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Chronic Back Pain, Diabetes and Exercise

diabetes and back pain exercise aquarobicsExercise is a key component of diabetes management and staying active is now also recognised as an essential part of relieving back pain and other chronic pain conditions. Unfortunately, a lack of energy, increased stress, poor diet, reduced joint mobility, diabetic ulcers, and increased pain can all seriously undermine efforts to exercise. Our latest article in this mini-series on back pain and diabetes looks at the role of physical activity in chronic pain relief and diabetes management. Continue reading “Chronic Back Pain, Diabetes and Exercise” »


Sleep, Back Pain and Diabetes

diabetes sleep and back painIn the second article in our mini-series looking at the link between back pain and diabetes we focus on how both conditions are not only affected by a lack of sleep but might actually be a major cause of sleeping difficulties. When sleep is disturbed this can lead not only to an increasing level of pain perception but also poorer control of blood sugar. A lack of sleep actually makes diabetes harder to manage and predisposes people to complications from the disease, such as diabetic neuropathy and more pain. Continue reading “Sleep, Back Pain and Diabetes” »

How Common is Back Pain in Diabetes?

Diabetes and back pain In the second in our series looking at the links between diabetes and back pain we examine the research on how the two conditions overlap. Just how common is back pain in those with diabetes and how do the two conditions interact?

In a 2005 study published in Diabetes Care, 1000 patients with diabetes were asked to rate their degree of difficulty in the following key areas:

  • Taking medications
  • Getting regular exercise
  • Sticking to the recommended diet
  • Performing blood glucose checks
  • Examining their feet

Around 60% of the patients reported chronic pain and this pain caused disruption to their daily life for an average of 18 out of the past 28 days. Regular or occasional use of painkillers was reported by 78% of participants and those who were younger, heavier, female, and on insulin were most likely to have chronic pain. Those with severe pain had increased difficulties taking their medications and around half of those with chronic pain had signs of depression (compared to 20% of those without chronic pain).

Similar interactions between diabetes and chronic pain have been found in other studies, suggesting that physicians need to be wary of overlapping concerns when working with patients to manage diabetes and back pain. Researchers at the San Francisco VA Medical Center, the University of California, San Francisco and the Kaiser Permanente Division of Research in Oakland, California, looked at the records of over 13,000 adults with type 2 diabetes and found that almost half reported acute and chronic pain, and close to one quarter report:

  • Neuropathy
  • fatigue
  • depression
  • sleep disturbance
  • physical or emotional disability
  • shortness of breath
  • nausea
  • constipation

Constipation is potentially a significant problem for those with lumbar disc herniation as straining can put extra pressure on spinal structures. Back pain is the most common type of pain reported by those with diabetes, along with neuropathy in the hands and/or feet. Headaches, arthritis, fibromyalgia and other painful conditions are also noted and pain has been seen to adversely affect how well people are able to manage their diabetes.

Pain is also often invisible to others, making it difficult for those with diabetes and back pain to adequately communicate their suffering to family, friends, coworkers, and even to health care workers. It may be that a physician, or even a patient, fails to pay adequate attention to a new or worsening symptom of pain as it is seen as part of the overall diabetic condition rather than a possible indication of an overlapping condition such as spinal stenosis.

Diagnosing Back Pain in Diabetes

Indeed, diagnosing diabetic neuropathy requires ruling out other potential causes of symptoms, as does diagnosing symptomatic spinal stenosis, but the symptoms of the two can be very similar. Peripheral neuropathy can occur in the nerves in the head, arms, legs, face, and all over the body and may originate from nerve damage at the site of pain or anywhere along that nerve branch, including at the spinal nerve root or even the spinal cord itself.

Such nerve pain could result from shingles, cancer, AIDS, diabetes, or spinal nerve compression of central canal stenosis. Treatment for spinal nerve compression is usually very different from treatment of shingles or diabetic neuropathy, making it of vast import that the source of pain be properly isolated in those with back pain and diabetes.


Sudore RL, Karter AJ, Huang ES, Moffet HH, Laiteerapong N, Schenker Y, Adams A, Whitmer RA, Liu JY, Miao Y, John PM, Schillinger D. Symptom burden of adults with type 2 diabetes across the disease course: diabetes & aging study. J Gen Intern Med. 2012 Dec; 27(12):1674-81.
Krein SL, Heisler M, Piette JD, Makki F, Kerr EA. The effect of chronic pain on diabetes patients’ self-management. Diabetes Care. 2005 Jan;28(1):65-70.


Diabetes and Back Pain – What’s the Connection?

back pain and diabetesChronic back pain and diabetes often occur together, but the connection isn’t as simple as one causing the other. Sometimes the effects of diabetes can trigger pain but in other cases it may be that inactivity associated with back pain actually increases the risk of diabetes.

In this mini-series we take a look at the links between back pain and diabetes, how commonly they occur together, why sleep plays a major role in treating both, and how physical activity is vital for successfully managing both. Continue reading “Diabetes and Back Pain – What’s the Connection?” »


SNRI Antidepressants for Back Pain

duloxetine for back pain relief and spinal stenosisBack pain and depression can be connected but not everyone prescribed antidepressants for back pain is necessarily suffering from both conditions.

Duloxetine (Cymbalta, Ariclaim, Xeristar, Yentreve, Duzela, Dulane) and other serotonin and norepinephrine reuptake inhibitors (SNRIs) are sometimes used to help with pain management as they act to reduce central nervous system-related pain. Continue reading “SNRI Antidepressants for Back Pain” »