From the eyes to the feet, diabetes can wreak havoc on the human body if left unchecked, and your back is no exception. In one 2019 review published in PLoS ONE, data were analyzed from 11 studies, which consisted of people older than 18 with a diagnosis of type 1 diabetes or type 2 diabetes. The results showed people with diabetes had a 35% higher risk of experiencing low back pain (LBP).

According to the Centers for Disease Control and Prevention (CDC), 34.2 million people in the United States were found to have diabetes (10.5% of the population) in 2020.

Though it’s known primarily for its impact on blood sugar (glucose) levels, the reality is that diabetes is a disease that affects numerous body systems.

"Diabetes is more than just problems with blood sugar,” states Jessica Starr, M.D., an endocrinologist with the Hospital for Special Surgery in New York, NY. “It's a state of chronic inflammation."

There are a few issues that link diabetes and back pain that you may be unaware of. These include:

Neuropathy

Diabetic neuropathy is when continuously high glucose levels damage the nerves, resulting in symptoms like pain, tingling, or numbness. It’s a problem that may affect as many as 50% of people with diabetes, according to Mayo Clinic, and can lead to chronic back pain.

"I think neuropathy can definitely come into play when it comes to the back,” Dr. Starr says. “High sugars can damage a number of organ systems including the nervous system itself, resulting in neuropathy that causes pain or discomfort."

Bone Health

Among all of the complications diabetes can cause, compromised bone health may be the least known. High glucose levels may damage the collagen that makes up bone. This can cause a greater risk of vertebral fractures, among other types and locations of fracture, in people with diabetes. Additionally, the increased fracture risk in people with diabetes is compounded by impaired fracture healing, according to a 2019 review published in the International Journal of Molecular Sciences.

"People with diabetes [often] have better bone density than their peers, but it's a paradox because diabetes is a state associated with increased fracture risk,” Dr. Starr says. “We think diabetics have a higher risk of fracture because of a higher accumulation of advanced glycation end products, a substance formed when proteins or lipids combine with sugar. Over time, these end products can damage a number of tissues including bone."

Obesity

Obesity is the double-edged sword of diabetes. It serves both as a factor that contributes to the development of type 2 diabetes and is also a complication resulting from poorly managed glucose levels. Regardless of which came first, obesity is a major contributing factor to back pain due to the extra load on the spine over time.

"Carrying excess weight and being physically inactive can take a toll on the skeletal system," states Dr. Starr.

Other Factors

In addition to the bigger contenders, poorly controlled diabetes can also reduce muscle blood flow and increase the likelihood of cartilage inflammation. It can cause other tissue damage as well, like degeneration of intervertebral discs—the cushion-like discs between each vertebra—and consequently spinal canal stenosis. Disc degeneration and spinal stenosis are common causes of low back and neck pain.

Dr. Starr also notes: "Diabetics are also more prone to infection, which can also cause back pain if it's in the bone (known as osteomyelitis)."

There are some steps that people with diabetes and back pain can do to ease pain and discomfort.

Exercising is great because it kills two birds with one stone: It can help improve diabetes and ease back pain.

"Exercise is important for everyone, but I would say even more so for people with diabetes because of bone health as well as other organs," Dr. Starr states.

Remaining sedentary can make back pain worse over time, even though that may be your first inclination when you’re hurting. Even something as simple as taking a walk, doing stretches, or doing gentle laps in a pool can stretch muscles, improve blood flow, and aid in weight loss, all of which are good for both conditions. Exercising also releases endorphins, which are pain relief chemicals the body produces.

We’ve all heard it before: Reduce stress where you can for a longer life. However, reducing stress also applies to managing back pain, which can be especially important if you have diabetes.

There are a few things you can try to decompress and reduce stress in your life, such as:

  • Listening to a relaxation tape or soothing music

  • Meditating

  • Therapy

  • Yoga (which can also help to reduce physical pain and discomfort in the back)

According to Cleveland Clinic, smokers are almost three times as likely to have low back pain as nonsmokers. Nicotine in cigarettes may alleviate your pain in the short term, but over time it makes the nerves more sensitive and can increase pain.

Along with quitting smoking, eliminating alcohol from your list of vices may help improve your back pain as well. Alcohol may help numb the pain when consuming it, but it can also cause muscle spasms and dehydration that ultimately can make back pain and discomfort worse. It may also cause complications if you’re taking medications for pain.

At the end of the day, the most important thing to remember is to effectively manage your diabetes.

"If you don't have good control of your diabetes, the chance of all these complications is obviously much higher,” says Dr. Starr. “In doing so, you’ll feel better, move better, and have a better chance of keeping back pain at bay.”

This article was originally published April 22, 2021 and most recently updated April 23, 2021.
© 2024 HealthCentral LLC. All rights reserved.
Mary Kate Phan:  
Jessica Starr, M.D., Assistant Attending Physician:  

More Like This

Back Pain

Diabetes Raises Your Risk of These Spine Conditions

Medically Reviewed
Woman with diabetes has back pain and greater risk for spine conditions
Diabetes

Diabetes Causes

Medically Reviewed
birthday cake with 60 candles
Diabetes

Diabetes: Everything You Need to Know

Medically Reviewed
spoonful of sugar
Type 2 Diabetes

Can Green Tea or Garlic Prevent Diabetes, Prediabetes?

Medically Reviewed
Extracts from green tea and from aged garlic may lessen risks of diabetes.