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