Diabetes and Musculoskeletal (MSK)
Anyone can get muscle or joint problems (called musculoskeletal conditions), but people with diabetes are more likely to experience them. These problems can also affect the connective tissues around joints, muscles, and bones.
We don’t fully understand why diabetes causes these problems, but they are more common in people who have other diabetes complications, such as:
- Nephropathy – kidney disease
- Retinopathy – eye disease
- Neuropathy – nerve damage
People with diabetes commonly develop musculoskeletal conditions due to chronic hyperglycemia, collagen glycosylation, and microvascular changes that affect connective tissues, joints, and tendons.
Frequent problems include:
- Limited joint mobility (stiff hands)
- Frozen Shoulder
- Trigger finger
- Carpal tunnel syndrome
- Dupuytren’s Contracture
These are caused by tendon thickening and fibrosis. Adhesive capsulitis (frozen shoulder) is also common, leading to shoulder stiffness and pain.
More severe complications include Charcot arthropathy, a destructive neuropathic joint disease of the foot, and diffuse idiopathic skeletal hyperostosis (DISH), causing spinal stiffness. Additionally, diabetes increases osteoporosis and fracture risk despite normal bone density.
Overall, these conditions are common but often overlooked, and maintaining good glycaemic control along with early diagnosis and physiotherapy can help prevent or manage them effectively.
Joints lose flexibility, most often in hands, but can affect wrists, elbows, shoulders, knees, ankles, neck, and lower back.
- Symptoms in hands: stiff fingers, trouble straightening fingers, difficulty with small tasks like buttoning clothes, reduced grip strength.
Treatment - keeping blood sugar close to target, stretching exercises with physiotherapy, steroid injections if needed.
- Causes pain, stiffness, and limited shoulder movement.
- More common in people with long-standing diabetes, older age, or those with heart attacks or other diabetes complications.
Treatment - painkillers, physiotherapy, steroid injections, sometimes surgery.
- Fingers, usually the ring and little finger, bend towards the palm and cannot straighten.
- More common in men, older people, and those with long-term diabetes or other complications.
Treatment - surgery for severe cases, steroid injections if painful.
- Tendons in the hand get stuck, causing fingers or thumb to click or lock.
- Common in thumb, index, or middle fingers.
Treatment - steroid injections, finger splints, sometimes surgery.
- A nerve in the wrist is compressed, causing pain, numbness, or tingling, especially in the thumb, forefinger, and middle finger.
- Symptoms often worse at night.
Treatment - wrist splints, steroid injections, surgery if needed.
- Calcium builds up, causing ligaments to harden, usually in the spine.
- Symptoms: neck stiffness, back pain, reduced movement.
- More common in people with type 2 diabetes and obesity.
Treatment - physiotherapy, pain relief, steroid injections.
- Loss of muscle mass and strength that can affect movement, balance, and increase fall risk.
- Happens faster in people with diabetes, especially those with eye, kidney, or nerve complications.
- Strength/resistance exercises (using body weight, weights, or resistance bands)
- Keep blood sugar near target
- Eat a healthy diet with plenty of protein
If you have diabetes:
- Watch for joint stiffness, pain, or reduced movement
- Stay active with stretching and strength exercises
- Keep your blood sugar under control
- Talk to your GP or physiotherapist for advice and treatment
Robert Jones Agnes Hunt Orthopaedic Hospital offer Musculoskeletal Services Shropshire and Telford (MSST) offer specialist multi-disciplinary team assessments and management to patients who suffer from musculoskeletal health problems that don't require hospital treatment.
Patients will either be seen by a Therapist from the best profession for the their condition or, if further diagnostic work and opinion is required, by an expert Advanced Practice clinician from the correct profession and speciality or one of our Medics who specialise in MSK.
All clinicians will have MSK expertise and skills enabling them to assess, manage appropriate patients with musculoskeletal problems, reducing the need for a referral into hospital or consultant care.
The diagnostic expertise includes access to the following investigations, which may be required in the patient assessment:
- Diagnostic ultrasound
- MRI
- Nerve conduction studies
- X-Ray
- CT-Scan
- Blood tests
Following assessment and diagnosis, treatment and management options available to the patient include:
- Physiotherapy
- Podiatry
- OT Hand Therapy
- Provision of orthotics
- Specialist pain care
- Joint or soft tissue injections – where required under ultrasound guidance
- Advice on self-management
Some patients may need to be referred onto hospital consultants such as Orthopaedics and Rheumatology. Patients who are likely to require surgery with be referred to the surgeons.
If you are over 16 and require further management for musculoskeletal conditions, that do not require hospital treatment, then you are an appropriate patient for MSST.
The team do not see patients with suspected cancer.
Appointments are offered at a variety of locations across Shropshire, Telford and Wrekin.
