Neck pain in type 2 diabetes

By Benjamin Sewell

Associate Physiotherapist, The Headache, Neck & Jaw Clinic


Neck exercises 

Peripheral nerve pain and chronic problems with feet are facts of life for many who live long-term with diabetes.


But there other aspects of diabetes that affect our musculoskeletal system and will have an impact on the entire body.


At The Headache, Neck & Jaw Clinic, we place a special emphasis on issues involving headaches/migraines, neck/jaw pain and vertigo. We work a lot with patients' posture and look to determine how their set-up at work and home can be a key contributor to their overall health.


Evidence suggests that diabetes mellitus (both type 1 and 2) can cause muscle cramps and increased joint degeneration.


Muscle cramps can result from a decreased nutrient flow (due to arterial damage) and from vitamin deficiency, a symptom of chronic Metformin usage (in type 2 cases). Joint degeneration begins with the patient losing sensation in a joint and over-using it. This causes neuropathic changes and hence degeneration.


In any case, it's important to be aware of these chronic side effects when dealing with diabetes and to take steps to decrease the risk.


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Stretches and general activity are often the best way to control all of these symptoms. It's no surprise to people with diabetes that regular exercise is among the best possible ways to control blood sugar levels and therefore reduce the risk of side effects, including muscle and joint concerns.


A regular stretching program serves also to further reduce the risk of musculoskeletal symptoms. Stretching has long been considered good practice in reducing muscle tension and by extension, muscle cramps.


A stretching program can also decrease a patient's risk of joint degeneration, by increasing the number of coordination-receptive fibres in individual joints. Increasing these fibres increases the sensitivity of the joint and provides the patient more awareness of how much they are using the joint, decreasing the risk of overloading it.


Here are some simple examples we recommend:


Cervical retractions 

  • 6 times a day (but the more the better)
  • Pull your chin directly backwards to make a double chin, without moving your whole head downwards. Hold for 10-15 seconds (remember to breathe) 


General ear to shoulder and nose to armpit stretches 

  • 6 times a day
  • 10-15 second holds


Posture work

  • all the time.
  • Shoulders back, chest forward, head up nice and tall. 


Living with type 1 diabetes and working as a trained physiotherapist at The Headache, Neck & Jaw Clinic, I spend my days treating patients' musculoskeletal issues and the evenings taking care of my own concerns. With a family history of chronic neck and back pain, it's important that I stay on top of any joint or muscle aches and pains to be sure they do not regress further.


Diabetes has long been considered a whole-body chronic disease. As such, the musculoskeletal system should not be ignored when discussing treatment strategies. The role of stretching should not be understated as a tool for aiding diabetes care.

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