The Blood Sugar and Joint Pain Connection

You may know that blood glucose levels have a significant effect on your metabolic health, but have you ever wondered how these levels might be connected to joint pain?

It may surprise you to learn that blood sugar levels can have a big effect on the health of your joints. However, while research indicates that diabetes affects the joints and can lead to osteoarthritis, there are many other conditions that can also play a role.

There are 360 joints in the human body, so taking care of them is crucial—and this only becomes more true as you age. Read on to learn more about the relationship between your joints and blood glucose levels. 

What is Joint Pain?

Your joints are the points in your body where two bones meet. Joints keep your bones from rubbing together, prevent breakage of bones, help your limbs bend and straighten, and allow for dexterity in areas such as your fingers.

Each joint has a particular structure, made up of bone, muscles, synovium (a connective tissue), cartilage, and ligaments.

Joint pain is defined as discomfort or inflammation that originates in any part of a joint. This type of pain can occur temporarily, after performing certain activities involving the joint. It can also be found as chronic pain and affect your ability to move the affected area without experiencing pain.

According to Harvard-trained pain medicine physician, Elisha Peterson, MD, MEd, FAAP, FASA,

"It is common for patients with joint pain to avoid moving because this can worsen pain—however, over time, not moving can result in worsening pain and impaired function over time."

People who are more likely to be affected by joint pain include:

• Those who have previously injured a joint
• People who have arthritis or diabetes
• Anyone experiencing depression and/or anxiety
• Individuals who are overweight or obese

What Are Some of the Causes of Joint Pain?

There are many causes of joint pain, ranging from viral infections, overuse, age, or even chronic diseases. Here are some of the common causes of joint pain: 

Osteoarthritis

Osteoarthritis is the most common type of arthritis. This disorder damages your joints, and usually affects the hands, hips, knees, and spine. This condition is caused by deterioration of the cartilage found in your joints that cushion and protect the ends of your bones. This results in pain, tenderness, swelling, stiffness and loss of flexibility.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disorder that occurs when your body’s immune system attacks your body’s healthy tissues. Rheumatoid arthritis commonly affects joints, but it can also damage your skin, eyes, heart, lungs and blood vessels.

Painful swelling in your joints as a result of rheumatoid arthritis can result in eventual bone erosion and joint damage. It usually affects the smaller joints of your hands and feet first before progressing to your wrists, knees, ankles, elbows, hips, and shoulders.

Gout

Gout is a form of arthritis that occurs when urate crystals accumulate in your joints, causing extreme pain and inflammation. This condition can lead to intense joint pain, inflammation, redness, limited range of motion, and lingering discomfort that can last from days to weeks. 

The body naturally produces something called uric acid as it breaks down compounds called purines. These chemical compounds occur naturally in the body, and are also found in red meat, organ meats (like liver), some seafoods, and alcoholic beverages, especially beer.

However, when your body produces too much uric acid, it can build up in the body, forming urate crystals in your joints. These crystals are sharp and needlelike, causing pain, inflammation, and swelling. Gout can affect anyone, but factors like diet, age, genetics, excess weight, and some medical conditions can increase your risk. 

Bursitis

Bursitis affects the small, fluid-filled sacs found near your joints that cushion your bones, muscles, and tendons. These sacs, called bursae, can become inflamed, resulting in stiffness, pain, swelling, and inflammation.

Bursitis most commonly affects the joints that perform repetitive motion, like your shoulders, elbows, and hips. However, it can also affect the joints of your knees, heels, and big toe.

Tendinitis

Tendinitis is inflammation of your tendon, which is a thick, fibrous cord that attaches muscle to bone. Tendinitis most commonly occurs in the shoulders, elbows, wrists, knees, and heels, resulting in pain, tenderness, and swelling. 

This condition is usually caused by repetitive motions that put stress on your tendons. Participating in certain hobbies, occupations, or sports can increase your chances of developing tendinitis.

Lupus

Lupus is an autoimmune disease that causes your body’s immune system to attack its own tissues and organs. This disease can cause inflammation in different places in your body, including your joints, skin, kidneys, blood cells, brain, heart and lungs. 

In some people, symptoms can be sudden or develop slowly and may be mild or severe, or temporary or permanent. Symptoms of lupus including fatigue, joint pain and stiffness, a butterfly-shaped rash on the face, chest pain, and headaches, are shared by many other ailments, so it can be hard to diagnose.

Lyme Disease

Lyme disease is an illness caused by bacteria that is transmitted to humans by the bite of an infected blacklegged tick. Most tick bites do not lead to Lyme disease.

If the tick is attached to your skin for less than 36-48 hours, your chances of developing Lyme disease are unlikely. The longer the tick remains on your skin, the greater your chances of getting Lyme disease.

Lyme disease can cause severe joint pain and swelling, especially in the knees. You may also develop neurological problems, such as inflammation of the membranes surrounding your brain, paralysis on one side of your face, numbness of weakness in your limbs, and impaired muscle movement. 

What is the Relationship Between Joint Pain and Blood Sugar Levels?

High blood sugar can be linked to joint pain for a few reasons. Factors like increased inflammation, obesity, and diabetes, which are associated with chronically high blood sugar may all have an affect on your joints.

Blood Sugar and Inflammation

According to orthopedic spine surgeon Dr. Carl Giordano, "high blood sugar levels can damage nerves and blood vessels throughout the body, including those in the spine and joints, leading to chronic pain and inflammation." Elevated glucose levels can cause an overproduction of reactive oxygen species, or ROS, in your body. These ROS can cause inflammation and damage to your cell tissues, though more research is needed to determine how exactly this happens. 

Research has also shown that a diet high in refined carbohydrates like sugar may trigger the innate immune system and increase the production of pro-inflammatory cytokines, which cause inflammation. One 2016 study even identified drinking sugar-sweetened beverages as an individual risk factor in developing rheumatoid arthritis, an inflammatory disease that causes pain and swelling in the joints.

Another side effect of inflammation can lead to increased visceral fat around the abdomen, which has been shown to increase the production of pro-inflammatory cytokines in the body. Chronically high blood sugar, inflammation, and insulin resistance can all increase your risk of obesity.

Diabetes and Joint Pain

There is a strong link between diabetes and joint pain, and there are several factors that contribute to it. Individuals with diabetes are more likely to develop osteoporosis. In fact, conditions that are linked to joint pain such as osteoarthritis, diabetes, and obesity share many of the same risk factors.

According to the Arthritis Foundation, pro-inflammatory cytokine levels are higher in both people with type 1 and type 2 diabetes and people with arthritis. One study also found that type 2 diabetes may contribute to the degradation of cartilage health, leading to an increased chance of developing arthritis and subsequent joint problems. 

However, arthritis is not the only joint and bone condition associated with diabetes. Charcot joint, or neuropathic arthropathy, is a type of nerve damage that can cause your joints to deteriorate. It primarily affects the feet, and results in numbness, tingling, or loss of sensation in the affected joints. 

High blood sugar can also lead to diabetic neuropathy, another common complication of diabetes that can result in nerve damage.

Tips and Tricks for Reducing Joint Pain

If you are experiencing joint pain, here are some tips to get relief. Keep in mind that these are tips to be used alongside any medications or therapies prescribed by your doctor.

Massage

Getting regular massages may be a great way to get relief from joint pain. A 2013 study of adults with rheumatoid arthritis found that getting a moderate-pressure massage once a week for four weeks resulted in less pain, better grip strength, and a greater range of motion in their upper body joints.

The Arthritis Foundation also supports this, stating that massages can be beneficial in lowering cortisol levels, as well as reduce levels of inflammatory cytokines. Remember to always consult your rheumatologist or doctor to makes sure that this treatment option is suitable for you.

Physical Therapy

For some people, a specialized treatment program designed by a physical therapist can be an effective solution. Joint pain has different causes, so it can often require unique types of treatment depending on the individual.

"If your joint pain is chronic (not due to a recent injury), then it is crucial to start moving again under the support and supervision of a physical therapist. A physical therapist will work with you on a personalized treatment plan, evaluate your gait, recommend orthotics if needed, and work in line with your goals. Your doctor can refer you to a physical therapist for treatment at least once a week for 10 to 12 weeks," says Dr. Elisha Peterson, MD, MEd, FAAP, FASA.

Heat Therapy

According to the Arthritis Foundation, heat therapy can help relax stiff joints and reduce pain. When heat is applied to a sore joint, the blood vessels grow, allowing more blood, oxygen, and nutrients to be delivered to the injured tissue.

Increased blood circulation can help relax your joint, but it’s important to note that heat therapy is not recommended for use on acute injuries.

Acupuncture

Acupuncture is a treatment that was derived from traditional Chinese medicine and is commonly used to treat pain. During an acupuncture session, very thin needles are inserted into your skin at strategic points in the body. This treatment is believed to stimulate nerves and muscles, releasing your body’s natural painkillers.

A 2021 review of past animal and human studies found that acupuncture may significantly relieve pain caused by diabetic neuropathy.

Exercise

According to the Mayo Clinic, exercise is crucial for relieving joint pain and stiffness because it strengthens the muscles around your joints. Experts suggest low-impact exercises to keep joint stress low and moving gently and slowly to avoid overworking your joints and muscles.

One study found this type of activity to be beneficial in treating knee pain in individuals who had knee osteoarthritis. Always consult your doctor before starting a new exercise regimen, especially if you suffer from severe joint pain.

Glucose Monitoring

According to Dr. Giordano, glucose regulation can play an important role for some individuals experiencing joint pain.

"Over time, high blood glucose levels can damage nerves, blood vessels, and tissues throughout the body, eventually causing chronic inflammation if left untreated. This damage can lead to a variety of musculoskeletal problems, including joint pain."

Paying attention to your blood sugar levels either via regular blood tests or by using a continuous glucose monitor can help you ensure that your blood sugar levels are within the ideal range. Dr. Giordano also recommends eating a balanced diet, maintaining a healthy weight, exercising regularly, and getting plenty of sleep to support healthy glucose metabolism.