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Pain associated with nodules?
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Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.

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Pain associated with nodules?

I am awaiting a biopsy this week for 2 solid nodules (one in each lobe) that were discovered last fall. They were not found in a physical exam in July even though the thyroid was palpated, found incidentally in an MRI of the back in August (not sure what size) and an ultrasound in late November showed one at 3.5 cm and the other at 2.5. My level of discomfort has increased significantly since then, so I imagine they have grown, although I cannot confirm this yet.

I have been experiencing sharp neck pains when I move my head, and generally feel my neck swollen and a bit stiff. I also have pain that radiates from the sides all the way to the back, mostly back of the head just behind the ears. Could this be related to the nodules?

I am not too concerned about malignancy, as I understand the cure rate to be quite good, but my surgeon stated in January he would not remove nodules of this size if they were benign, as he felt they didn't cause a problem. It feels like a problem to me.

My day to day life is certainly altered by this pain, and I don't know what else it would be. Stretching and general home care has not made any difference since December. If this is not the nodules I am at a loss for what is causing this pain.

If the nodules are causing this pain, can I insist on having surgery to remove them?
Any info would be appreciated.
Michel
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Typically nodules do not cause this type of pain -- they can cause hoarseness, trouble swallowing and a chocking sensation.  Sounds like FNA (biopsy) is the right next step.  If no other cause for the pain can be identified and the pain persists/increases it may be worth asking for a thyroidectomy with the understanding that the pain may not be resolved after the operation.
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Adding to the previous questions, what size would the nodules generally have to get to for surgical removal to be warranted? 3.5 cm or more seems to me like an enourmous lump to have in my neck.

Thx,
Michel
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Avatar_n_tn
Interesting.  I just posted a question today regarding some of the issues I have been having. Unfortunately, I have no answers at all, though I can tell you that I have several nodules on my thyroid.  The enlargement was discovered 2 months ago.  Since then I have had many tests run, but my problems seem to be increasing and I really feel like they all have to connect in some way or another.  The right side of my thyroid is 4.2 (that is the side they are concerned with), I have had difficulty swallowing off and on and I keep getting an infection on the right side of my throat.  This week, I have begun to have intense neck pain, almost like I have whiplash.  I can't rotate my neck well, nor can Iift my head back or bend forward without pain.  If you get any answers to the neck pain, please let me know.  Right now I feel helpless.  The Endochronologist can't justify surgery b/c I dont have direct pain on my thyroid, but I feel like there has to be a common link. The ENT doesnt answer alot cause he's convinced the problems are being caused by my thyroid.  I keep getting the run around and I don't know where to get answers.  I hope the pain in your neck gets better. Good luck with everything!
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Well these forums if nothing else reinforce the fact that I'm not alone with this.  The results from a FNA biopsy done under ultrasound just got returned yesterday as non-diagnostic, due to lack of cells in the sample (hypocellular). So after waiting 3 months with this neck pain, I am no further ahead and have to wait another 2-3 months before the next one. I sympathize with you, as I too have this neck pain that is affecting my daily life, and both GP and surgeon are telling me they don't think it is related, but they have no idea what else it would be. The pain for me is almost exclusively on the SCM muscle on the left side, and the largest nodule (3.5 cm) is also located there, very low. I have some compression discomfort as well while swallowing, but that is way more manageable...constant pressure like a chokehold that gets worse when my head is down, but not painful... just annoying. I have been very diligent in home care (stretching, making sure to not sleep with too many pillows etc) but no amount of being careful has helped. I got an appointment with another specialist (ear, nose and throat) late April to get a second opinion on this pain, as well as evaluate my vocal chords in prep for a possible TT. The waiting around is just the worse part. I hope you live somewhere where you can get timely treatment, as opposed to me in Canada where all I get is insurance coverage, but no treatment to go with it.
Michel
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Starting in November of last year, I felt a lump inside my throat.  After doing some research, I found this could be caused by stress.  I discounted the lump do to going through a very stressful time in my life.  I went to the Doc two weeks ago, because of the lump not going away, and the annoyance is getting worse.  I had an ultrasound performed which revealed a nodule in the right side of my thyroid.  I also have had a complete blood test done and according to the doc's office all levels are within the normal range.  (I have not seen the lab tests so I do not know if I am on the low or high sides of normal)  The next test that was performed today is the thyroid scan.  I am awaiting the results.  (the person performing the scan said she did not see any "Cold or Hot" areas.)  As I await the results, I am confused on hyper or hypo thyroid and my symptons.  I have the following symptons:

weight gain (unable to loose weight even with exercise)
tiredness or feeling completely exhausted
aches and joint pain (particularly shoulders, arms and ankles)
hair loss (have approx 15-25 strands in the sink every morning)
hair is now curly when I have always had very straight hair (so straight it would not curl with a curling iron)
skin is very dry
eyes are blurry (frequently tear)
mood swings/irritable
difficulty swallowing
frequent coughing or clearing of the throat
ringing in the ears or inside of ears itch
sex drive is almost none
forgetfulness
trouble focusing or staying on task
hands shake
get cold easily, and cannot tolerate heat

Do the symptoms above sound hyper or hypo thyroid?  Is it possible to be hypo or hyper with blood tests in the normal range?  Can normal ranges still be determined as not a normal range that makes you feel normal?  My concern with all of the blood test being normal, that this annoyance and difficulty swallowing lump in my throat will be a wait and see in 6 months.  I personally am getting inpatient with the feeling.  Also a little over a year ago, I was diagnosed with anemia and had a hysterectomy due to 15 day periods with only 7 days of non periods which ultrasounds revealed fibroids in my uterus.  I had the same symptoms as above, but the docs thought it was due to the anemia.  Thanks, BaseballMom#5
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