Exercise training is associated with reduced pains from the musculoskeletal system in patients with type 2 diabetes

Jensen, Trine Munk; Eriksen, Sofie Bjerre Milling; Larsen, Jane Sedum; Aadahl, Mette; Rasmussen, Søren; Olesen, Louise Bockhoff; Rehling, Thomas; Mølsted, Stig

doi:10.1016/j.diabres.2019.07.003

Cited by 10 publications

(12 citation statements)

References 17 publications

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“…For instance, implementation of regular exercise programs can be of interest for this population. In fact, exercise does not only alleviate musculoskeletal pain but also promotes improved quality of life, and reduces mortality in individuals with diabetes [ 38 , 39 ]. However, caution should be taken for proper and gradual prescription in people with chronic pain since they present distinct responses and adaptations to exercise [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Is There an Association between Diabetes and Neck and Back Pain? Results of a Case-Control Study

López‐de‐Andrés

Hernández-Barrera

Palacios‐Ceña

et al. 2020

JCM

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We aimed to assess if subjects with diabetes exhibit higher prevalence of chronic back pain than age-sex-province of residence-matched non-diabetic controls. We also aimed to identify predictors for chronic neck pain (CNP) or chronic low back pain (CLBP) among subjects with diabetes. A case control study was conducted using data obtained from the Spanish National Health Survey 2017. Multivariable conditional and unconditional logistic regression models were constructed. A total of 2095 diabetes sufferers and 2095 non-diabetic matched controls were analyzed. The prevalence of CNP and CLBP was 27.3% and 34.8%, respectively, in diabetes sufferers and 22.1% and 29.0% in non-diabetes controls (both, p < 0.001). After multivariable analysis, the ORs showed significantly higher adjusted risk of CNP (OR 1.34; 95% CI 1.19–1.51) and CLBP (OR 1.19, 95% CI 1.09–1.31) in diabetes cases. Diabetes sufferers with CNP or CLBP showed higher use of pain medication and higher prevalence of migraine/frequent headache than controls. Female sex, worse self-rated health and use of pain medication were predictors for CNP and CLBP in subjects with diabetes. CNP and CLBP are significantly more prevalent in diabetes sufferers than in controls. Current results can help to design better preventive and educational strategies for these highly prevalent and burdensome pains among diabetic patients.

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Section: Discussionmentioning

confidence: 99%

Is There an Association between Diabetes and Neck and Back Pain? Results of a Case-Control Study

López‐de‐Andrés

Hernández-Barrera

Palacios‐Ceña

et al. 2020

JCM

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“…The source of chronic pain in DM is multifactorial. Approximately 15%‐30% of patients with DM experience pain related to diabetic polyneuropathy, a specific complication of diabetes 7‐11 . Up to 80% of persons with DM report widespread musculoskeletal pain, most frequently located in the joints, neck, or lower back 1,5,7 .…”

mentioning

confidence: 99%

“…Approximately 15%‐30% of patients with DM experience pain related to diabetic polyneuropathy, a specific complication of diabetes 7‐11 . Up to 80% of persons with DM report widespread musculoskeletal pain, most frequently located in the joints, neck, or lower back 1,5,7 . Diabetes often co‐occurs with osteoarthritis: 12 about 30% of patients with DM also had osteoarthritis, 13 and recent data suggest that diabetes may also predispose one to the development of metabolic osteoarthritis 13 and various rheumatologic conditions 14 …”

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confidence: 99%

“…Recent epidemiological data suggest that even if patients are aware of pain, seek care, and take pain control medications, many still experience unacceptable levels of pain 1 . Furthermore, a lot of patients with DM and chronic pain are offered predominantly pharmacological modalities and elect to rest and decrease physical activity, 1 whereas an increase in physical activity may actually be more beneficial in the long‐term control of pain 1,7 . While opioids, acetaminophen, and nonsteroidal anti‐inflammatory drugs (NSAIDS) are an important part of pain management, frequently they are not sufficient pain control options for patients with diabetes and have potential life‐threatening side effects.…”

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confidence: 99%

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Peer Support Intervention Improves Pain‐Related Outcomes Among Rural Adults With Diabetes and Chronic Pain at 12‐Month Follow‐Up

Khodneva

Richman

Andreae

et al. 2020

The Journal of Rural Health

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Purpose Adults with diabetes mellitus (DM) suffer often from chronic pain, yet evidence‐based interventions for comorbid pain and DM are scarce. We tested the effect of a peer‐led cognitive behavioral training (CBT) intervention on pain self‐efficacy (PSE), pain intensity, and pain‐related functional limitations (PRFL) in adults with DM, 1 year after trial initiation. Methods The yearlong “Living Healthy” cluster‐randomized trial included 230 residents of rural Alabama with DM, who reported pain in the past month; communities were treated as clusters. Intervention participants received a peer‐delivered 8‐session structured CBT intervention in the context of diabetes self‐management; attention control arm participants received a peer‐delivered 8‐session general health education program. Outcomes included PSE (Arthritis Self‐Efficacy Scale, range 10‐100); pain intensity (McGill Pain Questionnaire, range 0‐45); and PRFL (Western Ontario and McMaster Universities Osteoarthritis Index scale, range 0‐100). We examined control‐intervention differences in changes in outcome scores from baseline to 3‐month and 12‐month follow‐up, adjusted for clustering. Findings The 195 participants with follow‐up data were aged 59 ± 10.4 years, 96% were African American, 79% were women, and 80% reported pain on the day of baseline data collection. At 3‐month follow‐up, PSE increased more for intervention (21‐point increase) than control (5‐point increase) participants (P for control‐intervention (C‐I) difference in change < .001); pain intensity decreased for both groups; and PRFL decreased only for intervention participants (–11 score; P for C‐I difference in change < .001). Results were sustained at 12 months, and pain intensity significantly improved in only the intervention arm (P for C‐I difference in change = .01). Conclusions This peer‐delivered CBT intervention improved pain self‐efficacy, pain‐related functional limitations, and pain intensity over 12 months among rural participants with DM and chronic pain.

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“…Unfortunately, scores were not evaluated at baseline for their cohort. Munk Jensen and colleagues (2019) recently found 12weeks of combined aerobic and resistance exercise training reduced musculoskeletal pain, as measured by a self-report 0-10 Numeric Rating Scale, in people with type 2 diabetes, though they had no control group for comparison [31]. A potential explanation for the analgesic effects of higher intensity exercise is that the demanding nature of the exercise leads to the release of endogenous opioids [12].…”

Section: Discussionmentioning

confidence: 99%

Effect of different exercise training intensities on musculoskeletal and neuropathic pain in inactive individuals with type 2 diabetes – Preliminary randomised controlled trial

Cox

Gajanand

Burton

et al. 2020

Diabetes Research and Clinical Practice

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People with type 2 diabetes (T2D) have a greater prevalence of musculoskeletal and neuropathic pain. This exploratory analysis investigated whether exercise of different intensities leads to changes in self-reported musculoskeletal pain or symptoms of diabetic neuropathy in inactive individuals with type 2 diabetes. Methods: Thirty-two inactive adults with T2D (59% male, mean age 58.7±9.1yrs, median HbA1c 7.8%) were randomised to usual care (CON), supervised combined aerobic and resistance moderate-intensity continuous training (C-MICT), or supervised combined highintensity interval training (C-HIIT). At baseline and 8-weeks, musculoskeletal and neuropathic pain were evaluated using a modified Nordic Musculoskeletal Questionnaire and the Neuropathy Total Symptom Score-6 respectively. Quantitative sensory testing was used to determine thermal, mechanical and vibration detection thresholds, as well as pain pressure thresholds. Adverse events were recorded throughout the intervention.Results: Compared to CON, reduction in musculoskeletal pain intensity was significantly greater for C-HIIT (MD -5.4, 95% CI [-10.6 to -0.2], p=0.04) and non-significantly greater for C-MICT (MD -5.9 [-12.4 to 0.7], p=0.08). Changes in neuropathy symptoms were not different between C-HIIT and CON (MD 1.0 [-0.9 to 2.8], p=0.31), or C-MICT and CON (MD 0.2 [-3.1 to 3.6], p=0.89). No differences in sensory function were observed between groups. Similar rates of adverse events were seen in both exercise interventions (19 C-HIIT; 17 C-MICT), all but one of which were mild. Conclusions:Preliminary data suggests 8-weeks of high-intensity combined aerobic and resistance exercise may be safely prescribed for inactive individuals with T2D and may reduce musculoskeletal pain but not neuropathic symptoms.

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Exercise training is associated with reduced pains from the musculoskeletal system in patients with type 2 diabetes

Cited by 10 publications

References 17 publications

Is There an Association between Diabetes and Neck and Back Pain? Results of a Case-Control Study

Is There an Association between Diabetes and Neck and Back Pain? Results of a Case-Control Study

Peer Support Intervention Improves Pain‐Related Outcomes Among Rural Adults With Diabetes and Chronic Pain at 12‐Month Follow‐Up

Effect of different exercise training intensities on musculoskeletal and neuropathic pain in inactive individuals with type 2 diabetes – Preliminary randomised controlled trial

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