The researchers, who were from the University of Sydney, conducted what is called a meta-analysis of existing studies that looked into the association between diabetes and back or neck pain (a meta-analysis uses statistics to combine data from many studies on a single topic). The researchers drew their information from a systematic search of four large electronic health databases. After eliminating the studies that they considered problematic, they scrutinized eleven. The studies involved more than 165,000 people over 18 who had diabetes. The subjects were from Canada, Finland, Iran, Spain, Denmark and the United States. In the end, the meta-analysis found that people with diabetes have a 35 percent higher risk of feeling low back pain and a 24 percent higher risk of experiencing neck pain than people without diabetes.
Although the findings were fascinating, the evidence presented in the studies was not strong enough to determine a causal link between diabetes and neck and back pain, leaving the researchers to speculate on what it could be. They developed several theories. First, they pointed out that the “biochemical milieu of diabetes,” which includes high blood sugar and abnormal cholesterol levels, “facilitates tissue damage.” Second, they said, “Poorly controlled diabetes can also reduce muscle blood flow, increasing the likelihood of cartilage inflammation and other tissue damage.” Third, diabetes is associated with loss of muscle mass and strength. Fourth, it might be that some diabetes medications influence pain. And, finally, some people with diabetes have “a low level of physical activity,” which can predispose them to back and neck pain.
According to senior author Manuela Ferreira, PhD, “Type 2 diabetes and low back pain both have a strong relationship with obesity and lack of physical activity, so a logical progression of this research might be to examine these factors in more detail. Our analysis adds to the evidence that weight control and physical activity play fundamental roles in health maintenance.”
The researchers also mentioned one take-away that physicians can get from the study: they might consider screening back and neck pain patients for undiscovered diabetes.