Thyroid and Parathyroid Dysfunctions and the Musculoskeletal System

The thyroid and parathyroid glands are critical endocrine organs responsible for regulating a myriad of physiological processes, including those within the musculoskeletal system. The thyroid gland synthesises thyroid hormones, which are essential for normal bone and muscle development and function. Conversely, the parathyroid glands secrete parathyroid hormone (PTH), a pivotal regulator of calcium levels in the bloodstream. Dysfunctions of these glands can significantly affect the musculoskeletal system, leading to a range of symptoms and complications.

Thyroid Dysfunction and Musculoskeletal Health


Hypothyroidism, characterised by inadequate thyroid hormone production, is the most common thyroid disorder, affecting approximately 1-2% of the population. This condition can have a profound impact on the musculoskeletal system, resulting in various symptoms and complications:

  • Muscle Weakness and Fatigue: Individuals with hypothyroidism often experience muscle weakness and debilitating fatigue, hampering their daily activities.
  • Myalgia and Arthralgia: Hypothyroidism is associated with myalgia (muscle pain) and arthralgia (joint pain), further limiting mobility and causing discomfort.
  • Carpal Tunnel Syndrome: Hypothyroidism elevates the risk of developing carpal tunnel syndrome, characterised by numbness, tingling, and weakness in the hands, affecting fine motor skills.
  • Myositis and Osteoporosis: Myositis, marked by inflammation of the muscles, is another musculoskeletal manifestation of hypothyroidism. Additionally, individuals with hypothyroidism face an increased risk of osteoporosis, a condition typified by brittle bones and heightened susceptibility to fractures.
  • Adhesive Capsulitis (Frozen Shoulder): Emerging studies have unveiled a link between hypothyroidism and an augmented risk of adhesive capsulitis, commonly known as frozen shoulder. Adhesive capsulitis entails inflammation and thickening of the shoulder joint capsule, leading to a gradual loss of both active and passive shoulder mobility.

The exact mechanisms underlying how hypothyroidism affects the musculoskeletal system, including the development of adhesive capsulitis, remain incompletely understood. Nevertheless, it is postulated that thyroid hormones play crucial roles in muscle metabolism, bone turnover, and nerve function.


Hyperthyroidism, characterised by excessive thyroid hormone production, is less common than hypothyroidism, affecting approximately 1% of the population. Despite its lower prevalence, hyperthyroidism can also impact the musculoskeletal system, leading to symptoms such as:

  • Muscle Weakness and Atrophy: Hyperthyroidism accelerates muscle metabolism and bone turnover, culminating in muscle weakness and atrophy.
  • Osteoporosis and Fractures: The influence of hyperthyroidism on bone turnover contributes to the development of osteoporosis and heightens the risk of fractures.

Parathyroid Dysfunction and Musculoskeletal Health


Hypoparathyroidism occurs when the parathyroid glands fail to produce sufficient PTH. This condition can result from various factors, including surgery, autoimmune disease, and genetic disorders, leading to musculoskeletal symptoms like:

  • Muscle Cramps and Tetany: Reduced PTH levels lead to low blood calcium levels, precipitating muscle cramps and tetany (muscle spasms).
  • Osteomalacia and Fractures: Hypoparathyroidism impairs bone mineralization, resulting in osteomalacia (softening of the bones) and an elevated risk of fractures.


Hyperparathyroidism is characterised by excessive PTH production, which can be caused by factors such as tumours, overgrowth of the parathyroid glands, and genetic disorders. This condition can affect the musculoskeletal system in the following ways:

  • Muscle Weakness: Elevated PTH levels can damage muscles, leading to muscle weakness.
  • Bone Pain: Individuals with hyperparathyroidism may experience bone pain due to high blood calcium levels.
  • Osteoporosis and Fractures: Chronic hyperparathyroidism can result in osteoporosis and an increased susceptibility to fractures.


Treatment for thyroid and parathyroid dysfunctions aims to restore normal hormone levels and address resulting imbalances:

  • Hypothyroidism: Treatment involves thyroid hormone replacement medication to elevate thyroid hormone levels to normal.
  • Hyperthyroidism: Management options encompass medication to counteract the effects of thyroid hormones, radioactive iodine therapy to obliterate thyroid tissue, or surgery to remove part or all of the thyroid gland.
  • Hypoparathyroidism: Patients with hypoparathyroidism frequently require calcium and vitamin D supplements to maintain adequate calcium levels in the bloodstream.
  • Hyperparathyroidism: Treatment typically entails surgical removal of the affected parathyroid gland(s) to restore normal PTH levels.


Thyroid and parathyroid dysfunctions wield a profound influence on the musculoskeletal system, eliciting a spectrum of symptoms and complications, including adhesive capsulitis. Recognising the potential musculoskeletal repercussions of these disorders is imperative for early diagnosis and prompt intervention. Timely treatment can mitigate the risk of severe complications, such as osteoporosis, fractures, and frozen shoulder (adhesive capsulitis), enabling individuals to preserve their musculoskeletal health and overall well-being.