Anyone can develop muscle pain or joint problems, known as musculoskeletal conditions, which also affect the surrounding body tissues called connective tissue. But it’s more likely if you have diabetes.
We don’t know exactly how diabetes causes musculoskeletal conditions, as it’s not as well researched as some of the other complications of diabetes. But these conditions are more common in people with the microvascular complications of diabetes. These are the ones that affect the small blood vessels: nephropathy (kidney disease) retinopathy (eye disease), and neuropathy (nerve damage).
Musculoskeletal conditions are sometimes called musculoskeletal disorders, or MSDs. People with diabetes are at increased risk of the following:
Limited joint mobility
Limited joint mobility, also known as diabetic cheiroarthropathy, causes the joints to lose normal flexibility. Although most common in the hands, it can affect wrists, elbows, shoulders, knees, ankles, neck and lower back. Limited joint mobility is more likely if you have nephropathy (kidney disease) retinopathy (eye disease), and neuropathy (nerve damage).
Symptoms of limited joint mobility in the hand include joint stiffness especially the fingers, being unable to fully straighten the finger, difficulty with fine motor skills such as buttoning up clothes and reduced grip strength.
It is treated by keeping blood glucose levels as close to target as possible, but physiotherapy for regular stretching exercises and steroid injections may also be helpful.
Frozen shoulder
Frozen shoulder causes pain, stiffness and limited mobility in the shoulder. It is more common in people who have had diabetes for a long time, are of older age, have had a heart attack or who have retinopathy, nephropathy and neuropathy.
It will often resolve over time but can be treated with painkillers, steroid injections, physiotherapy and, in some cases, surgery.
Dupuytren’s contracture
Dupuytren’s contracture is a condition in the palm of the hand that causes contraction of the fingers (particularly the ring and little finger) towards the palm so they cannot be straightened.
It is more common in men than women and in people who have had diabetes for a long time, are of older age, or have nephropathy (kidney disease) retinopathy (eye disease), and neuropathy (nerve damage).
It is generally treated by surgery, but usually only if the contraction of the fingers causes a serious deformity. Steroid injections are sometimes given if it is causing a lot of pain.
Trigger finger
Trigger finger (also known as stenosing tenosynovitis) is a painful condition that affects the tendons in the hand.
When the finger or thumb is bent towards the palm, the tendon gets stuck and the finger clicks or locks. It most commonly affects the thumb, index and middle fingers.
It is more common in people who have had diabetes for a long time, are of older age, or who have retinopathy or nephropathy.
Trigger finger is treated with steroid injections, splinting the finger or, in some cases, surgery.
Carpal tunnel syndrome
Carpal tunnel syndrome is where a nerve that goes from the forearm into the wrist and hand is compressed or squeezed.
The symptoms of carpal tunnel syndrome include pain, numbness or pins and needles in the hand and wrist, particularly the thumb, forefinger and middle finger. The pain (often described as a tingling or burning sensation) is often worse at night.
It is treated by splinting the wrist, steroid injections and, in some cases, surgery.
Diffuse idiopathic skeletal hyperostosis (DISH)
DISH is an arthritis condition where calcium builds-up and causes the ligaments in the spine, and sometimes other areas, to harden. The symptoms include stiffness in the neck, back pain and reduced movement.
It is more common in people with type 2 diabetes and people living with obesity. Physiotherapy, pain killers and steroid injections can be used to help treat the symptoms.
Sarcopenia or muscle loss
Sarcopenia is the loss of muscle mass and strength that happens as people get older. You may also hear the term muscle atrophy. Muscle loss can affect movement and balance and can increase the risk of falling over.
In people with diabetes, this loss of muscle mass or strength can happen quicker than it does in older people who don’t have diabetes. It is more common in people who have retinopathy, nephropathy or neuropathy.
How to stop muscle loss with diabetes
Resistance training exercises, keeping blood sugar levels as close to target levels as possible and eating a healthy diet with plenty of protein can all help to delay and treat muscle loss.
Resistance exercises are ones in which you contract your muscles against a force or resistance. This is often called strength or weight training. The resistance could be your bodyweight (such as squats or press-ups), gym machines, free weights or resistance bands.
