Electrotherapy
Computerised ultrasound therapy
Computerised pelvic traction
Computerised cervical traction
Computerised interferential therapy
Shortwave diathermy
Wax therapy
Electrical stimulation
IR red light therapy
Exercise therapy
Joint mobilisation
Strengthening exercise
Neuro muscular re-education exercise
Chest physiotherapy
Stroke rehabilitation
Gait training
Vertigo exercise
Stump exercise
Cryotherapy
Biomechanical analysis
Core exercises
Massage
Pilates
Posture correction
Resistance band exercises
Soft tissue injury care
Stretching exercises
Swiss ball eExercises
Diabetes and joint pain
Diabetes and joint pain are considered to be independent conditions. Joint pain may be a response to an illness, injury, or arthritis. It can be chronic (long-term) or acute (short-term). Diabetes is caused by the body not using the hormone insulin correctly, or insufficient production of it, which affects blood sugar levels.
Diabetes can damage joints, a condition called diabetic arthropathy. Unlike pain caused by immediate trauma, the pain of arthropathy happens over time. Other symptoms include:
Thick skin
Changes in the feet
Painful shoulders
Carpal tunnel syndrome
A joint is a place where two bones come together. Once a joint wears down, the protection it provides is lost. Joint pain from diabetic arthropathy comes in different forms
Charcot’s joint
Charcot’s joint occurs when diabetic nerve damage causes a joint to break down. Also called neuropathic arthropathy, this condition is seen in the feet and ankles in people with diabetes. Nerve damage in the feet is common in diabetes, which may lead to Charcot’s joint. A loss of nerve function leads to numbness. People who walk on numb feet are more likely to twist and injure ligaments without knowing it. This places pressure on the joints, which can eventually cause them to wear down. Severe damage leads to deformities in the foot and other affected joints.
Bone deformities in Charcot’s joint may be prevented through early intervention. Signs of the condition include:
Painful joints
Swelling or redness
Numbness
An area that is hot to the touch
Changes in the appearance of feet
If your doctor determines that your joint pain is related to diabetic Charcot’s joint, it’s important to limit use of the affected areas to prevent bone deformities. If you have numb feet, consider wearing orthotics for additional support.
Osteoarthritis (OA)
Osteoarthritis (OA) is the most common form of arthritis. It may be caused or aggravated by excess weight, which is a common problem in those with type 2 diabetes. Unlike Charcot’s joint, OA is not directly caused by diabetes. Instead, being overweight increases the risk of developing both type 2 diabetes and OA.
OA occurs when the cushioning between the joints (cartilage) wears down. This causes the bones to rub up against each other, and results in joint pain. While joint wear-and-tear is natural to some extent in older adults, excess weight speeds up the process. You may notice increasing difficulty in moving your limbs, as well as swelling at the joints. The hips and knees are the most commonly affected areas in OA.
The best way to treat OA is to manage your weight. Excess weight puts more pressure on the bones. It also makes diabetes harder to control, so losing extra pounds can not only alleviate chronic joint pain; it may ease other diabetes symptoms.
Losing 15 pounds may decrease knee pain by 50 per cent. Regular exercise can do more than maintain weight. Physical movement also helps lubricate your joints. As a result, you may feel less pain. Your doctor may prescribe pain medications to use when joint discomfort from OA becomes unbearable. Surgery, such as knee replacement, may be required in severe cases.
Frozen Shoulder
Codman introduced the term “frozen shoulder” in 1934 to describe patients who had a painful loss of shoulder motion with normal radiographic studies. In 1946, Neviaser named the condition “adhesive capsulitis” based on the radiographic appearance with arthrography, which suggested “adhesion” of the capsule of the GH joint limiting overall joint space volume. Patients with adhesive capsulitis have a painful restriction of both active and passive GH joint motion in all planes, or a global loss of GH joint motion
People with diabetes are up to twice as likely to suffer from frozen shoulder due to effects on collagen in the shoulder, which holds the bones together in a joint. Collagen can become sticky if sugar molecules become attached, resulting in movement being restricted and the shoulder beginning to stiffen. This process is known as glycosylation.
Poorly controlled diabetes has long been linked to muscular and skeletal problems, with consistently high blood sugars likely to increase the risk of complications such as frozen shoulder.
Low Back Pain
Back pain is a problem that affects many people including those with diabetes. Often people with diabetes have other conditions that could cause back pain, such as arthritis, fibromyalgia or kidney problems.
More than half of people with diabetes report they have chronic pain. The most common types of chronic pain are back pain and pain in the feet or hands as a result of neuropathy. Chronic pain can make it more difficult to handle diabetes self-management activities and may lead to elevated blood sugar levels. It is important to deal with back pain so it does not have a negative impact on your ability to sleep, work, function physically and have positive relationships.
There are ways to relieve pain, improve your mood and enjoy a better quality of life:
The first step is to discuss back pain with your doctor. Learn the difference between acute and chronic pain. Acute pain is a reaction to an injury. This is what we feel when we touch the hot stove, realized we are burned and seek immediate help. Chronic pain might start with an acute injury but remain long after that initial problem. It can be related to irritation or inflammation, which is often associated with diabetes. Factors such as fear, stress, anger and trauma can lead to chronic pain. If left untreated, pain can lead to sleeplessness, tension, depression and anger. All of these emotions can contribute to chronic back pain. Your health care team can help determine whether the pain is caused by physical, emotional and/or mental factors to figure out the best way to treat it.
There are a variety of physical treatments that can relieve chronic back pain. This might include applying heat or cold to the area. Massage is a good way to relieve the symptoms of pain, including shiatsu and acupressure. Rest can help and the doctor might prescribe something to help you sleep or reduce tension. Exercise is often a very effective way to relieve back pain, including certain types of weight and resistance training to strengthen the supporting muscles and ease pressure on your joints and tendons. Do not start any exercise routine without consulting with your doctor. Your health care team might recommend a physiotherapist or dietitian. Excess weight can contribute to back pain. Losing just 10 per cent of your body weight can relieve this pressure and reduce back pain. Your doctor may also prescribe certain anti-inflammatory medicines such as aspirin, ibuprofen or naproxen. You may have to take steroids to alleviate back pain which could lead to elevated blood sugars.
There are also neurological and mental ways to approach back pain and relieve overactive nerves. This may include antiseizure medications. Electrical stimulation may also help. Often a TENS (transcutaneous electrical nerve stimulation) unit is used to send electrical pulses from the surface of your skin to your nerves to help reduce pain. Relaxation techniques can also relieve back pain such as meditation, yoga, deep breathing
Positive lifestyle habits can help you achieve healthy blood sugar levels and reduce back pain. Losing weight takes pressure off your back, hips, feet and knees. Choose whole foods rather than packaged or processed ones with additives. Avoid pushing yourself until you feel fatigued. Work at a steady pace and plan your day to avoid stress. Take time to smile and laugh to boost your mood and minimize pain. Get enough sleep each night. Make sure your mattress is firm enough to support you comfortably. Take breaks when sitting and pay close attention to your posture. Do stretching exercises which may loosen tight back muscles.
