By Benjamin Sewell
Associate Physiotherapist, The Headache, Neck & Jaw
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
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
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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
Here are some simple examples we recommend:
- 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
- 6 times a day
- 10-15 second holds
- all the time.
- Shoulders back, chest forward, head up nice and
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
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.