Diabetes Linked to Back and Neck Pain

People with diabetes have a higher risk of developing low back, and neck pain than people without the disease, according to a recent study published in PLOS ONE by researchers from the University of Sydney.

Diabetes has become an increasingly prevalent condition, affecting an estimated 328 million people worldwide. Comparatively, 80% of the adult population experiences low back pain at some period in their lives, and approximately 47% suffer neck pain at some point. While a previous cohort study indicated that diabetes patients have a significantly higher risk of sustaining back and neck pain, and although there are several links between the two conditions, the exact connection remains unclear. The researchers for this study sought to identify and appraise literature to gauge the true association between diabetes and back, and neck pain.

Correlation with Pain

For this report, the researchers performed a meta-analysis of eight studies that included 165,445 participants, all above the age of 18, evaluating the corrleation between diabetes and back or neck pain outcomes. The studies, which were identified by performing a systematic search using the Medline, CINAHL, EMBASE, and Web or Science electronic databases, reported data from six different countries (Canada, Finland, Iran, Spain, Demark, and the US). One of the studies presented longitudinal data of the association between the two conditions.

The meta-analysis unveiled that people with diabetes are more likely to report low back pain (5 studies; n=131,431; OR=1.35; 95% CI, 1.20 to 1.52) and neck pain (2 studies; n=6,560; OR=1.24%; 95% CI: 1.05 to 1.47) juxtaposed to those without diabetes.  However, the longitudinal cohort indicated that diabetes is not associated with the risk of developing future low back, neck, or spinal pain (n=1,077; OR=0.84; 95% CI, 0.51 to 1.40 and n=218; OR=1.91; 95% CI, 0.67 to 5.46).

Stronger Longitudinal Evidence Required

Given that the researchers could only identify one longitudinal study to assess this correlation, they recommended future studies of a larger sample size, and as well as subsequent longitudinal investigations addressing the connection should incorporate the duration of diabetes and pain symptoms.

“This review highlights a positive association between diabetes and low back or spinal pain. However, given the lack of evidence from longitudinal studies, it is unknown whether the association is casual,” the researchers concluded. They added that future studies, “should aim to elucidate the mechanisms of the association to provide an opportunity to target preventive and management strategies for people with diabetes.”