From the eyes to the feet, diabetes can wreak havoc on the human body if left unchecked, and your back is no exception. In one review, data were analyzed from 11 studies, which consisted of people over the age of 18 with a diagnosis of type 1 diabetes or type 2 diabetes. The results showed people with diabetes had a 35 percent higher risk of experiencing low back pain (LBP)2.
The condition is all too common. In fact, according to the Centers for Disease Control and Prevention (CDC) 34.2 million people in the United States were found to have diabetes (10.5 percent of the population) in 20201.
Though it’s known primarily for its impact on blood sugar (glucose) levels, the reality is that diabetes is a disease that affects numerous body systems. "Diabetes is more than just problems with blood sugar,” states Jessica Starr, MD, an endocrinologist with the Hospital for Special Surgery. “It's a state of chronic inflammation."
There are a few issues that link diabetes and back pain together that you may be unaware of. These include:
Neuropathy
Diabetic neuropathy is nerve damage that occurs when continuous high glucose levels damage the nerves, resulting in symptoms like pain, tingling, or numbness. It’s a problem that may affect as many as 50 percent of people with diabetes3 and can lead to chronic back pain.
"I think neuropathy can definitely come into play when it comes to the back,” Dr. Starr says. “High sugars can damage a number of organ systems including the nervous system itself, resulting in neuropathy that causes pain or discomfort."
Bone Health
Among all of the complications diabetes can cause, compromised bone health may be the least known. However, the reality is that high glucose levels may damage the collagen that makes up bone. This can cause a greater risk of vertebral fractures, among other types and locations of fracture, in people with diabetes. Additionally, the increased fracture risk in people with diabetes is compounded by impaired fracture healing4.
"People with diabetes [often] have better bone density than their peers, but it's a paradox because diabetes is a state associated with increased fracture risk,” Dr. Starr says. “We think diabetics have a higher risk of fracture because of a higher accumulation of advanced glycation end products, a substance formed when proteins or lipids combine with sugar. Over time, these end products can damage a number of tissues including bone."
Obesity
Obesity is the double-edged sword of diabetes. It serves both as a factor that contributes to the development of type 2 diabetes and is also a complication resulting from poorly managed glucose levels. Regardless of which came first, obesity is a major contributing factor to back pain due to the extra load on the spine over time.
"Carrying excess weight and being physically inactive can take a toll on the skeletal system," states Dr. Starr.
Other Factors
In addition to the bigger contenders, poorly controlled diabetes can also reduce muscle blood flow5 and increase the likelihood of cartilage inflammation6. It can cause other tissue damage as well, like degeneration of intervertebral discs7—the cushion-like discs between each vertebra—and consequently spinal canal stenosis8. Disc degeneration and spinal stenosis are common causes of low back and neck pain9.
Dr. Starr also notes: "Diabetics are also more prone to infection, which can also cause back pain if it's in the bone (known as osteomyelitis)."
Managing Diabetes and Back Pain
Thankfully, there are some steps that people with diabetes and back pain can do to ease pain and discomfort.
Exercising is great because it kills two birds with one stone: It can help improve diabetes and improve back pain. "Exercise is important for everyone, but I would say even more so for people with diabetes because of bone health as well as other organs," Dr. Starr states.
Remaining sedentary can make back pain worse over time, even though that may be your first inclination when you’re hurting. Even something as simple as taking a walk, doing stretches, or doing gentle laps in a pool can stretch muscles, improve blood flow, and aid in weight loss, all of which are good for both conditions. Exercising also releases endorphins, which are pain relief chemicals the body produces.
We’ve all heard it before: Reduce stress where you can for longer life. However, reducing stress also applies to managing back pain, which can be especially important if you have diabetes. Diabetes already takes a toll on multiple systems of the body, including a few that contribute to back pain. Adding stress will only compound the problem.
There are a few things you can try to decompress and reduce stress in your life, such as:
Listening to a relaxation tape or soothing music
Meditating
Therapy
Yoga (which will also help to reduce physical pain and discomfort in the back)
According to Cleveland Clinic, smokers are almost three times as likely to have low back pain as nonsmokers10. Nicotine in cigarettes may alleviate your pain in the short term, but over time it makes the nerves more sensitive and can increase pain.
Along with quitting smoking, eliminating alcohol from your list of vices may help improve your back pain as well. Alcohol may help numb the pain when consuming it, but it can also cause muscle spasms and dehydration that ultimately make the pain and discomfort worse. It may also cause complications if you’re taking medications for pain.
At the end of the day, the most important thing to remember is to effectively manage your diabetes. "If you don't have good control of your diabetes, the chance of all these complications is obviously much higher,” says Dr. Starr. “In doing so, you’ll feel better, move better, and have a better chance of keeping back pain at bay.”
https://www.spineuniverse.com/conditions/back-pain/stop-diabetes-back-pain#
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