It is a challenge to treat Pain In People With Diabetes

Pain Medicines Affect Blood Sugar Levels

TALK TO DIABETIC PAIN EXPERTS

 

People with diabetes carry high risk of developing musculo-skeletal pain pains. 

 

It ranges from pain in neck, back, shoulder, hands, knees, thighs and feet. Because of altered glucose metabolism and insulin resistance they develop weakness in muscles of thighs and shoulder. Widespread changes in connective tissue causes pain in muscles and stiffness in joints.

 

 

Commonly seen pains in diabetic include those of spinal joints, calcium deposits in shoulder muscles, shoulder capsulitis, rotator cuff tear, pain in the arms, pain on lateral side of thigh, pain on front of thigh and pain in feet. Most of the pains in shoulder and knee are due to muscle imbalances. The severity of problem depends on the duration of diabetes and also how good is the control. People with uncontrolled diabetes, though may not have long duration diabetes still develop pains with minimal exertion; and many time without any cause. Similarly, people with long standing diabetes also report with pains though their blood glucose levels are well under control. 

 

Challenge #1

When in pain, the first response is pain medicine. NSAID taken in higher than regular dosage or taken for long duration affects blood sugar levels. (Ibuprofen and naproxen lowers blood sugar levels whereas diclofenac increases it). Also, if the body has adapted to the dose of these drugs, then other issues like increase in blood pressure is recorded. 

SO THE BOTTOMLINE IS THAT PEOPLE WITH DIABETES SHOULD NOT DEPEND ON PAIN MEDICINES FOR PAIN RELIEF. 

Challenge #2

Most of the people with diabetes have associated health problems like high blood pressure, altered kidney functions, skin problems, neuropathy and malnourishment. Exercises planned should be such that blood pressure and serum creatinine levels are not disturbed. Planning exercises for knee pain should consider if neuropathy present, as wrong planning can cause more wear and tear in the joint and subsequently lead to back pain. Even use of electrotherapy has to be done with due caution. 

THE BOTTOMLINE HERE IS THOUGH PHYSICAL THERAPY IS AN EFFECTIVE APPROACH FOR PAIN, BUT PLANNING OF EXERCISES IS A SPECIALISED AREA. 

Challenge #3

There is a correlation between diabetes and cholesterol disturbances. Long term diabetes reduces HDL (good cholesterol) and increases LDL( bad Cholesterol) for which patients are then put on statins (cholesterol reducing drugs). Statins increase blood sugar levels and cause muscle pains. In a diabetic person with musculo-skeletal pains, long duration administration of statins ( >1 month) interfere with recovery from pain. 

LIFESTYLE MODIFICATIONS UNDER DIRECT CARE OF A MEDICAL PROFESSIONAL SPECIALISED IN LIFESTYLE MEDICINE CAN HELP YOU REGULATE CHOLESTEROL AND REVERSE DIABETES AND RECOVER FROM PAIN. 


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