Diabetes and Back Pain
Yesterday, I was asked if there is a relationship between diabetes and back pain? The short answer, in my opinion is yes. But just so we can all have a general understanding, we must first review diabetes and its effects.
As many of you know, there are two forms of diabetes. Type I diabetes usually occurs at a young age. It was formerly known as juvenile diabetes. To generalize, your body does not form insulin, the hormone necessary to absorb glucose (sugar), and transform it into energy. The glucose levels build up in the body, and unfortunately, high glucose concentration causes destruction of your body tissues( As an aside, just so you can understand the nature of glucose, sugar cannot spoil. No bacteria can grow in high sugar concentrations. In a similar matter, it can destroy your cells).
Type II diabetes usually occurs with age, and also has a hereditary component. The body develops a resistance to insulin, and will not absorb the sugar, despite the insulin. Again, the blood glucose levels increase, and leads to the destructive cellular processes.
Thus far, the science is still being explored, but the cellular distruction caused by higher glucose levels have been shown to be toxic to skin cells, nerve cells, skin cells, smooth muscles, etc. In addition, some studies suggest the higher glucose levels activate osteoblast activities in muscle cells. In other words, causes the calcification seen in blood vessels.
In the spine, studies have shown an increased disk degeneration incidence in patients with diabetes.
For Spine Specialists, we already know that patients with diabetes often develop the so called double crush phenomenon, where the nerves can be crushed once by the physical pressure of disk or bone pressure on the nerve. Then, the second “crush” comes from the high sugar effects on the nerve tissues, causing the so call peripheral neuropathy. Demographic studies show that People with diabetes have associated increased musculo-skeletal complaints.
For spine surgeons, it is general accepted that patients with diabetes will have higher complication rates and lower success rates. So in addition to having more disk degeneration, and musculoskeletal complaints, diabete patients have poor surgical outcomes, with increased complication rates.
For those who have diabetes, please do what you can to control your sugar levels, and monitor your ratio of glycosylated hemoglobin (A1C). You want to minimize the bad effects of a high glucose level. From the perspective of you spine, you can help moderate the rate of degeneration, and subsequent development of back pain.
If you have concerns, please visit your internist, or get more information from the American Diabetes Association.
- Armaghani SJ, Archer KR, Rolfe R, Demaio DN, Devin CJ. Diabetes Is Related to Worse Patient-Reported Outcomes at Two Years Following Spine Surgery. J Bone Joint Surg Am. 2016 Jan 6;98(1):15-22. PubMed PMID: 26738899