomboids: This pair of upper back muscles pull your shoulder blades together when they contract and attach the upper limbs to your shoulder blade. These muscles run diagonally from the neck and chest vertebrae of the spine down to the back of the shoulder blades.
Types Of Subacute Thyroiditis
There are four different subtypes of subacute thyroiditis:
Subacute granulomatous thyroiditis: Thisis the most common type of subacute thyroiditis. Its mostly caused by viral infections.
Postpartum thyroiditis: This occurs in women within one year after giving birth, and usually goes away within 18 months. Women who develop this form of thyroiditis are thought to have an underlying autoimmune disease that causes the inflammation. Symptoms occur in two phases, starting with hyperthyroid symptoms and moving to hypothyroid symptoms.
Subacute lymphocytic thyroiditis: This also occurs during the postpartum period. Hyperthyroid symptoms develop earlier , and hypothyroid symptoms can last for several months after.
Palpation thyroiditis: This develops when thyroid follicles are damaged from mechanical manipulation such as repeated examination of the thyroid gland or surgery.
All of the subtypes of subacute thyroiditis follow a similar course of symptoms, with hyperthyroid developing first. The key differences are the causes.
Is It Menopause Or Thyroid Disorder
Thyroid disorders can cause symptoms that are mistaken for those of a woman approaching menopause. Both menstrual cycle changes and mood changes can result from the menopausal transition or from thyroid conditions. Blood tests can determine which of these conditions is responsible for your symptoms. Its also possible to have a combination of the two causes.
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Questions Your Healthcare Provider May Ask To Diagnose Myofascial Pain Syndrome:
Your healthcare provider may order a few tests to rule out other conditions and ask you questions about your pain, including:
- Where do you feel the pain?
- How would you describe your pain?
- How often do you experience pain?
- What makes your pain better?
- What makes your pain worse?
- Have you had any recent injuries?
- Do your symptoms get better at certain times during the day?
- What does your work day look like ?
Your healthcare provider may check your gait and your posture to see if there is a balance of muscle use and look for signs of muscle weakness. You may also be asked about other health problems that can contribute to myofascial pain syndrome including how much and how well you sleep and if you feel stressed, anxious or depressed.
My Hashimotos And Shoulder Pain Story
During the years of my long Hashimotos journey of being misdiagnosed, there was a period of about 6 months when I struggled with excruciating shoulder pain. It interrupted sleep, driving, travel and basically robbed my joy. I saw several specialists including orthopedists, neurosurgeons, and physical therapists. I was prescribed oral steroids, antidepressants and trigger point injections . I had an MRI and other tests which did not reveal anything structurally wrong.
Relief from the one round of trigger point injections was such a relief and I slept like a baby for the first time in quite a while.
But those benefits only lasted 24 hours and the smack-down pain returned with a vengeance, and I gained 20 pounds from the steroids.
Eventually, the cycle of pain stopped, but it was sort of by accident. After having surgery to remove fibroids, the pain that radiated from my shoulder and was about to drive me nuts somehow disappeared, literally the next day. My doctors believed it was some sort of paradox that happened as a result of anesthesia.
Whatever it was, I was grateful!
Two years ago I started experiencing mystery shoulder pain again. This time it was in the opposite shoulder and there wasnt any obvious cause, no rhyme or reason as to why it was happening. Im in good shape and always do some form of exercise every day and stretch afterward.
So, whats the connection between thyroid disease, Hashimotos and shoulder pain?
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How Is Subacute Thyroiditis Treated
If youre diagnosed with subacute thyroiditis, your doctor will give you medications to help reduce the pain and control inflammation. In some cases, this is the only treatment required for subacute thyroiditis. Possible medications include:
- Over-the-counter nonsteroidal anti-inflammatory drugs . Medications like aspirin and ibuprofen work by reducing inflammation. As a result, you will experience less pain. Acetaminophen is not as effective because it doesnt reduce the inflammation thyroiditis causes.
- Corticosteroids. Corticosteroids are used when NSAIDs arent enough to reduce swelling. Prednisone is a common corticosteroid used to treat subacute thyroiditis. Your doctor may prescribe 15 to 30 milligrams per day to start, and then slowly decrease the dosage over three to four weeks.
- Beta-blockers. Your doctor may prescribe beta-blockers if hyperthyroidism is present in the early stages. These medications lower blood pressure and pulse rate to relieve certain symptoms, including anxiety and an irregular heartbeat.
Treatment for hyperthyroidism is important at the beginning of the disease. However, it will not be helpful once your condition progresses into the second phase. During the later stages of the disease, youll develop hypothyroidism. Youll probably need to take hormones such as levothyroxine to replace the ones that your body isnt producing.
What Is Hypothyroidism
Hypothyroidism is a condition of the thyroid gland when it is not able to produce enough thyroid glands. This can have an effect on the pituitary gland, hypothalamus, or the thyroid gland itself. While most cases of hypothyroidism have been recorded in people above the age of 50, this does not mean that younger people cannot suffer from this condition.
This condition often takes place because of deficiency in iodine, but there are also many other lesser known causes for this condition, like stress. Some common symptoms of hypothyroidism include muscle cramps, depression, skin dryness, low heart rate, weight gain, fatigue, constipation, etc.
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What Is The Scm Muscle
The sternocleidomastoid muscle is located at the base of your skull on either side of your neck, behind your ears.
On both sides of your neck, each muscle runs down the front of your neck and splits to attach to the top of your sternum and collarbone. The functions of this long, thick muscle are:
- rotating your head from side to side
- turning your neck to bring your ear to your shoulder
- bending your neck forward to bring your chin to your chest
- aiding in breathing and respiration
It also helps in chewing and swallowing and stabilizes your head when you drop it backward.
In The Study Of The Sinus Infection Neck Pain:
Which including more than 5,000 people, the association of sinus infection neck pain with the risk of neck cancer was found at 58 percent, especially pharyngeal cancer?
The findings also support the need for cervical cancer in people with Sinus infection Neck Pain, the researchers said.
Sinus Infection Neck Pain leads to a headache in the head, and pain behind the ear is associated with otitis media.
This inflammation in the sinuses lead to obstruction of the nose, headache, and inability to breathe well, especially during sleep, and leads to congestion of the throat Breathing can only be done by mouth.
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Can Thyroid Cause Neck And Shoulder Pain
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The most obvious symptom of subacute thyroiditis is pain in the neck caused by a swollen and inflamed thyroid gland. Sometimes, the pain can spread to the jaw or ears. Other symptoms include: Tenderness when gentle pressure is applied to the thyroid gland.
Subsequently, question is, can hypothyroidism cause inflammation in the body? The condition causes the immune system to attack the thyroid gland, leading to inflammation and interfering with its ability to produce thyroid hormones.
Also asked, can thyroid nodules cause neck and shoulder pain?
Most thyroid nodules do not cause symptoms. However, most thyroid nodules, including those that cancerous, are actually non-functioning, meaning tests like TSH are normal. Rarely, patients with thyroid nodules may complain of pain in the neck, jaw, or ear.
What are the early signs and symptoms of thyroid cancer?
Thyroid cancer can cause any of the following signs or symptoms:
- A lump in the neck, sometimes growing quickly.
- Swelling in the neck.
- Pain in the front of the neck, sometimes going up to the ears.
- Hoarseness or other voice changes that do not go away.
- Trouble swallowing.
What Happens When A Person Experiences Myofascial Pain Syndrome How Does It Start
Myofascial pain is a common syndrome. If you have myofascial pain syndrome, you may feel pain and tenderness in muscles in a certain area of your body. This pain and tenderness is often related to one or more trigger points. To the touch, trigger points feel like small bumps, nodules or knots in your muscle.
If you could look at a trigger point under a microscope, youd see that it lies within a taut band, which is a tight strand of muscle that feels like a cord or tendon. The trigger point itself the knot is actually many nearby segments of muscle fibers that are stuck in the contracted state.
When muscle fibers are stuck in contraction, blood flow stops. If blood flow to the area stops, that area of muscle is not getting the oxygen it needs. Waste materials also build up in these fibers. This irritates the trigger point, which reacts by sending out a pain signal. Your brain responds by telling you not to use that muscle. Lack of use actually causes the muscle to tighten, become weak and it causes a loss in your range of motion. Muscles around the affected muscle have to work harder to do the work of the affected muscle. Trigger points can develop in these muscles too and add to the localized pain you feel.
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Can Thyroid Cause Neck Pain
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For some people, hypothyroidism can contribute to joint and muscle problems. Specifically, hypothyroidism may lead to: Muscle aches, tenderness and stiffness, especially in the shoulders and hips. Joint pain and stiffness.
One may also ask, can hyperthyroidism cause pain in neck? The patient may have generalized neck pain, sore throat, fever, chills, and a tender thyroid. The inflammation of the thyroid causes an increased amount of thyroid hormone to be secreted into the body, causing hyperthyroidism.
Also know, what are the symptoms of an inflamed thyroid?
Acute or infectious thyroiditisSymptoms may include pain in the throat, feeling generally unwell, swelling of the thyroid gland and, sometimes, symptoms of an overactive thyroid gland or symptoms of an underactive thyroid gland. Symptoms usually get better when the infection is treated with antibiotics.
Can thyroid cause pain in back of neck and head?
Unlike other forms of thyroiditis, subacute thyroiditis causes pain in the thyroid gland. In some cases, this pain might also spread to other parts of your neck, ears, or jaw. The American Thyroid Association estimates that the pain commonly lasts between 1 and 3 months.
How Do I Know If I Have Thyroid Nodules
Most thyroid nodules do not produce any symptoms. However, if you have several nodules, or large nodules, you may be able to see them. Although rare, nodules can press against other structures in the neck and cause symptoms, including:
- Trouble with swallowing or breathing
- Hoarseness or voice change
Hyperfunctioning thyroid nodules can lead to overproduction of thyroid hormones, also known as hyperthyroidism. Symptoms of hyperthyroidism include:
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Common Thyroid Symptoms You Probably Arent Aware Of
The following symptoms are fairly common among those with thyroid disease even if theyre a surprise to you.
Other symptoms of thyroid disease include hoarseness, mood swings, fertility problems, peripheral neuropathy, constipation, poor temperature regulation, muscle weakness, eye pain and pressure, vertigo, depression, headaches, shortness of breath and wounds that heal slowly.
If you are experiencing any of these symptoms and havent been diagnosed with thyroid disease, we suggest contacting your Portland ENT specialist for an examination.
What Should I Monitor During Treatment Session
- Vital Signs: This is especially important if the patient is an older adult, has CAD or previous hx of heart disease, or presents with signs of dyspnea, fatigue, tachycardia, and/or arrhythmia.
- Watch for signs of hypoparathyroidism such as muscular twitching, tetany, numbness, and tingling around mouth, fingertips, or toes if patient is post thyroidectomy. Hypoparathryoidism may result 1-7 days after thyroidectomy if there are complications during the surgery resulting in unintentional removal of part of the parathyroid glands.
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What You Can Do
If you are experiencing or have experienced sudden shoulder pain as described in this article, I do recommend that you see a doctor to rule out a structural problem with the joint itself and surrounding tissues.
Also, make sure your Free T3, Free T4, and vitamin D levels are optimal. At the time of my last shoulder episode, my FT3 and vitamin D levels had dropped. As I was going through therapy I also increased my thyroid hormone dose and vitamin D intake slightly.
From there, you can always try what I dida conservative approach and seek the help of a soft tissue therapist and trainer skilled in working with women who have shoulder problems. What you definitely want to avoid is rigorous physical therapy, the kind where they use aggressive and sometimes painful techniques. If your pain is related to your thyroid, painful therapy is the wrong approach for you.
More than likely it isnt a true frozen shoulder and aggressive approaches will make you feel worse, and youll be very unhappy.
Give this some time before making the decision to have surgery because it may not help at all and if it does help it may only be temporary.
I also found that using Inflammatone,an anti-inflammatory agent which is safe for Hashimotos and doesnt suppress the mucosal lining of the GI tract to be very helpful. I used it daily for 4 months.
Anti-inflammatory supplement safe for Hashimotos & reduces oxidative stress
How Is Hypothyroidism Diagnosed
With well-controlled RA, your doctor may suspect thyroid disease if you have unusual swelling in your hands, arms, legs and feet, or even unusual fatigue and weight gain, says Dr. Matteson. Thyroid tests will help to sort this out, he says.
Hypothyroidism is diagnosed with a physical exam for symptoms and results from a blood test that measures the levels of thyroid-stimulating hormone . An abnormally high TSH means hypothyroidism. It indicates the thyroid gland is being asked to make more of the hormone thyroxine because there isnt enough T4 in the blood.
Sometimes doctors may run another blood test to measure T4 levels, if needed.
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Frozen Shoulder More Common In People With Endocrine Disorders
Thyroid disease is a type of endocrine disorder. These disorders happen when a gland produces too much or too little of an endocrine hormone. As a result, people experience hormone imbalances that can affect everything from their weight to their energy levels.
Though its not clear why, frozen shoulder is more common in individuals who have endocrine problems, including thyroid disease. Researchers believe that this connection may be the result of inflammation in the body.
The shoulder is made up of bones, ligaments and tendons that are wrapped in a capsule of connective tissue. When this capsule becomes inflamed, it contracts and causes scar tissue to form. Inflammation is a classic symptom of thyroid disease and may be the reason why the shoulder freezes up.
Antithyroid Drugs: Methimazole Or Propylthiouracil
Antithyroid drugs work by blocking the thyroid glands ability to make new thyroid hormone. These drugs are the choice of therapy during pregnancy or breastfeeding, for children under the age of 12 years, for people with severe Graves disease, and as a pretreatment for older adults, cardiac patients, or patients with toxic nodular or multinodular goiter before radioactive iodine or surgery. About half of the people treated with antithyroid drugs have a later recurrence of hyperthyroid activity. Relapse is higher in smokers, patients with large goiters, and patients with positive thyroid-stimulating antibody levels at end of therapy. Major side effects include rheumatoid-like arthritis and agranulocytosis, which usually resolve after 10 days of discontinuing the drug. Minor side effects include rash, fever, gastrointestinal effects, and arthralgia. Liver damage is another very rare side effect.
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Aches And Pains Aren’t Inevitable If You Have Hypothyroidism
Could there be a connection between hypothyroidism and your joint pain? Yes but certain activities and therapies may help ease the pain.
Your thyroid gland secretes hormones that control metabolism, the body’s way of converting the food you eat into fuel, according to You and Your Hormones, an educational resource from the Society for Endocrinology. People with hypothyroidism have an underactive thyroid, which means less of those metabolism-controlling hormones, notes the Mayo Clinic. “Any disturbance in the way you burn energy can affect how your muscles feel,” says R. Mack Harrell, MD, medical and imaging director at the Memorial Center for Integrative Endocrine Surgery at Memorial Healthcare System in Hollywood, Florida.
People with advanced hypothyroidism may find that fluid builds in joints as their metabolism slows and that causes swelling that, the Mayo Clinic points out, can lead to pain. Also, joint pain commonly can occur in people with poorly managed hypothyroidism, which makes it all the more important to ensure your thyroid hormone dose is optimal.
In the meantime, these steps may help you decrease that shoulder or knee pain that’s keeping you down.