The thyroid influences a wide array of bodily functions. Unsurprisingly, this means that thyroid dysfunction can cause an equally diverse number of symptoms that can impact virtually any part of the body.
Although the most common problems associated with thyroid issues involve energy level, cognitive function, and weight fluctuations, there is another area of discomfort that can develop from thyroid dysfunction. Muscle and joint pain is not an uncommon occurrence for those with thyroid disease (get the full list of thyroid dysfunction symptoms here). However, many may not be aware that these pains can become centralized on specific regions such as the shoulder resulting in a condition known as frozen shoulder.
Unfortunately, the connection between inhibited muscle function and thyroid dysfunction is frequently ignored. In order to combat the significant impact of conditions such as frozen shoulder, it is important to become familiar with the the condition and understand how thyroid function impacts its development and intensity.
What Is Frozen Shoulder?
Unlike the cold shoulder which may cause emotional damage to one’s ego, frozen shoulder or adhesive capsulitis is a medical condition that impacts physical health. Frozen shoulder causes long-term pain and inhibits movement of the shoulder. The condition can remain for months or multiple years.
Various conditions including hyperadranalism, Parkinson’s disease, cardiac disease, pulmonary disease, and stroke may contribute to the development of frozen shoulder. However, those with a thyroid condition, specifically hypothyroidism, have a notably higher risk of developing this long-lasting and in some cases debilitating condition.
Typically, frozen shoulder is seen among middle aged women between the ages of 40 and 60. Interestingly, this is the same group that exhibits higher rates of thyroid disease. Although the two conditions are not dependent on each other, thyroid disease is frequently seen in those with frozen shoulder.
Development of frozen shoulder is usually gradual and reflects a decline in thyroid functionality. Trauma or significant physical damage done to the shoulder may also induce frozen shoulder. In either case, it usually takes multiple weeks or months before pain reaches a point where individuals seek out medical assistance. Reduced range of motion is another identifying symptom of frozen shoulder. However, poor mobility is often overlooked until the condition develops further.
The Stages of Frozen Shoulder
Clinically speaking, there are three distinct stages of frozen shoulder. Inflammation throughout each stage is the primary source of pain and discomfort. As a component of the inflammatory process, excess liquid and scar tissue may develop, causing additional pain and limiting the shoulder’s range of motion. Growth of the capsule lining in the shoulder, known as the synovium, may also occur resulting in more pain and further loss of mobility.
Stage 1: Development
Typically, the development of frozen shoulder involves an initial buildup of inflammation within the shoulder and associated joints. This causes minor pain that slowly increases over time. During this phase, patients may notice a decrease in passive and active range of motion in the shoulder. The developmental phase can last anywhere between three to nine months.
Stage 2: Freezing
During this stage, inflammation, scar tissue and collagen buildup becomes severe resulting in intense shoulder pain and discomfort. Movement is further restricted, and patients may not be able to move their arms above their heads due to the constriction of their joints. In severe cases, the shoulder may become so stiff that movement may become almost impossible. Patients may experience a slight lessening of pain as the shoulder and arm becomes increasingly immobile. The freezing stage can last multiple months to a full year.
Stage 3: Thawing
Most cases of frozen shoulder begin improving between one to four years. During this time, shoulder pain slowly decreases as range of motion improves at a similar rate. Ideally, the patient is able to remain relatively inactive to allow for slow and steady recovery.
The Impact of the Thyroid on Frozen Shoulder
There are many types of thyroid dysfunction including hypothyroidism (reduced thyroid function), hyperthyroidism (accelerated thyroid function), and autoimmune thyroid conditions such as Hashimoto’s thyroiditis and Graves’ disease. Any of these disorders can cause muscle and joint pain. However, hypothyroidism is the condition most often associated with the development of frozen shoulder.
Muscle weakness in the mid portion of the body affects approximately 90 percent of hypothyroid patients. A smaller percentage, around 30 percent, experience distal weakness, or loss of strength in the limbs and extremities. This is known as hypothyroid myopathy and is often a contributing factor to cold shoulder. Common indicators of hypothyroid myopathy include:
- Muscle pain and weakness that is worsened with exposure to cold temperatures
- Widespread aching over various muscle groups
- Muscle cramps
- Joint pain
- Weakened grip strength
- Difficulty raising arms above the head
Studies suggest that up to 80 percent of thyroid patients experience disruption of muscle tissue that can cause pain, discomfort, cramps, and spasms. In addition to generic muscular pain and discomfort, thyroid disease is often associated with paresthesia, or tingling and numbness. Many may be familiar with this sensation and describe it as a specific limb or extremity “falling asleep.” Typically, this sensation is felt in the arms, legs, hands, or feet. In some cases, patients may experience these feelings in centralized locations. Such sensations are a common occurrence in frozen shoulder.
Another study showed that shoulder conditions such as calcific tendonitis are common among women who experience abnormal thyroid function. Calcific tendonitis shares many symptoms with frozen shoulder and may be easily misdiagnosed. Some of these symptoms include severe shoulder pain in the morning, stiffness and limited range of motion, and sleep disruptions due to intense pain. The findings in this study suggest that the thyroid has notable influence over the development of shoulder conditions that may cause significant pain and dysfunction. Therefore, it is likely that thyroid dysfunction plays an important role in the development of frozen shoulder.
Safeguarding the Shoulder by Supporting the Thyroid
Typically, thyroid dysfunction is associated with hormonal imbalances resulting in weight gain or loss, fluctuations in energy level, and cognitive difficulties. However, there are significant physical issues that may arise from a thyroid disorder. Painful physical conditions, such as frozen shoulder, are often found in conjunction with abnormal thyroid function. Therefore, it is important to maintain healthy thyroid function to not only regulate critical processes but also protect the body from painful and debilitating conditions.
If you’re suffering from chronic pain or discomfort, especially if it is in a centralized location such as the shoulder, it may be beneficial to examine and subsequently optimize thyroid function.
For more information on proper thyroid function and treatment, read our Thyroid 101 e-book!
1. Thyroid Patients: Could You Have Frozen Shoulder? VeryWell. https://www.verywell.com/thyroid-patients-could-you-have-frozen-shoulder-3233156
2. Is Hypothyroidism Causing Your Frozen Shoulder? Natural Endocrine Solutions. http://www.naturalendocrinesolutions.com/archives/is-hyperthyroidism-causing-your-frozen-shoulder/
3. Nerve, Muscle, and Joint Pain in Thyroid Patients. HealthCentral. https://www.healthcentral.com/article/thyroid-disease-and-nerve-muscle-joint-pain
4. Conditions That Cause Frozen Shoulder. Livestrong. https://www.livestrong.com/article/239543-conditions-that-cause-frozen-shoulder/
5. What’s the Link Between Shoulder Pain & Hashimoto’s? Holistic Thyroid Care. https://holisticthyroidcare.net/link-between-shoulder-pain-hashimotos/