Diabetes can influence the development and severity of many musculoskeletal disorders. These are conditions that adversely affect muscles and bones.

The higher incidence of musculoskeletal disorders in people with diabetes appears to be partly a result of damage caused by high levels of glucose (blood sugar). In addition to damaging nerves and blood vessels, excess glucose (hyperglycemia) increases the risk of infections and alters the amount and structure of protein and collagen (fibrous protein that strengthens tissue) in a person’s body. Reduced bone density may also occur with diabetes, and is another risk factor for certain musculoskeletal disorders.

Musculoskeletal disorders associated with diabetes can be grouped into four categories:

• Collagen disorders. Diabetes may cause excessive accumulation of collagen, which can restrict the joints and may cause musculoskeletal disorders such as stiff-hand syndrome and frozen shoulder.
  
  
• Neuromuscular disorders. Nerve damage (neuropathy), a common complication of diabetes, can restrict muscle and body movement. Patients with diabetes may be more susceptible to musculoskeletal disorders that involve nerve damage, such as carpal tunnel syndrome, sciatica, restless leg syndrome, Charcot foot and complex regional pain syndrome.
  

  

• Autoimmune disorders. People with type 1 diabetes (an autoimmune disorder) have an increased risk of developing other autoimmune diseases, such as rheumatoid arthritis and lupus.
  
  
• Bone and other disorders. People with diabetes have an increased risk of bone loss (e.g., diabetic osteopathy, osteoporosis) and fractures. They may also be more likely to develop other musculoskeletal disorders such as osteoarthritis, gout and myofascial pain syndrome.

Diagnosis of musculoskeletal disorders associated with diabetes may vary, depending on the disorder suspected. After the initial physical examination and compilation of the patient’s medical history, additional tests may include a comprehensive foot exam, neurological examination, and various blood tests, urine tests or imaging tests.

In addition, a patient’s diabetes may conflict with some treatments for musculoskeletal disorders. As a result, patients may have to consult with their physician about adjusting their treatment regimen before using medications designed to treat musculoskeletal disorders.