Chronic Pain

I shocked a patient by connecting the dots of her pain to her hypothyroid issue... I had a patient come to see me with chronic pain of 10 years, and no idea where the pain was coming from. I asked do you have anything systemic going on like arthiritis, vitamin defecencies, thyroid etc... No one had ever told her that her muscle aches, cramps/spasms and feeling of tightness was directly connected to here low thyroid.

Pain is an extremely complex and misunderstood topic, so today we are going to help with reframing the way you look at pain. Pain science is a rapidly growing area of study due to the opioid epidemic, growing number of people stuck in chronic pain and advances in imaging like Functional MRIs (that have forced medical providers to face the reality that they jumped the gun on thinking people were faking pain).

I have already looked at chronic pain not coming from tissue issues extensively, so today I want to talk about other causes of tissue issues not related to an injury. Did you know your pain can come from your body's organs, immune responses, intestinal issues and vitamin deficiencies? It can come from so much more as well, but I do not want to be exhaustive.

A few examples of systemic conditions linked to pain that can get miss diagnosed as fibromyalgia

  • Low thyroid levels
  • Cushing's Syndrome
  • Diabetes
  • Vitamin Deficiencies
  • Autoimmune and Inflammatory Arthritis
  • Intestinal: IBS and Non Celiac Gluten Sensitivity
  • Referred pain

Hypothyroidism, aka low levels of thyroid hormone, is a condition in which your thyroid gland (a small butterfly-shaped gland in the neck, look up goiters) that is responsible for regulating your metabolism, does not produce enough thyroid hormones needed by the body. One autoimmune example of this is hashimoto's thyroiditis and it can be linked to low iodine levels in the diet as well.

We know low thyroid causes pain, but how this happens is not understood yet. Thyroid hormones have a significant influence on your body's cells (think about lego blocks of the body) metabolism, and their deficiency causes problems of the normal functioning of the body’s cells. One of the thyroid hormones called Thyroxine (T4) deficiency leads to a crisis in your body which leads to selective muscle wasting, of type 2 muscle fibers (fast-twitching type), causing the slowing of muscle contraction which leads to muscle pain.

Cushing syndrome is caused by prolonged exposure to high circulating levels of cortisol or Familial Cushing's Syndrome (in primary pigmented micronodular adrenal disease, children or young adults develop small cortisol-producing tumors of the adrenal glands). Patients can have a history of weight gain, fatigue, weakness, delayed wound healing, easy bruising, back pain, arm pain, bone pain, loss of height, depression, mood swings and so many other symptoms.

People with diabetes or family members of people with diabetes are too familiar with the foot and hand loss of feeling that happens with diabetes. The exact way diabetes causes nerve pain and loss of feeling is not fully understood. One theory is that changes in the blood vessels that supply the nerves in the arms, forearms, hands, legs and feet cause metabolic and autoimmune disorders accompanied by nerve systems cell activation, and changes in electrolyte channels which lead to increased pain in the body.

One of the most common vitamin deficiencies that leads to pain is vitamin D which exerts anatomic, hormonal, neurological, and immunological influences on pain presentation, thereby potentially playing a role in the maintenance of chronic pain states and associated comorbidities is an active vitamin D metabolite.

Some of the most common autoimmune arthritis and immune system dysfunctions that cause pain are: Rheumatoid Arthritis, Lupus, Psoriatic Arthritis, Ankylosing Spondylitis, etc...

One area that is finally getting research is gut health. Researchers and scientists theorize that the bioproducts in the gut that irritate the nervous system cause brood pain like fibromyalgia. Small intestinal bacterial overgrowth, irritable bowel syndrome and non celiac gluten sensitivity all need to be ruled in and out with pain.

Another area of more concern is referred pain from organs.

  • Shoulders and neck
    • An injured spleen
    • A heart attack
    • A liver cyst
  • Upper back right below and between your shoulder blades
    •  Stomach conditions
  • Lower back and sides of your body
    • Kidneys
    • Colon
  • Teeth and jaws
    • An early symptom of a heart attack.

What can you do if you think you are suffering from a misdiagnosis of fibromyalgia or what is causing your pain and want to know if it is from a misunderstood condition like those listed above? The first step is getting examined by a provider who will exhaust all theories on what could be leading into your unique pain experience. The next step is getting labs and other tests to rule conditions in and out. Fibromyalgia should only be used as a diagnosis after all other possibilities have been ruled out.

The main take away I hope you will gain from this is how complex pain can be. If you think you are falling into this category of pain there is hope with the right provider. Doctor Hendrix has earned a reputation for solving complex cases and helping you build the medical team around you to get your entire pain causes treated, he would be honored to help you get back your life from pain.

Dustin  Hendrix

Dustin Hendrix


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