Hashimoto’s Thyroiditis Presenting As Non-specific Low Back Pain: A Case Report on Diagnostic Challenges and Management in Primary Care

Abstract

Non-specific low back pain (NSLBP) may account for 90-95% of cases of low back pain presenting to primary care. Clinicians should remain vigilant however to non-spinal musculoskeletal conditions that may mimic NSLBP and musculoskeletal complaints.  We present a case of a 38-year-old female with low back pain, lower limb tightness, groin pain, and leg cramps. Symptoms failed to improve with physiotherapy and subsequent blood tests revealed elevated thyroid-stimulating hormone (TSH), and elevated thyroid peroxidase antibody (TPO). The patient was diagnosed with hypothyroidism secondary to Hashimoto's thyroiditis (HT), an autoimmune endocrine thyroid disorder. Levothyroxine 100 microgram(µg) was prescribed, and clinical symptoms improved within eight weeks. Clinicians may wish to consider thyroid dysfunction when patients with common musculoskeletal complaints, weight gain, and fatigue respond atypically to evidence-based physiotherapy management.