Thyroid Issues, Shoulder Pain, and Neck Discomfort: A Patient's Journey

Hyperthyroidism, frozen shoulder, and a sensation of pressure in the neck?

Hello, I am fifty-five years old.
I had hyperthyroidism at the ages of twenty-four and thirty-two, and it has recurred this year.
I have been seeing a specialist at a large hospital and have been on medication for a month and a half, with significant improvement in my symptoms.
Additionally, two months ago, I developed "frozen shoulder" after a shoulder strain, and I am currently undergoing rehabilitation, with noticeable reduction in pain, although I still have difficulty with certain movements.
About two weeks ago, I started feeling a pressure sensation in my neck around the thyroid area, on both sides, as if someone were squeezing it.
I initially thought it was a normal symptom associated with hyperthyroidism (as I read online), but due to the discomfort, I later visited a private clinic's internal medicine/ENT department.
The doctor examined my throat and noted mild inflammation (possibly of the tonsils?), but could not confirm that it was related to my neck pressure sensation.
He suggested that I should follow up with my thyroid specialist for further evaluation but prescribed me cold medication.
After taking the cold medication for three days, I experienced a sudden relief each time I took it, and the pressure sensation disappeared.
I thought I was better, but after three to four hours, the pressure sensation returned.
I suspect that the anti-inflammatory and analgesic effects of the cold medication might have alleviated symptoms in other areas, and the issue may not be related to tonsil inflammation.
I also returned to my thyroid specialist, but since my recent blood test results are not yet available, she only showed me the neck ultrasound images from May 20, which indicated no abnormalities or signs of tumors.
She advised me to return in a week to review the blood test results and did not provide any explanation for my neck pressure sensation.
My question is: what other possible causes could there be for my symptoms? I lack medical knowledge, so I often find myself guessing based on online information, which causes me anxiety.
The simultaneous occurrence of hyperthyroidism and frozen shoulder has also confused my perception of my symptoms.
I am unsure whether I should wait for the thyroid doctor's evaluation next week or if I should seek examination from a family medicine or other specialist.
Currently, the pressure sensation is localized to both sides of my throat (thyroid and tonsil area), without pain, and my throat does not hurt; it just feels tight.
Thank you.

Jiǎkàng, 50~59 year old female. Ask Date: 2009/06/09

Dr. Cai Mengru reply Family Medicine

Dear Mr.
regarding your question about hyperthyroidism, if it is confirmed that the size and shape of your thyroid gland are normal, it would be less reasonable to suspect that the thyroid is causing compression.
The manifestations of functional abnormalities should not only include a sensation of pressure in the neck.
(However, based on your medical history, it is still advisable to monitor your thyroid function.) You mentioned that your symptoms improved after taking anti-inflammatory medication; could it be that there is inflammation or tension in the muscles of your neck? Therefore, my recommendation is that if, after consulting with an endocrinologist, thyroid issues are ruled out, you might consider seeing a family medicine physician for a more thorough evaluation.
Wishing you a speedy recovery.
Sincerely, Dr.
Tsai Meng-Ju, Family Medicine Department, Taoyuan Hospital, Department of Health.

Reply Date: 2009/06/09

More Info

Hello! Thank you for sharing your journey regarding your thyroid issues, shoulder pain, and neck discomfort. It sounds like you are navigating a complex set of health challenges, and it's understandable to feel concerned about the various symptoms you are experiencing.

First, let's address your thyroid condition. Hyperthyroidism, which you have experienced in the past, can lead to a variety of symptoms, including anxiety, weight loss, and muscle weakness. It’s good to hear that you have been under treatment and that your symptoms have improved. However, it’s important to monitor your thyroid levels regularly, as fluctuations can occur, especially after a history of thyroid disease. The pressure sensation in your neck could potentially be related to thyroid enlargement (goiter) or inflammation, but since your ultrasound showed no abnormalities, this is less likely.

Regarding the shoulder pain, "frozen shoulder" or adhesive capsulitis can be quite painful and limit your range of motion. It's encouraging that you are undergoing rehabilitation and noticing improvements. The connection between your shoulder pain and neck discomfort could be due to referred pain, where pain from one area is felt in another. This is common in musculoskeletal issues, especially when the shoulder and neck are interconnected.

The pressure sensation you are feeling in your neck, particularly around the thyroid area, could be attributed to several factors. While you mentioned that a doctor noted mild inflammation in your throat, it’s essential to consider other possibilities. Stress and anxiety can manifest physically, leading to muscle tension in the neck and throat area, which might feel like pressure. Additionally, if you have been compensating for shoulder pain, it could lead to altered posture, further contributing to neck discomfort.

Given that your symptoms are persisting, it may be beneficial to seek further evaluation. While waiting for your upcoming thyroid appointment is important, you might also consider consulting with a primary care physician or a specialist in musculoskeletal disorders. They can assess your neck and shoulder pain more thoroughly and determine if physical therapy or other interventions might be beneficial.

In the meantime, here are some suggestions to help manage your symptoms:
1. Gentle Stretching and Exercises: Engage in gentle neck and shoulder stretches to alleviate tension. Physical therapy can provide tailored exercises that may help improve your range of motion and reduce discomfort.

2. Heat Therapy: Applying heat to the neck and shoulder area can help relax tight muscles and improve blood flow.

3. Mindfulness and Relaxation Techniques: Practices such as deep breathing, meditation, or yoga can help reduce stress and may alleviate some of the physical symptoms you are experiencing.

4. Stay Informed: Continue to communicate with your healthcare providers about your symptoms. Keeping a symptom diary can help you track changes and provide valuable information during your appointments.

5. Avoid Self-Diagnosis: While it’s natural to seek information online, it’s crucial to rely on professional medical advice for diagnosis and treatment. Misinformation can lead to unnecessary anxiety.

In conclusion, while your symptoms may be interconnected, it’s essential to have a comprehensive evaluation to rule out any underlying issues. Your healthcare team is best equipped to guide you through this process. Don’t hesitate to reach out for support, whether through medical professionals or support groups, as managing chronic health issues can be challenging. Wishing you the best on your journey to recovery!

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