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 Diabetes was associated with a 35 percent higher likelihood of
reporting back pain, in an analysis of five studies with a total of
131,431 people, and with a 24 percent greater risk of neck pain,
according to two studies with 6,560 people.
But the only study in the analysis to follow people over time found
no connection between diabetes and the risk of back, neck or spinal
pain, the study team notes in PLoS ONE. That suggests other factors
might also account for increased reports of back pain among diabetes
patients.
"We know that obesity and physical inactivity are risk factors for
both conditions so it is likely that they underlie that link," said
senior study author Manuela Ferreira of the University of Sydney in
Australia.
"Keeping normal blood sugar levels, managing body weight and most
importantly keeping physically active are key in managing and
preventing this combination of chronic diseases," Ferreira said by
email.
One in two people will experience low back pain or neck pain at some
point in their lives, the study authors note. Some previous research
suggests that diabetes makes this type of chronic pain more likely
to develop, but results have been mixed and strength of the
connection isn't clear, they write.
Researchers looked at patients with both types of diabetes, each of
which is a chronic disease that affects the way the body manages
blood sugar.
The most common form, type 2 diabetes, is linked to obesity and
aging and happens when the body can't properly use or make enough of
the hormone insulin to convert blood sugar into energy. The less
common form, type 1 diabetes, develops in childhood or young
adulthood and occurs when the pancreas produces no insulin at all.
Altogether, researchers examined data from 11 different studies in
six countries that looked at back pain, neck pain, spinal pain or
some combination of these issues.
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Only one study tracked people with diabetes who didn't have skeletal
pain to see if they developed this problem over time. After two to
four years of follow-up, this study failed to find a connection for
back pain, neck pain or spinal pain.
The studies included in the analysis were not designed to prove
whether or how diabetes might cause back, neck or spinal pain. The
smaller studies also varied in their definitions of pain and the
context in which diabetes patients reported their pain.
Even so, it's likely that obesity contributes to both diabetes and
musculoskeletal pain issues, said Dr. Ahmed Hassoon, a researcher at
the Johns Hopkins Bloomberg School of Public Health in Baltimore who
wasn't involved in the study.
"If we add more weight beyond the capacity of the spine and its
supporting disks and muscles, then we will destabilize it and will
have all sorts of issues, and if we don't move enough, our support
muscles will not be strong enough to support the spine," Hassoon
said by email.
People with diabetes may be overweight or obese, and have diabetes
complications that impair how blood vessels and nerves function.
These problems can, in turn, compromise spinal health and contribute
to back pain, Hassoon said.
"Long-term uncontrolled diabetes has negative impact on our blood
vessels, nerves, muscles, and bone," Hassoon said. "Which, in turn,
can generate all kinds of musculoskeletal symptoms, like chronic
pain."
SOURCE: https://bit.ly/2XUxoLX PLoS ONE, online February 21, 2019.
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