by Dr. David Borenstein M.D. updated 07/2020
Diabetes and chronic low back pain are two very common conditions. The concern exists to whether diabetes is a risk factor for the development of CLBP over time.
A prolonged study of a Norwegian population helped answer this problem. A total of 18,972 who were diabetic who had no CLBP and 6802 with recurrence or persistence of CLBP between the ages of 30 to 69 years made up the groups at the end of the study. The study started with 58,928 people but a number of individuals died or moved away from the area.
In the group without CLP, 2105 women (20.5%) and 1275 men (14.6%) reported CLBP at the end of follow-up. The incidence of CLBP was correlated with increased weight but not age. The percentage of CLBP was greater with men with diabetes than those without, but not with women. Men with diabetes had a 43% increased risk of developing CLBP within 11 years. No increase was noted with women. In regard to those with diabetes and CLBP at the initiation of the study, no excess probability of continuing CLBP was found.
The strength of this study is its long duration. However, a number of characteristics limit its applicability to other groups. The study group was Norwegian. The same factors may not apply to other populations. Also, body mass index (BMI) is associated with CLBP and diabetes. The study made allowances for this parameter, but may not be able to totally separate this characteristic from the findings of the study. For instance, diabetes may have resulted in an increase in BMI resulting in decreased physical activity that resulted in glucose intolerance. The issue of BMI may explain in part the gender difference found in this study.
The considerations from this study include the need for glucose control particularly in men. Maintaining a BMI in the normal range from 25 to 29.9 should help for the control of diabetes in men and women. Physical activity that controls weight and strengthens muscles has the potential to decrease the riskof a number of medical problems for both women and men.
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- Heuch I et al. Does diabetes influence the probability of experiencing chronic low back pain? A population-based cohort study: the Nord-Trondelag health study.BMJ Open 2019:9:e031692.doi:10.1136/bmjopen-2019-031692