Hyperparathyroidism can cause unusually high calcium levels in the blood. This can lead to back pain when there is damage to the kidneys or bones. It can also cause muscle pain.
Most people with hyperparathyroidism do not develop symptoms. However, when the condition is severe enough to cause symptoms, these often include musculoskeletal pain, which may affect the lower back.
Hyperparathyroidism can cause back pain in various ways. Some people develop kidney stones, which can cause intense back pain. Hyperparathyroidism can also weaken the bones, causing a loss of bone mineral density. This may cause bone pain and an increased risk of fractures.
Read on to learn more about the link between hyperparathyroidism and back pain.
In people with hyperparathyroidism, the parathyroid glands release an excessive amount of parathyroid hormone into the bloodstream. This causes blood calcium levels to rise.
Parathyroid hormones are responsible for tightly controlling the amount of calcium in the blood. This nutrient is important for healthy bone development, and the body uses it for various functions.
Too much calcium in the body, known as hypercalcemia, can negatively affect the bones and kidneys. Muscle pain — including in the back — is a common symptom of hyperparathyroidism.
Primary hyperparathyroidism means that another medical condition is not the reason for the symptoms. In many people, a benign tumor called an adenoma causes the condition.
Hypercalcemia is when there is too much calcium in the blood. It is also the main cause of hyperparathyroidism symptoms.
High levels of parathyroid hormone promote the release of calcium from bones into the blood, leading to excess calcium in the blood and causing the bones to become weaker. Excess calcium may lead to a kidney condition called nephrolithiasis, in which calcium stones are present in the organ.
Damage to the bones may cause bone pain in the back or hips. Nephrolithiasis can cause pain in the lower back and lower abdomen. Over time, bone damage can cause weaker bones that may break, leading to fracture-related back pain.
People with hyperparathyroidism may experience back pain due to the following reasons:
- Psychological distress: Psychiatric health conditions and chronic stress — both of which may occur in people with hyperparathyroidism — increase the risk of chronic pain. Chronic pain may then intensify feelings of psychological distress, initiating a cycle of worsening back pain and stress.
- Muscle weakness: People with hyperparathyroidism commonly experience muscle weakness, which can increase the risk of injuries that lead to pain, including in the back. For example, a person may fall or struggle to lift certain items.
- Inflammation: People with hyperparathyroidism may experience chronic inflammation. Inflammation can cause muscle pain, including back pain, which may become chronic.
- Bone damage: Hyperparathyroidism
can lowerbone mineral density, weakening the bones. This may cause bone pain. It also increases the risk of painful bone fractures, including in the back.
- Kidney stones: Kidney stones, a potential symptom of hyperparathyroidism, can cause back pain. Intense pain in the lower back may indicate kidney stones.
There are also many other possible causes of back pain.
In the early stages of hyperparathyroidism, a person may not have any symptoms. Instead, a doctor may diagnose the condition during routine blood tests, when calcium levels are unusually high.
Some symptoms of primary hyperparathyroidism
A doctor may perform various exams to determine whether hyperparathyroidism is causing back pain. These may include:
- Medical history: The doctor will ask the person questions about the severity of their back pain, its exact location, and when the symptoms began.
- Physical exams: Physical examinations may involve testing reflexes and muscle strength, as well as assessing the spine.
- Imaging tests: These tests, which include X-rays, MRI scans, and bone scans, can rule out other causes of the pain and indicate whether fractures or spine issues are present.
If a doctor suspects that hyperparathyroidism is causing back pain, they will
Blood tests showing high calcium levels may require further evaluation. A doctor may recommend additional testing for elevated levels of parathyroid hormone.
A doctor may screen for signs of secondary hyperparathyroidism, potentially by testing kidney function.
There are various treatment options for back pain, including medication and nonsurgical and surgical interventions. Doctors will be able to advise on the best option for people with hyperparathyroidism who are experiencing back pain.
If further examination of the back pain reveals that hyperparathyroidism has progressed, doctors may recommend surgery. Typically, the following signs may show that the disease is advanced:
- higher calcium level
- lower bone density
- kidney stone
Surgery to remove the parathyroid glands is the
In some cases, a doctor may recommend a type of surgery called bilateral neck exploration. During this procedure, a surgeon assesses which glands are overactive and then removes only those glands.
In people with no symptoms, it may be possible to avoid surgery. Alternative options include:
- bisphosphonates, which are a group of drugs that can reduce bone loss
- cinacalcet (Sensipar), a drug for hypercalcemia
- vitamin D supplements for people deficient in vitamin D
People with this condition should also avoid becoming dehydrated, as this may cause calcium levels to increase in the body.
People should consider contacting a doctor if their back pain does not improve after a few weeks or if they experience any of the
- numbness and tingling sensations
- severe back pain that does not ease with medication
- back pain after a serious injury or fall
- back pain alongside trouble urinating, weakness, fever, and unintentional weight loss
Hyperparathyroidism does not always cause symptoms, especially in mild cases. However, by the time symptoms appear, there may be damage to the bones and kidneys, and a person may have significant pain.
Treating hyperparathyroidism can prevent it from getting worse and help minimize symptoms, such as back pain. A person with elevated blood calcium levels should discuss the treatment and management options with a doctor.
In some cases, it may be possible to avoid surgery, but a person must monitor their condition and tell a healthcare professional if the symptoms get worse.