By David Spero, BSN, RN
If you have diabetes and back pain, you are part of a very large club. A study of 67,000 patients at the Mayo Clinic found that about 27% had chronic pain in either their lower back or neck, compared to about 13% in the general population.
Back pain seriously impacts people’s quality of life and is a leading cause of disability in the U.S. and worldwide. But why should people with diabetes be twice as likely as other people to develop severe, life-damaging pain?
An Australian analysis of over 160,000 patients in 11 studies in six countries found several possible links. High blood sugar levels and bad cholesterol levels could “facilitate tissue damage.” Animal studies confirm that rats’ spines deteriorate in the presence of high blood sugar.
The Australian researchers wrote that “poorly controlled diabetes reduces blood flow, increasing the likelihood of cartilage inflammation.” This process has also been found in rats. The spinal discs have no blood vessels of their own and rely on nutrients from the vessels of the vertebral bones. If those vessels are narrowed, as they often are in diabetes, the discs may degenerate, causing pain. The researchers also say that loss of muscle strength or the effects of diabetes medication could influence pain.
Lead researcher Manuela Ferreira, PhD, told Science Daily, “Type 2 diabetes and low back pain both have a strong relationship with obesity and lack of physical activity… Weight control and physical activity play fundamental roles in health maintenance.” Other potential pain/diabetes links include social isolation and depression, which are common in people with diabetes and increase the risk of chronic pain.
The study concluded that the connection between diabetes and back pain was strong enough that doctors should consider screening for diabetes in patients seeking care for neck and low-back pain.
Like other diabetes complications, back pain can usually be prevented with good self-management. It can also be treated by doctors and managed with self-care practices. You don’t have to do all of these; just pick one or two that seem comfortable for you.
On their neck pain page, WebMD cautions, “Staying immobile…can be harmful because it can decondition the muscles that support your neck and actually increase neck pain in the long run.” Keep physically active, without overdoing it. Walking, cycling or swimming, for example can keep back and neck muscles from tightening up. According to WebMD, physical exercise also releases endorphins, our bodies’ natural pain relief chemicals.
Before starting your day and periodically throughout the day, stretch your back muscles to protect them against injury and help them function with less pain. Professional trainer Laurel Dierking, MEd, NFPT, 200-YTT, wrote on Diabetes Self-Management, “Sedentary lifestyles, poor posture, previous untreated injuries and anatomically misaligned chairs at work, home or in the car can all be contributors to chronic compression of the spine, which invites chronic pain into our lives.” Sitting too long in one place increases back pain, especially if our chair squeezes us forward or back. Every 15 minutes or so, change position or do some simple stretches in your chair. Better yet, get up and walk around for a minute.
Dierking recommends group of stretches called twists, which can be done in various ways you can see in this article.
When we’re under stress, we tend to breathe more shallowly and hold muscles tighter. WebMD advises, “Negative feelings like depression, anxiety, stress and anger can increase the body’s sensitivity to pain.” They suggest listening to calming music or a relaxation tape. Practice deep breathing. Consider therapy or a support group to help deal with stress and depression.
Diabetes.co.UK reports that, numerous scientific investigations show that “meditation has a positive influence on pain management in general and chronic back pain in particular.” In one study, people with diabetes who took an 8-week meditation class reported better pain management and ability to function. If nothing else, meditation gets people breathing better and relaxes muscles. Meditation can also reduce fasting blood sugar levels.
Mayo Clinic researchers wrote that “the likelihood of chronic back pain (CBP) may increase to the degree to which a patient’s diabetes is uncontrolled.” People with diabetes who had CBP had a greater incidence of high blood pressure, had more neuropathy (nerve damage), higher A1C (a measure of blood glucose control over the previous 2–3 months) and bad cholesterol levels than those without chronic back pain. Consider improving your diet, exercising more (again!), using some of the tips on our website, and consult with your doctor about medication.
Cleveland Clinic reports that smokers are nearly three times as likely to have low back pain as nonsmokers. Nicotine in cigarettes will relieve pain for a while, but it makes nerves more sensitive and increases pain over time.
As with smoking, alcohol may give temporary pain relief, but it interferes with sleep and leaves you feeling worse when it wears off.
Find something to occupy your thoughts. It could be watching movies, reading, getting out in nature, visiting with friends or family, work or whatever takes your mind away from pain. You will feel better, but don’t forget to stretch occasionally while doing it!
Does that suggestion surprise you? Most experts say, “Don’t focus on the pain,” but pain is our bodies’ way of telling us something is wrong. Maybe paying attention is what the body wants us to do.
Writing in Psychology Today, chronic pain sufferer Toni Bernhard, author of the books How to Be Sick and How to Live Well suggests, “Focus on the sensations that make up the pain. Is there burning? Is there throbbing? Is there tingling? Does the pain get more intense and then less intense? This separating out of the sensations is called ‘sensory splitting.’ What you’ve been thinking of as a permanent solid block of pain is really many different constantly changing sensations.”
I use this technique a lot. I find that pain and other unpleasant symptoms like itching are reduced when I focus on them and breathe into them. Just for a short while; you don’t have to stay there.
Bernhard also suggest focusing attention on a part of the body that doesn’t hurt or on other sensations in the environment: smells, sounds, touch. Your whole life isn’t pain, include the other parts when you can. You can be more comfortable and enjoy life, even with diabetes and back pain.
Want to learn more about diabetes and musculoskeletal conditions? Read “Thawing Out That Frozen Shoulder,” “Frozen Shoulder,” “Diabetes and Bone and Joint Disorders: Quiz” and “Diabetes, Bones.”
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