How Diabetes & Musculoskeletal Pain Are Connected: What You Can Do Now

Introduction

Living with diabetes can feel like the challenges never stop—especially when you begin noticing aches in your back, shoulders, hips, or limbs that don’t seem to correspond to any obvious injury. These aches often fall under the term musculoskeletal pain—pain originating in bones, joints, muscles, tendons, or ligaments. In people with elevated blood sugar levels or a diagnosis of diabetes, musculoskeletal pain often appears alongside other complications, yet it doesn’t always get the attention it deserves.

At Unpain Clinic we see many patients who ask: “Why do I hurt in places I shouldn’t?” or “Can my diabetes be causing this pain?” The answer is: yes — and we’re here to help you understand why, what you can do about it now, and how to manage it effectively.
In this article we’ll explore the connection between diabetes and musculoskeletal pain, lay out what the research says, and offer actionable steps — including what we do in clinic — so you feel empowered rather than stuck. Please keep in mind: results may vary; always consult a healthcare provider.

What is “musculoskeletal pain”?

Musculoskeletal pain refers to pain arising from structures of the movement system — joints (arthritis, cartilage), muscles, tendons, ligaments, bones, or the supportive soft tissues. It may be acute (e.g., an injury) or chronic (persists beyond expected recovery). Symptoms may include: aching, throbbing, stiffness, reduced range of motion, or weakness.
Related searches: what is musculoskeletal pain, how does musculoskeletal pain feel like, musculoskeletal pain in back, musculoskeletal pain in chest, musculoskeletal pain syndrome.

How is musculoskeletal pain connected to diabetes?
When someone has diabetes (or elevated blood sugar) several things happen that can increase risk of pain:

Why does the pain persist (and become chronic)?
Because structural damage (joint wear, tendinopathy, stiffness) accumulates while the metabolic/vascular environment remains unfavourable.
Because compensation patterns develop: one part hurts, you offload or change movement, other parts compensate and over-work → more pain.
Because traditional treatments may target only the symptom (pain) without addressing the underlying systems (metabolism, circulation, tissue health).
Because staying active becomes harder, and inactivity itself worsens muscle/ joint function, creating a vicious cycle.
Thus, in someone with diabetes, what might have been a short-term muscle strain becomes a lingering musculoskeletal pain syndrome.

What Research Says

Prevalence & risk
A large retrospective cohort found that people aged 18–50 with type 2 diabetes had a higher 10-year cumulative incidence of musculoskeletal pain than non-diabetic peers (RR ~1.39).
A systematic review/meta-analysis on patients with diabetes found a high prevalence (~58.1 %) of musculoskeletal disorders.
A 2025 systematic review (“Review: Musculoskeletal Manifestations of Diabetes Mellitus”) confirmed that musculoskeletal (MSK) complications in people with diabetes are clinically significant.
These data show that musculoskeletal pain is common in diabetes — both more likely to occur, and more likely to persist.

Mechanisms & contributing factors
The review by Csonka et al. (2023) discusses mechanisms: hyperglycaemia, microvascular damage, neuropathy, AGEs, and connective tissue changes linking diabetes with MSK disorders.
Another review noted that metabolic dysfunctions leave people with diabetes at high risk for developing musculoskeletal pain and impairments.
In patients with T2DM in Jordan, musculoskeletal pain was strongly associated with neuropathy score and duration of diabetes, rather than vitamin D levels.

Specific pain-locations & functional impact
Pain in the lumbar spine/back/pelvis was the highest number of doctor visits in the diabetic group vs non-diabetic in the Taiwanese study.
The association of diabetes with osteoarthritis, osteoporosis and musculoskeletal pain was shown in a 2019 study: diabetes linked to higher rates of MSK pain, osteoarthritis.

Why this matters
Musculoskeletal pain in people with diabetes can reduce physical activity, impair mobility, worsen glycaemic control (less exercise), and decrease quality of life. Early detection and intervention are key.

Treatment Options at Unpain Clinic

At Unpain Clinic we recognise that musculoskeletal pain in the context of diabetes needs a whole-body, root-cause approach — not just icing the joint or giving generic exercise. Below are the key modalities we use, especially when standard therapies haven’t delivered the desired outcome.

1. Initial Assessment
Before treatment begins, we perform our signature “Initial Assessment” (history, posture, full range of motion, HR variability, soft-tissue screening, possibly imaging). This allows us to contextualise the musculoskeletal pain in the context of your metabolic and functional state.

2. Shockwave Therapy
We use advanced shockwave therapy (radial, focal, electrohydraulic) to target deep-tissue issues — scar tissue, chronic tendinopathy, stiff fascia, adhesions — especially when diabetes has altered tissue repair.
In our podcast episode “Learn how to cure your chronic shoulder pain” (hosted by me, Uran Berisha) we discuss how high-blood sugar/inflammation links to frozen shoulder and how shockwave adds value.

3. Extracorporeal Magnetotransduction Therapy (EMTT) & Neuromodulation
Diabetes often involves nerve dysfunction or altered nervous system signalling. EMTT and neuromodulation can help reset dysfunctional pain patterns and enhance nerve/muscle communication.

4. Manual Therapy & Movement Retraining
Manual therapy (physio/chiro techniques) combined with movement retraining ensures that the body moves with better mechanics rather than compensating — especially important when chronic metabolic issues have altered tissue behaviour.

5. Exercise Prescription & Metabolic Support
Because musculoskeletal pain in diabetes is not only a mechanical problem but also a metabolic one, we integrate tailored exercise (strength, flexibility, mobility), coaching on lifestyle optimisation (nutrition, sleep, movement), and coordinate with medical teams for glycaemic control.
(A recent YouTube video from Unpain Clinic discusses how diabetes-related musculoskeletal conditions should not be ignored.)

Why this integrated approach matters
We do not rely solely on symptom-fixes (e.g., pills, injections) — we look for root-cause (metabolic + movement + tissue health).
We tailor everything to your unique functional assessment and diabetic context.
We coordinate with your broader healthcare team (prescribing doctor, endocrinologist) as needed.
We emphasise non-invasive where possible, and we build realistic expectations: nothing is guaranteed, but evidence-informed care offers far better chances of meaningful improvement.

Patient Experience / Case Example

A 52-year-old woman (anonymised) with type 2 diabetes (diagnosed 8 yrs), HbA1c ~8.2, presented with persistent low-back pain and hip stiffness for over 2 years. She reported that her pain was limiting her walks, she felt “locked” in the lumbar spine, and her activity had dropped. On Initial Assessment, we identified: lumbar-hip motion restriction, glute weakness, postural imbalance, elevated resting HR variability suggesting autonomic stress, and history of a knee injury 10 yrs earlier.

We implemented:
Weekly shockwave therapy focused on lumbar-hip fascia & glute tendon insertions.
Manual therapy and movement retraining (hip hinge, glute activation, core stability).
Neuromodulation sessions to help reset chronic nerve-related pain signalling.
A home-exercise plan + lifestyle coaching (moderate aerobic walks, low-impact strength, blood-sugar friendly nutrition).
Over 12 weeks, the patient reported reduction in pain intensity (from 6/10 to 2-3/10), regained walking endurance, improved hip range of motion, and had lower resting HR. Her endocrinologist noted a modest HbA1c improvement to 7.4 (though that was incidental to the MSK work). She emphasised that treating the “whole body” (not just the back) made the difference.

At-Home Guidance: What You Can Do Now

Here are safe, evidence-informed tips you can start today to help manage musculoskeletal pain in the context of diabetes. Always check with your provider before starting new exercise.

Safe Exercises
Hip hinge / glute-bridge (body weight)
Lie on your back, knees bent, feet flat. Engage glutes and lift hips to form a straight line shoulder–hip–knee. Hold 2-3 s, lower slowly. 8-12 reps × 2-3 sets.
Helps activate glutes (often under-used when low-back pain + diabetes) and reduce lumbar compensation.

Cat-Camel (spinal mobility)
On hands and knees, drop your belly (extend spine) then round your back (flex) gently. 8-10 reps.
Encourages spinal mobility, reduces stiffness, promotes circulation.
Seated Row with Resistance Band
Sit tall, band anchored in front, pull elbows back, squeeze shoulder-blades. 10-15 reps × 2 sets.
Strengthens upper back to improve posture (poor posture contributes to musculoskeletal pain).

Walking
Walk briskly 20–30 minutes most days. Helps circulation, glycaemic control, and promotes overall tissue health.

Helpful Tips
Monitor your blood sugar levels regularly, especially if you exercise more — fluctuations can affect tissue recovery.
Stay hydrated and ensure protein intake supports tissue repair.
Take breaks from prolonged sitting or static posture — frequent changes in position help joints, muscles, tendons.
Prioritise sleep (7–8 hrs) — poor sleep is associated with increased pain sensitivity.
Keep a pain-and-activity journal: track when pain is worse (after sugar spikes? inactivity? prolonged sitting?). This can help identify patterns.
If you feel new or worsening numbness, tingling, or signs of neuropathy — notify your healthcare provider.

When to Seek Help Sooner
Sudden onset of musculoskeletal pain following a high blood sugar episode, or with signs of infection.
Pain accompanied by limb weakness, loss of sensation, or changes in gait.
Pain that prevents walking or standing and is persistent despite home effort.
In these scenarios, a professional evaluation is warranted.