Underactive Thyroid and Foot Pain: Causes and Treatment

Understanding the Link Between Hypothyroidism and Foot Pain

Hypothyroidism, also known as underactive thyroid, is a common condition where the thyroid gland doesn't produce enough thyroid hormone. Left untreated, hypothyroidism can cause widespread symptoms including joint and muscle aches, fatigue, weight gain and mood changes.

Many people with hypothyroidism also experience pronounced foot pain. The connection is not fully understood, but several factors are likely at play.

Inflammation

Low thyroid hormone levels allow inflammation to rise in the body. Inflammation can target joint tissues, including in the feet, prompting pain.

Arthritis Development

Hypothyroidism raises risk for osteoarthritis and rheumatoid arthritis, two common causes of foot pain. Arthritis leads to joint stiffness, swelling and damage over time.

Nerve Damage

Peripheral neuropathy, or nerve damage affecting the hands and feet, occurs more often with hypothyroidism. Neuropathy can manifest as numbness, tingling or shooting pains.

Muscle Stiffness

Muscles require adequate thyroid hormone to function normally. Low levels lead to muscle stiffness and cramping which contribute to foot discomfort.

Weakened Cartilage

Thyroid hormone supports production of synovial fluid which cushions joints. Deficiency diminishes fluid levels and cartilage breakdown can ensue.

Impaired Circulation

Poor circulation from hypothyroidism reduces blood flow to the extremities, depriving tissues of oxygen and nutrients needed for repair.

Gout

Gout, caused by excess uric acid crystallizing in joints, appears more common in those with underactive thyroid. Gout frequently impacts the feet.

Diabetes

The risk of developing diabetes is higher with hypothyroidism. Diabetic neuropathy often first causes symptoms like tingling and pain in the feet.

Common Types of Foot Pain

There are a few varieties of foot pain frequently seen with hypothyroidism:

Plantar Fasciitis

Inflammation of the plantar fascia, the connective tissue along the sole of the foot, causes stabbing heel pain made worse by standing and walking. It's one of the most common foot complaints.

Achilles Tendonitis

The Achilles tendon attaching the calf muscles to the heel bone can become painfully inflamed. Pain tends to worsen with activity like running or climbing stairs.

Bunions

Bunions are bony bumps at the base of the big toe from misalignment causing rubbing and irritation. The abnormal rubbing can be very painful.

Morton's Neuroma

This entrapment of a nerve between the toes, often between the third and fourth toes, feels like a sharp, burning pain in the ball of the foot that radiates outward.

Metatarsalgia

Generalized pain and inflammation in the ball of the foot is termed metatarsalgia. It can make the front of the foot extremely tender.

Arthritis

Osteoarthritis causes joint pain, swelling and stiffness. It commonly affects the midfoot and big toe joints of those with hypothyroidism.

Other Associated Symptoms

Beyond just foot pain, hypothyroidism can also lead to other changes including:

Cold Intolerance

Poor circulation and inability to regulate body temperature prompts sensitivity to cold. Feet often feel icy.

Numbness and Tingling

Nerve compression or damage manifests as numbness or "pins and needles" in the feet.

Cramping

Muscle cramps and spasms are common, especially at night. Foot cramps can be very painful.

Swelling

Fluid accumulation, or edema, causes puffy feet and ankles.

Skin Changes

Dry, scaly, cracked skin and slower wound healing makes feet more prone to infection.

Weakness

Muscles tire easily with hypothyroid myopathy. Walking and high impact exercise may become difficult.

Risk Factors

Certain individuals appear more prone to developing foot pain related to hypothyroidism, including:

Women

Women are at much higher risk for hypothyroidism and associated musculoskeletal pain.

Middle Aged and Older Adults

Hypothyroidism prevalence rises with age as does risk for arthritis and diabetes contributing to foot issues.

High Cholesterol

Dyslipidemia and high cholesterol from hypothyroidism can worsen circulation to the lower extremities.

Overweight or Obese

Excess weight stresses joints and may exacerbate foot pain.

Diabetics

Having both hypothyroidism and diabetes accelerates rates of neuropathy and foot damage.

Autoimmune Conditions

Those with rheumatoid arthritis, lupus, celiac or other autoimmune disorders have higher hypothyroidism risk.

Previous Injury

Old injuries like ankle sprains increase likelihood of developing certain foot problems like plantar fasciitis.

Getting a Diagnosis

See your doctor if you have persistent, unexplained foot pain. Your physician will likely:

Review Symptoms

Looking at your full spectrum of symptoms helps determine if hypothyroidism could be the culprit.

Examine Feet

Examining the painful foot for swelling, redness, warmth, and range of motion provides clues.

Check Reflexes

Diminished reflexes and muscle weakness may point to neurological issues.

Order Blood Tests

Blood tests to check TSH levels confirm hypothyroidism. Anti-TPO antibodies are assessed for autoimmune cause.

Obtain Imaging

X-rays, MRI or ultrasound visualize damage to bones, tendons, ligaments, and soft tissues.

Consider Nerve Studies

Electromyography assesses nerve conduction and can confirm neuropathy.

Medical Treatment Options

Addressing the root hypothyroidism is key for resolving associated foot pain. Treatment approaches include:

Thyroid Hormone Replacement

Levothyroxine or liothyronine tablets restore thyroid hormone levels and relieve symptoms.

Synthroid

The synthetic T4 thyroid hormone Synthroid improves metabolism and inflammation underlying pain.

Pain Relievers

OTC anti-inflammatories like ibuprofen, naproxen or aspirin can alleviate mild pain.

Steroid Injections

Injecting corticosteroids into severely inflamed joints or tendons reduces swelling and discomfort.

Physical Therapy

Stretches, exercises, and modalities like ultrasound target musculoskeletal causes of foot pain.

Surgery

Surgeries like bunionectomy, hammertoe correction, or plantar fascia release cure structural foot problems driving pain.

Home Remedies and Lifestyle Changes

There are also home-based approaches to lessen foot pain associated with hypothyroidism:

Cold Therapy

Applying ice packs intermittently reduces inflammation and swelling to ease pain.

Heat Therapy

Warm baths or heating pads can relax tense muscles and increase blood circulation.

Massage

Massaging sore feet enhances blood flow and limbers stiff muscles and connective tissue.

Foot Stretches

Gently stretching the plantar fascia, Achilles tendon and toes keeps these structures flexible.

Orthotics

Arch support orthotics distribute weight evenly and take pressure off painful areas.

Lose Weight

Slimming down lessens impact on feet and lowers inflammation.

Diet Modifications

An anti-inflammatory diet with more vegetables and omega-3s may ease sore feet.

Exercise

Low impact activities like walking, swimming, or yoga improve circulation and muscle strength.

When to See a Doctor

Contact your doctor promptly if you experience:

Constant Pain

Foot pain present around the clock, even at rest, warrants medical evaluation.

Difficulty Walking

If pain makes walking severely difficult, seek immediate attention.

Trauma

See a doctor after any injury like a fall or ankle roll to assess for fracture.

Redness/Swelling

These signs may indicate an infected bunion, neuroma or diabetic foot ulcer requiring antibiotic treatment.

Numbness

Loss of sensation or tingling suggests nerve damage needing diagnosis.

A Link Worth Exploring

Foot discomfort and hypothyroidism often go hand-in-hand. Addressing the thyroid deficiency and resulting inflammation, circulatory changes, and arthritis risk are key to alleviating the pain. With proper treatment, you can get back on your feet feeling comfortable.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.