If you are suffering from diabetes, then you are more likely to have any of the related complaints such as high B.P, high cholesterol levels, and obesity. Diabetes causes damage to blood vessels in the eye (retinopathy), nerves (neuropathy), and kidneys (nephropathy). Diabetic nerve damage causes degeneration of joints, bones, and soft tissue which in turn causes joint pain.

In case you are suffering from type 1 diabetes affecting pancreatic cells, it is highly likely that due to the same autoimmunity reason you may also experience rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis affecting the respective joints. This is because due to autoimmunity, type 1 diabetes coexists with other autoimmune arthritic conditions.

But in case you are suffering from type 2 diabetes, which is a metabolic disorder it is advisable that you be cautious about osteoarthritis because of common risk factors like old age, obesity, or a sedentary lifestyle.

Apart from the above reasons, some of the joint problems that occur due to diabetes are as follows:

Diabetes and various types of joint pains

1) Charcot (Shahr-KOH) joint

a) Otherwise known as neuropathic arthropathy

b) The most common joint problem due to diabetes.

c) Symptoms: Numbness, tingling, or loss of sensation in affected joints that may be warm, red, swollen, and deformed.

d) Limit the weight-bearing activities and use of orthotic supports are helpful.

2) Limited joint mobility

a) Also called diabetic hand syndrome and is irreversible.

b) Stiffness is seen in small joints of hands such as finger joints.

c) Inability to extend your fingers or press your palms together.

d) Can be slowed down by better management of blood sugar and regular physical activity.

3) Osteoarthritis (OA)

a) Type 2 diabetes patients with obesity have an increased risk of OA.

b) Joint pain, stiffness, swelling, and loss of flexibility of joint movements.

c) Physical exercise and maintaining a healthy body weight are helpful. Either Total or Uni-compartmental knee replacement surgery is recommended based on the extent of cartilage damage.

4) Diffuse Idiopathic Skeletal Hyperostosis (DISH)

a) Also called Forestier disease which involves hardening of ligaments (the connection between two bones), and tendons (the connection between bone and muscle).

b) Affected in individuals with type 2 diabetes due to insulin or insulin-like growth factor that promotes new bone growth.

c) Commonly affects the spine. Pain and stiffness are seen.

d) Pain is managed by pain killers such as paracetamol or ibuprofen.

5) Dupuytren’s contracture

a) Seen in patients suffering from diabetes for a long time in which one or more fingers are bent towards the palm.

b) Skin thickening on the palm is a symptom

c) Pain is managed by steroid injections and surgery might be required.

6) Frozen shoulder

a) Diabetes is the risk factor

b) Shoulder pain in only one shoulder.

c) Intensive physiotherapy can help in movement.

d) Glucocorticoid injections can help in relieving moderate to severe pain.

In the case of knee osteoarthritis, diabetes mellitus is associated with severe pain distributed unilaterally or bilaterally. Other than obesity, which is coexistent with diabetes, independently high blood sugar (hyperglycemia) is known to aggravate osteoarthritis (OA) by three mechanisms –

1) Joint degradation by Advanced Glycation end products (AGEs) generated due to oxidative stress

2) Provoke local joint inflammation (swelling and pain in joints).

c) Cause neuromuscular deficiencies that destabilize joints and worsen OA.

So, controlling blood sugar in type 2 diabetes and managing autoimmunity in type 1 diabetes are of paramount importance in preventing or managing joint pain due to diabetes mellitus