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5 Hidden Causes of Pain


If you’re hurting, it’s crucial to find the real culprit…

Do you have arthritis, backaches or some other type of nagging pain that just won’t go away?

Why pain often persists: For a significant number of people who chalk up their pain to a creaky joint, muscle aches or some other common problem, the true culprit actually has never been properly diagnosed.

But don’t give up. One of the following conditions may be at the root of your pain—or at least making it much worse. The good news is that there’s plenty you can do to treat these hidden causes of pain…


What does your backache have to do with the amount of vitamin D in your body? More than you might think, according to recent research.

Here’s why: Vitamin D is needed for normal bone metabolism. People who don’t produce enough are especially susceptible to low-back pain, possibly because the vertebrae become weakened. Low vitamin D levels also have been linked to hip pain and knee pain.

My advice: Get your vitamin D level tested once a year, particularly if you live in the Northeastern US or the Pacific Northwest. Limited sun exposure in these areas can make it difficult for the body to synthesize enough vitamin D, and it is difficult to get adequate amounts of this vitamin from food.

If your vitamin D level is low (most experts put the optimal blood level between 20 ng/mL and 36 ng/mL), take a daily supplement that provides 1,000 international units (IU) to 2,000 IU…and continue to get tested annually.


Underactive thyroid gland (hypothyroidism) is more common than most people realize. Even though the condition is most often found in women, it can affect men, too. The blood tests used to detect the condition are simple and inexpensive, yet few doctors order the testing routinely, as they should.

Thyroid hormones are real workhorses in the body—for example, they help regulate how many calories you burn, your heart rate and body temperature. If you have low thyroid levels, you’re likely to suffer from fatigue, sensitivity to cold and unexplained weight gain.

What’s not so well-known is that people with hypothyroidism tend to have nagging muscle and joint pain. This is because low thyroid can accelerate the loss of cartilage in those who already have a touch of arthritis.

My advice: If you have arthritis or any type of joint or muscle pain that has unexpectedly worsened, ask your doctor for a thyroid test. This advice applies to men, too. A thyroid function panel measures blood levels of thyroid stimulating hormone (TSH), along with levels of different thyroid hormones. A normal TSH level is typically between 0.4 mlU/L and 4.0 mlU/L.

Even if your TSH level is “border­line,” your thyroid may be contributing to your pain, so ask your doctor about medication. Thyroid-replacement hormones, such as Synthroid or Levothroid, mimic the effects of natural thyroid hormone and can start to relieve symptoms, including thyroid-related arthritis pain, within a month.


Women tend to experience more pain overall once they go through menopause—not necessarily because of pain-causing conditions, but because the body’s drop in estrogen lowers their pain tolerance.

Example: Knee pain that you might have rated as a 5 (on a 1-to-10 scale) before menopause might now feel like an 8. Pain sensitivity is higher in postmenopausal women who also have low thyroid.

My advice: Try supplemental curcumin. This potent anti-inflammatory reduces pain and improves joint flexibility. Most postmenopausal women (and men, too!) notice an improvement when they take it. Dose: 2,000 mg daily. This supplement is generally safe for everyone to use, but consult your doctor first, especially if you take any medication (it can interact with some drugs, such as anticoagulants)…or if you have gallstones, since it could increase painful symptoms. Good product: Northeast Natural’s Triple Curc.

If this doesn’t give you adequate pain relief, you may also want to consider estrogen replacement. It de­creases pain sensitivity and reduces the loss of joint cartilage. Important: Estrogen replacement can increase risk for heart disease, stroke and breast cancer in some women, so ask your doctor to help you sort out the pros and cons.


This tick-borne illness can be easily treated (usually with a three-week course of antibiotics)—if it’s detected early. But many people don’t know they have it, in part because the test isn’t always accurate.

What happens: The bacterium that causes Lyme can destroy joint cartilage. Many people with Lyme know that something’s wrong, but it often takes months—and multiple visits with different specialists—to get an accurate diagnosis.

My advice: If you live in an area where ticks and Lyme disease are common, do not wait to get help. The symptoms might include muscle or joint pain, unexplained fatigue and/or a burning sensation that affects your whole body. Treating Lyme disease quickly reduces the risk of lingering joint pain and other symptoms.

If you test negative but still suspect that your pain may be caused by the disease, consider seeing a doctor who specializes in diagnosing Lyme for a second opinion. To find such a specialist near you, consult the International Lyme and Associated Diseases Society.


People who have chronic pain often don’t sleep well. But it also works the other way—less deep sleep lowers your tolerance to pain.

Even if you think that you sleep well, you may not be getting enough rapid eye movement (REM) sleep—the more time you spend in this stage of sleep, the better equipped your body will be at tolerating pain.

My advice: Get at least 30 minutes of aerobic exercise every day. This type of exercise increases levels of deep sleep, which is needed for you to get adequate REM sleep.

Source: Source: Vijay Vad, MD, a sports medicine specialist at the Hospital for Special Surgery and assistant professor of rehabilitation medicine at Weill Cornell Medical College, both in New York City. He is also the founder of the Vad Foundation, an organization that supports medical research related to back pain and arthritis, and the author of Stop Pain: Inflammation Relief for an Active Life. Date: July 1, 2015 Publication: Bottom Line Health
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