Health & Medical

Bone and joint problems associated with diabetes

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If you have diabetes, you’re at increased risk of various bone and joint disorders. Certain factors, such as nerve damage (diabetic neuropathy), arterial disease and obesity, may cause these problems — but often the cause isn’t clear.

Learn more about various bone and joint disorders, including symptoms and treatments.

Charcot joint

What is it?

Charcot (shahr-KOH) joint, also called neuropathic arthropathy, occurs when a joint deteriorates because of nerve damage — a common complication of diabetes. Charcot joint primarily affects the feet.

What are the symptoms?

You might have numbness and tingling or loss of sensation in the affected joints. They may become warm, red and swollen and become unstable or deformed. The involved joint may not be very painful despite its appearance.

How is it treated?

If detected early, progression of the disease can be slowed. Limiting weight-bearing activities and use of orthotic supports to the affected joint and surrounding structures can help.

Limited joint mobility

What is it?

Limited joint mobility, also called diabetic hand syndrome or diabetic cheiroarthropathy, is stiffness of the joints most often affecting the small joints of the hands. The skin on the hands may become waxy and thickened. Eventually finger movement is limited. Other joints can be affected, including the shoulders, feet and ankles. What causes limited joint mobility isn’t known. It’s most common in people who’ve had diabetes for a long time.

What are the symptoms?

You may be unable to fully extend your fingers or press your palms together flat.

How is it treated?

Better management of blood sugar (glucose) levels and physical therapy can slow the progress of this condition, but the limited movement may not be reversible.

Osteoporosis

What is it?

Osteoporosis is a disorder that causes bones to become weak and increases the risk of broken bones. People who have type 1 diabetes have an increased risk of osteoporosis.

What are the symptoms?

Osteoporosis rarely causes symptoms in the early stages. Eventually, when the disease is more advanced, you may experience loss of height, stooped posture or broken bones.

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How is it treated?

A healthy lifestyle, including weight-bearing exercise, such as walking, and eating a balanced diet rich in calcium and vitamin D — including supplements if needed — are the best ways to address this condition. In some patients with more severe or advanced disease, medications to prevent further bone loss or increase bone mass may be needed.

Osteoarthritis

What is it?

Osteoarthritis is a joint disorder that involves the breakdown of joint cartilage. It may affect any joint in your body. People who have type 2 diabetes have an increased risk of osteoarthritis, likely due to obesity — a risk factor for type 2 diabetes — rather than to the diabetes itself.

What are the symptoms?

Osteoarthritis may cause joint pain, swelling and stiffness, as well as loss of joint flexibility or movement.

How is it treated?

Treatment involves exercising, maintaining a healthy weight, caring for and resting the affected joint, physical therapy, and medications for pain. Treatment may also include surgery such as knee or hip replacement. Complementary treatments — such as acupuncture and massage — also may be helpful for managing pain.

DISH

What is it?

Diffuse idiopathic skeletal hyperostosis (DISH), also called Forestier disease, is a hardening of tendons and ligaments that commonly affects the spine. DISH may be associated with type 2 diabetes, perhaps due to insulin or insulin-like growth factors that promote new bone growth.

What are the symptoms?

You may experience pain, stiffness or decreased range of motion in any affected part of your body. If DISH affects your spine, you may experience stiffness in your back or neck.

How is it treated?

Treatment involves managing symptoms, usually with pain relievers such as acetaminophen (Tylenol, others) and ibuprofen (Advil, Motrin IB, others), and corticosteroid injections.

Dupuytren’s contracture

What is it?

Dupuytren’s contracture is a deformity in which one or more fingers are bent toward the palm. It’s caused by thickening and scarring of connective tissue in the palm of the hand and in the fingers. Dupuytren’s contracture is common in people who’ve had diabetes for a long time, perhaps due to the metabolic changes related to diabetes.

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What are the symptoms?

You may notice thickening of the skin on the palm of your hand. Eventually, you may not be able to fully straighten one or more fingers.

How is it treated?

If you have pain, a steroid injection may help by reducing inflammation. Surgery, collagenase enzyme injection and a minimally invasive technique called aponeurotomy to break apart the thick tissue are other options if the condition prevents you from being able to grasp objects.

Frozen shoulder

What is it?

Frozen shoulder is a condition that causes shoulder pain and limited range of motion. It typically affects only one shoulder. Although the cause is often unknown, diabetes is a common risk factor.

What are the symptoms?

Frozen shoulder causes pain or tenderness with shoulder movement, stiffness of the joint, and decreased range of motion.

How is it treated?

If started early, aggressive physical therapy can help preserve movement and range of motion in the joint. A health care provider may give glucocorticoid injections to people with moderate to severe symptoms.

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April 09, 2022

  1. Additional types of neuropathy. American Diabetes Association. https://www.diabetes.org/diabetes/complications/neuropathy/additional-types-neuropathy. Accessed Dec. 2, 2021.
  2. Hordon LD. Limited joint mobility. https://www.uptodate.com/contents/search. Accessed Dec. 2, 2021.
  3. Osteoporosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. www.niams.nih.gov/health-topics/osteoporosis. Accessed Dec. 2, 2021.
  4. What people with diabetes need to know about osteoporosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/diabetes. Accessed Dec. 2, 2021.
  5. Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/osteoarthritis. Accessed Dec. 2, 2021.
  6. Depuytren’s disease. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases–conditions/dupuytrens-disease. Accessed Dec. 2, 2021.
  7. Prestgaard TA. Frozen shoulder (adhesive capsulitis). https://www.uptodate.com/contents/search. Accessed Dec. 2, 2021.
  8. Aggarwal R, et al. Depuytren’s contracture. https://www.uptodate.com/contents/search. Accessed Dec. 2, 2021.
  9. Papadakis MA, et al., eds. Diabetes mellitus. In: Current Medical Diagnosis & Treatment 2022. 61st ed. McGraw Hill; 2022. https://accessmedicine.mhmedical.com. Accessed Dec. 2, 2021.
  10. Stone JH. Approach to the patient with low back pain. In: Current Diagnosis & Treatment: Rheumatology. 4th ed. The McGraw-Hill Companies; 2021. https://accessmedicine.mhmedical.com. Accessed Dec. 2, 2021.
  11. Chang-Miller A (expert opinion). Mayo Clinic. Dec. 9, 2021.

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