Diabetes and back pain

 Diabetes mellitus is one of the major non-communicable diseases. It is metabolic disorder characterised by hyperglycemia which may further lead to peripheral vascular disease, hypertriglyceridemia and neuropathy. Diabetes has been associated with the incidence of back pain because 

1. The chain of events during high blood sugar leads to free plasma fatty acids and pro-inflammatory state, therefore promoting calcification of blood vessels, which may block the blood supply to vertebral disc degeneration which could lead to non specific back pain.

2. Further diabetes also increases risk of obesity due to disturbed metabolism, so increase in weight also increases the chances of back pain.

3. Metabolic disturbance during diabetes can lead to collagen accumulation in skin and periarticular structures which results in changes in connective tissue which affects collagen rich tissues like tendons and bones and there ability to perform normal function is compromised that can further lead to back pain.

4. Bone and joint alteration associated with DM include OA, hypertostosis, osteoarthropathy which may further lead to back pain due to biomechanical abnormality associated with OA knees etc.

5. In one of the study conducted on rat it was found that hyperglycemia promotes disc autophagy and accelerate the rate of stress-induced senescence in nucleus pulposus cells, both of which may contribute to disc prolapse and the onset of mechanical back pain.

Management

1. Maintaining sugar levels

2. Regular Excercise

3. Timely medication if required

4. Diabetic diet

5. Weight management

6. Adequate sleep

7.Stress management

Pandemic and back pain

 The pandemic has changed the individual behavior both due to lifestyle changes and due to physiologival effects of covid-19 on human body which has resulted in enhanced cases of backpain.

Back pain is the commonest musculoskeletal complain across the world resulting in maximum  sick leaves.  Back pain due to covid has increased the burden on economy and healthcare sector and deteriorated the quality of life.

Covid related causes of back pain

A. Altered Lifestyle

1-Work from home culture resulted in decreased mobility.

2.Reduced physical activity

3.Altered food habits

4.Binge watching

5.Binge eating

6.Disturbed sleep cycle

B.Physiological effects 

Coronavirus disease is a respiratory illness caused by SARS-COV-2, back pain is one of the most common symptom.

Covid-19 infection stimulate the release of cytokines like interlukin by body’s immune system, it further stimulates the formation of prostaglandin E2 molecule that acts on nerves and sends pain message to our brain. 

C. Covid medicine induced back pain

In few moderate to severe covd cases there has been long term administration of steroids which has resulted in osteopenia, osteoporosis, AVN which results in back pain.

Management

1.Active Rehabilitation

2.Active lifestyle

3. Adequate Hydration

4.Healthy eating habits

5.Proper Sleep hygeine