The thyroid gland is an important gland that is located at the front of the neck. Due to injury or various diseases, it may cause pan. However, there are a host of thyroid diseases which may be painless. This can apply to even serious thyroid conditions. Throat pain alone cannot be attributed to the thyroid gland as there may be other causes from the other structures in the neck. It is therefore important to differentiate thyroid pain from other causes of throat pain.
Why does the thyroid pain?
Like any part of the body, pain may arise from the thyroid gland when there is any injury or disease. Inflammation is one of the main reasons for pain. This can occur with both injury and various diseases but sometimes the thyroid gland is intact despite the presence of pain. This may occur when the nerves carrying pain signals from the thyroid gland to the brain are injured, diseased or malfunctioning.
Thyroid pain is any discomfort or pain emanating from the thyroid gland due to disease processes within the gland or rarely due to neighboring structures in the neck and upper thorax affecting the thyroid gland. Often pain in the thyroid gland is not identified as such if other signs of symptoms of thyroid dysfunction are not clearly evident. Problems in any one of the surrounding neck structures, like the neck muscles, larynx, trachea, esophagus, cervical lymph nodes and even the blood vessels, will cause pain in the area.
Other Symptoms with Thyroid Pain
Thyroid pain may vary in intensity from discomfort that is described as tightness especially when swallowing to a dull ache throughout the gland that exacerbates when palpated (tenderness). Acute thyroid pain is uncommon in cases other than viral thyroiditis but persistent pain can be prominent enough to be one of the indications for medical or surgical intervention. Thyroid pain may be accompanied by other clinical features like :
- Enlarged thyroid gland (goiter) that appears as a frontal neck mass.
- Discomfort (dysphagia) or pain (odynophagia) when swallowing.
- Hoarse voice.
- Signs and symptoms of thyrotoxiosis (hyperthyroidism or overactive thyroid) – diarrhea, tremors, irritability, insomnia, weight loss, sensitivity to heat, sweating.
- Signs and symptoms of hypothyroidism (underactive thyroid) – constipation, depression, weight gain, menstrual irregularity (women), fatigue, intolerance to cold, dry thinning hair and brittle nails.
Many of these symptoms can occur with other conditions that are unrelated to the thyroid gland. For example, a mass in the larynx can cause a hoarse voice and throat pain. It is therefore important that diagnostic investigations are conducted for thyroid pain. This may include an ultrasound, CT scan, MRI or endoscopic investigation. Blood tests may also be conducted to assess the levels of the thyroid hormones and hormones that stimulate the thyroid gland.
Thyroid Pain Location
The thyroid gland is located between the C5 and T1 vertebrae. However, since the position of the thyroid gland can vary slightly among people, changes position during swallowing and can be enlarged (goiter), it is difficult to use the vertebral column as the sole landmark.
Thyroid pain is any superficial discomfort, tenderness or pain in the neck, below the thyroid cartilage (Adam’s apple) around the level of the cricoid cartilage that is usually exacerbated during swallowing or palpation. This tenderness or pain can extend all the way to the superior mediastinum. However the pain may not be so localized and could radiate to the sides (sternocleidomastoid muscles), above (mouth, chin, jaw) or lower (beyond the superior mediastinum to the chest).
In some cases, thyroid pain can lie almost entirely behind the sternum (retrosternal) although tenderness will be detected in the neck during palpation. Depending on the cause, the pain can be localized to a small area of the thyroid gland whereas in other conditions the pain may be evident throughout the gland.
Causes of Thyroid Pain
As with pain anywhere, there are various possible causes for thyroid pin. Identifying the cause of thyroid pain is difficult without assessing considering signs and symptoms. Thyroiditis, a bleeding thyroid cyst and advanced stages of thyroid cancer are conditions where thyroid pain is prominent and clearly evident. Diagnostic investigations are usually necessary to confirm the diagnosis.
Thyroid pain may not be prominent or present at all in other thyroid diseases, yet some patients with these painless thyroid conditions may report severe thyroid pain. In other cases the thyroid pain may only be evident upon swallowing and should be considered under odynophagia (painful swallowing). It is also important to consider other causes of anterior neck pain that are not related to any thyroid disease.
Inflamed Thyroid Gland
As previously mentioned, inflammation of the thyroid gland is one of the most common cause of thyroid pain. This is known as thyroiditis. Pain is a typical feature of inflammation and is most prominent in acute and subacute thyroiditis. It may be a temporary feature in the early stages of the disease or persist throughout the course of the disease. This includes :
- Acute infectious thyroiditis (mainly viral)
- Subacute granulomatous thyroiditis (de Quervain’s thyroiditis)
- Hashimoto’s thyroiditis (not always present)
These conditions are due to an infection or autoimmune in nature. The latter, autoimmune diseases, occurs when the immune system attacks the body’s tissues. In autoimmune-related thyroid conditions, the immune system targets the thyroid gland specifically. Some of these conditions are acute while others can be chronic.
From nodules and cysts to benign tumors (non-cancerous) and malignant tumours (cancerous), there are various types of growths that can occur in the thyroid gland. A bleeding thyroid cyst and thyroid cancers are more likely to cause thyroid pain. However, the other conditions may also cause pain, specifically when pressure is applied to the gland. This is tenderness rather than pain.
An enlarged thyroid gland is known as a goiter. Most of the time this enlargement is due to swelling of the gland and it is usually painless. However, pain can occur with the swelling depending on the cause of the goiter. For example, inflammation of the thyroid gland (thyroiditis) causes both swelling and pain, both of which are features of inflammation.