Does type 2 diabetes increase musculoskeletal pain risk?

  • Carvalho-E-Silva AP & al.
  • Semin Arthritis Rheum
  • 26 May 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Type 2 diabetes (T2D) was associated with knee, hip and neck/shoulder pain, with stronger associations among people suffering from chronic pain.
  • In addition, T2D increased the risk of future reporting of neck/shoulder pain, particularly among women.

Why this matters

  • Findings highlight the need to consider musculoskeletal screening in patients with diabetes and warrant future studies to investigate the mechanisms explaining why T2D appears to be a risk factor for neck/shoulder pain and why gender differences exist.

Study design

  • This UK Biobank study included 495,327 participants in the cross-sectional (2006-2010) and 16,875 in the longitudinal (2014-2016) analyses.
  • Self-reported T2D and musculoskeletal pain (back, knee, hip, or neck/shoulder pain) were assessed using a touchscreen questionnaire.
  • Funding: None disclosed.

Key results

  • In cross-sectional analyses, T2D was associated with an increased risk of:
    • recent and chronic neck/shoulder pain (adjusted OR [aOR], 1.14 [95% CI, 1.10-1.18] and 1.15 [95% CI, 1.10-1.19], respectively); and
    • recent and chronic hip pain (aOR, 1.13 [95% CI, 1.08-1.17] and 1.14 [95% CI, 1.10-1.19], respectively).
    • chronic knee pain (OR 1.01; 95% CI, 1.01-1.01).
    • Analyses stratified by gender revealed that T2D increased the risk of recent (aOR, 1.06; 95% CI, 1.01-1.12) and chronic (aOR, 1.06; 95% CI, 1.01-1.13) back pain for women only [aOR, 1.06; 95%CI 1.01-1.12].
  • In longitudinal adjusted analyses:
    • T2D was associated with an increased risk of recent (OR, 1.39; 95% CI, 1.01-1.91) and chronic (OR, 1.56; 95% CI, 1.14-2.19) neck/shoulder pain.
    • Analyses stratified by gender revealed that women with T2D were at an increased risk of recent (aOR, 1.90; 95% CI, 1.10-3.25); and chronic (aOR, 1.92; 95% CI, 1.11-3.31) neck/shoulder pain.

Limitations

  • The questions regarding musculoskeletal pain did not identify any specific cause of pain.
  • Diabetes was self-reported and not based on biological criteria.