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Chronic Pain and Diabetes
Chronic pain is common among people with diabetes. Sometimes the pain is linked to a
complication of the diabetes, but other times it is not.
Common pains reported by people with diabetes include:
 Back pain
 Neuropathic pain in the feet and hands
 Headaches
 Arthritis
 Fibromyalgia
Pain can interfere with sleep, work, relationships with family and friends, level of energy, mood,
and overall quality of life. Unfortunately, pain reduces the chance that individuals have for
managing their diabetes and other health conditions.
Many types of chronic pain exist, including:
 Somatic pain—pain from the skin and muscles (fibromyalgia and chronic back pain are
usually somatic pain)
 Visceral pain—pain originating in the internal organs, such as that seen in patients with
chronic pancreatitis or chronic active hepatitis
 Bone pain—chronic causes of bone pain include bone cancer, osteoporosis, osteomyelitis,
phantom limb pain, arthritis, or Paget’s disease of bone
 Muscle spasm
 Peripheral neuropathy—pain coming from the nerves leading from the head, face, trunk, or
extremities to the spinal cord, such as sciatica, certain kinds of cancers, shingles, or the
peripheral neuropathy common in people with acquired immunodeficiency syndrome (AIDS)
or diabetes
 Circulatory problems—chronic pain caused by circulatory problems often is related to
tobacco use, diabetes, certain autoimmune diseases, arteriosclerosis, or reflex sympathetic
dystrophy
 Headache pain—pain from migraines, tension headaches, cluster headaches, sinusitis,
trigeminal neuralgia, giant cell arteritis, or brain tumors
In a study published in the January 2005 issue of Diabetes Care, 1000 patients with diabetes
(mostly men in their mid 60s) were asked to rate how much difficulty they had taking their
medications, engaging in physical activity, complying with a recommended diet, performing
blood glucose checks, and examining their feet. Roughly 60% of the study participants admitted
to having chronic pain (pain that was present most of the time for at least 6 months), and on
average, these participants stated that pain had disrupted their daily life for 18 out of the past 28
days. Of these participants, 78% took pain medications either regularly or occasionally.
Participants who were younger, heavier, female, and on insulin were the most likely to have
chronic pain.
Overall, chronic pain prevented these participants from exercising and adhering to a meal plan,
but they still were able to take their prescribed medications and perform foot checks. However,
participants with severe pain did have difficulty taking their medications, which was not a
problem for those with milder pain. About half of participants with chronic pain rated their
health status as fair or poor, and about one third of those without chronic pain said the same.
Roughly 50% of participants with chronic pain showed signs of depression, while only 20% of
those without chronic pain did the same.
Several treatments are available for chronic pain. Massage, exercise, rest, heat or cold therapy,
acupressure or acupuncture, and medications help many people. Medications commonly used for
chronic pain include anti-inflammatory medications, antiseizure medications, muscle relaxants,
antidepressants, and narcotics. Sometimes other medications also are prescribed, depending on
the cause of the chronic pain.
Some topical creams or gels are available over the counter, which usually help with muscular
pain. These generally contain menthol or capsaicin. However, other topical remedies for
peripheral neuropathy are available by prescription only (clonidine and lidocaine are the two
most often-used topical preparations). Sometimes pharmacies will compound these creams to
also contain gabapentin or amitriptyline.
Surgery can help with some types of pain, such as bypass of the clogged arteries with artificial
arteries for people with circulatory problems. Other individuals benefit from electrical
stimulation, herbal remedies, meditation, prayer, or distraction.
References and recommended readings
Hitti M. Chronic pain hampers diabetes self-care: harder to exercise, diet, and take meds with
chronic pain. Available at: http://www.webmd.com/pain-management/news/20050114/chronicpain-hampers-diabetes-self-care. Accessed August 27, 2012.
Lasich C. Topical medications for painful diabetic neuropathy. Available at:
http://www.healthcentral.com/chronic-pain/c/27148/153852/medications?ic=506048. Accessed
August 27, 2012.
Lindsay TJ, Rodgers BC, Savath V, Hettinger K. Treating diabetic peripheral neuropathic pain.
Am Fam Physician [serial online]. 2010;82:151-158. Available at:
http://www.aafp.org/afp/2010/0715/p151.html. Accessed August 27, 2012.
Spero D. Managing chronic pain. Available at:
http://www.diabetesselfmanagement.com/articles/alternative-medicine-complementarytherapies/managing-chronic-pain/all/. Accessed August 26, 2012.
Stöppler MC. Chronic pain. Available at:
http://www.emedicinehealth.com/chronic_pain/article_em.htm. Accessed August 26, 2012.
Review Date 8/12
D-0659