{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:07:21Z","timestamp":1787170041451,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Chronic back or limb pain is often debilitating and disabling resulting in loss of efficiency, depression, and low self-esteem. Diagnosis usually suggests arthritis or nerve root pathology and patients receive long-term oral analgesics and invasive procedures with little or no relief. Hypothyroidism may present as peripheral neuropathy which may be clinically indistinguishable from entrapment neuropathy as occurs with neural canal stenosis. Muscle cramps, aches, proximal symmetrical muscle weakness, stiffness, polymyositis, and exercise intolerance may be the only presenting symptom indicating hypothyroidism. We present five cases of acute on chronic pain that improved significantly on treatment with thyroxine. Neuromuscular pain may be the only presenting symptom of hypothyroidism. Thyroid profile (TSH, FT3, FT4) and anti-thyroid peroxidase (anti-TPO) antibodies should be screened before subjecting the patient to multiple analgesics and procedures.<\/jats:p>","DOI":"10.4103\/joacp.joacp_283_23","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T10:00:10Z","timestamp":1696586410000},"page":"535-537","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Pain as a presenting symptom of hypothyroidism"],"prefix":"10.4103","volume":"40","author":[{"given":"Nishant","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Lady Hardinge Medical College and Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrinal","family":"Kamal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Lady Hardinge Medical College and Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pramod","family":"Kohli","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Lady Hardinge Medical College and Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"key":"R1-20240830","doi-asserted-by":"crossref","first-page":"261","DOI":"10.4103\/amhsr.amhsr_39_16","article-title":"Peripheral and central nervous system involvement in recently diagnosed cases of hypothyroidism:An electrophysiological study","volume":"6","author":"Gupta","year":"2016","journal-title":"Ann Med Health Sci Res"},{"key":"R2-20240830","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1212\/WNL.11.2.125","article-title":"Myxedema neuropathy and myopathy. A clinical and pathologic study","volume":"11","author":"Nickel","year":"1961","journal-title":"Neurology"},{"key":"R3-20240830","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1136\/jnnp.68.6.750","article-title":"Neuromuscular findings in thyroid dysfunction:A prospective clinical and electrodiagnostic study","volume":"68","author":"Duyff","year":"2000","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R4-20240830","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1089\/10507250252949478","article-title":"Polymyositis-like syndrome in hypothyroidism:Review of cases reported over the past twenty-five years","volume":"12","author":"Madariaga","year":"2002","journal-title":"Thyroid"},{"key":"R5-20240830","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1046\/j.1365-2265.2003.01786.x","article-title":"Musculoskeletal manifestations in patients with thyroid disease","volume":"59","author":"Cakir","year":"2003","journal-title":"Clin Endocrinol (Oxf)"},{"key":"R6-20240830","first-page":"1261","article-title":"Prevalence of musculoskeletal manifestations among primary hypothyroid patient in North India","volume":"6","author":"Singh","year":"2018","journal-title":"J Med Sci Clin Res"},{"key":"R7-20240830","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1136\/jnnp.22.4.320","article-title":"Some muscular manifestations of hypothyroidism","volume":"22","author":"Wilson","year":"1959","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R8-20240830","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1136\/ard.29.1.10","article-title":"Hypothyroidism presenting with musculoskeletal symptoms","volume":"29","author":"Golding","year":"1970","journal-title":"Ann Rheum Dis"},{"key":"R9-20240830","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1136\/pgmj.63.742.661","article-title":"Myopathy in acute hypothyroidism","volume":"63","author":"Kung","year":"1987","journal-title":"Postgrad Med J"},{"key":"R10-20240830","doi-asserted-by":"crossref","first-page":"181","DOI":"10.4103\/0970-5333.165847","article-title":"A case of peripheral neuropathy due to hypothyroidism misdiagnosed as lumbar radiculopathy:A case report","volume":"29","author":"Singh","year":"2015","journal-title":"Indian J Pain"}],"container-title":["Journal of Anaesthesiology Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_283_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:17:25Z","timestamp":1787167045000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_283_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,5]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/joacp.joacp_283_23","relation":{},"ISSN":["0970-9185","2231-2730"],"issn-type":[{"value":"0970-9185","type":"print"},{"value":"2231-2730","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,5]]},"assertion":[{"value":"2023-06-30","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-19","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}