Diabetes complications

Joint pain in diabetes mellitus: treatment of legs and knees

Damage to the joints in diabetes mellitus is a frequent occurrence. This complication requires urgent treatment, which not only slows down the process of destruction, but also allows to improve the overall condition of the musculoskeletal system.

The leading causes of late diabetic complications, namely osteo-articular pathologies, lie in the constantly elevated level of glucose in the blood. After all, chronic hyperglycemia has an adverse effect on all human organs and systems.

It was found that an elevated glucose concentration affects the synthesis of sorbitol accumulated in neurons and the endothelial cell. Against this background, diabetic neuropathy often develops.

In addition, the causes of joint pain in diabetes may lie in the fact that changes in connective tissues provoke oxidative stress and the formation of free radicals. And in case of a lack of insulin, changes in the protein glycan composition of cartilage and bones are noted.

Articular Diseases in Diabetes

In chronic hyperglycemia, the joints are affected differently. In some cases, the diseases are caused by a malfunction in the microcirculation, proliferation of connective tissue, or neuropathic complications. And rheumatic syndromes are more common in patients with manifestations of organ pathology.

Articular diabetic complications are many. These include:

  1. diffuse idiopathic hyperostosis of the skeleton;
  2. osteoporosis;
  3. diabetic muscle infarction.

Also, with constantly elevated sugar levels in many patients, signs of a syndrome of limited mobility of articular tissues appear, including such lesions as:

  • Dupuytren's contracture;
  • diabetic chiroarthropathy (cyst);
  • tenosynovitis flexor muscles (snapping the finger);
  • adhesive capsulitis (periarthritis, numbness in the shoulder).

Another popular complication of diabetes is neuropathy. These include amyotrophy, neuropathic arthritis (osteoarthropathy, Charcot’s joints), sympathetic reflex dystrophy, carpal valve syndrome, and more.

In order not to develop these consequences, I and the patient did not have to insert implants, it is extremely important to carry out timely treatment. And to normalize glucose, you should regularly take antidiabetic drugs, such as Metformin.

Against the background of the long-term course of diabetes (5-8 years), diabetic osteoarthropathy develops in many patients. The primary symptoms of the disease are detected by ultrasound osteometry.

Most often the disease affects the lower limb. In 60% of cases, the tarsometatarsal joints are involved in the pathological process, and the ankle and metatarsophalangeal joints are used less frequently (30%).

Sometimes hip joint and knee are affected. As a rule, this process is one-sided.

Manifestations of osteoarthropathy are pain, swelling and deformity of the joints. Due to the violation of sensitivity, sprains and instability of the arch of the feet appear, which often leads to their shortening and deformation.

Also a frequent complication of chronic hyperglycemia is diabetic foot syndrome (DFS). It is a disease of the feet that develops when bone, joint and soft tissues are affected, as well as blood vessels and nerves. As a result, the patient has purulent-necrotic processes and ulcers are formed on the legs.

In general, PFS appears in elderly patients against the background of a long-term course of diabetes (from 15 years). Unfortunately, in 70% of cases, the progression of the disease requires amputation and sometimes it is necessary to implant the foot.

Clinical symptoms of pathology - edema and hyperthermia of the feet. Initially, pain appears in the lower part, which requires a differential diagnostic study with acute arthritis or thrombophlebitis of the veins.

In the process of development of the disease is flattening the feet. At a later stage, strong neuropathy develops and pain is absent.

Often, with a constant increase in blood sugar levels, diabetic syndrome of limited mobility of the joints appears. Mostly immobilized small, and sometimes large, joints.

Symptoms OPS - pain that occurs during movement of the joints. Proximal interphalangeal and metacarpophalangeal joints are most often affected, less often - elbow, trifacial, radiocarpal joints and ankle joints.

Often the disease is detected when the patient can not tightly press each other's hands. Often the "praying hands" syndrome develops against the background of other rheumatic changes. Moreover, the occurrence of OPS depends on the duration of diabetes and its compensation.

Another common complication of hyperglycemia is humeroscapular periarthritis. This pathology is often combined with OPS syndrome, and sometimes, with tenosynovitis palms. In order to prevent the development of such diseases, it is important to monitor glucose indicators, and for their normalization insulin-dependent patients need to constantly take Metformin.

Often, the long-term course of the disease that causes hyperglycemia contributes to changes in bone tissue remodeling. With insulin deficiency, this phenomenon adversely affects the osteoblastic function.

In half the cases, osteopenia and osteoporosis are diffuse. Moreover, the occurrence of these pathologies evades the likelihood of a fracture. Causes that may contribute to the development of osteopenic syndrome:

  1. long decompensation of carbohydrate metabolism;
  2. manifestation of diabetes in patients under the age of 20 years;
  3. course of diabetes for more than 10 years.

Rheumatoid arthritis is also a frequent complication of diabetes, especially in elderly patients. The disease is characterized by a sharp pain in the joint, a violation of its mobility and inflammation of the affected area.

But if there is a diabetes mellitus diet, all joints hurt and my legs go numb, what to do and how to treat these conditions?

Medical events

The main condition for the prevention of progression of joint diseases is to maintain the average glucose (up to 10 mmol / l) throughout the day. Otherwise, treatment of deformity of the feet and other complications of diabetes will not be effective. Therefore, it is important to take antidiabetic pills daily, such as Metformin or Siophore.

And for severe lesions of the joints, including arthritis, anti-inflammatory drugs and agents that renew cartilage are prescribed. In advanced cases, injections are given, but only if the inter-articular gap is preserved.

Also, treatment of joint damage in diabetic is often reduced to taking pyrazolone derivatives and vitamin B. 12. Corticosteroids are rarely used for atropathy, since they affect the concentration of sugar. But if necessary, intra- and periarticular administration of minimal doses is sometimes indicated (up to 37 ml of hydrocortisone).

For drug therapy to be effective, the patient must take medication courses and for a long time. At the same time, he needs to be tested systematically, which will allow the doctor to control the treatment process.

In the event of a foot injury, trophic ulcers are treated and antibiotics are prescribed. It is also necessary to give up bad habits, to provide unloading of the limb and to cure diseases that prevent the regeneration of ulcers.

In case of arthritis or arthrosis, diabetes mellitus can be used unconventional methods of treatment. One of the most popular methods is magnetic therapy, during which the articulations are heated at a depth of twelve centimeters.

The advantages of magnetic exposure:

  • removal of inflammation;
  • elimination of pain;
  • improving the overall condition of the musculoskeletal system;
  • The procedure can be performed at almost any age.

The course of treatment lasts about 30 days. However, the magnetic effect helps only at the beginning of the development of joint diseases. Moreover, this procedure is contraindicated in case of heart problems, cancer, tuberculosis, poor blood clotting and during pregnancy.

If the diabetic affects the joints, quite often laser therapy is prescribed. Similar procedures are conducted by courses - 20 sessions every day. But they are effective only in milder forms of the disease.

In addition to taking anti-hyperglycemic drugs, such as Metformin, vitamins, painkillers and anti-inflammatory drugs, for diabetics with joint problems, it is important to follow all the rules for foot care, paying particular attention to the feet. It is also important to do special gymnastics if an artificial limb has been installed, especially when the implantable element has been placed recently.

In addition, for problems with the joints, a therapeutic massage is indicated. So, if you carry out a similar procedure for at least 10 minutes a day, you can reduce the intensity of pain and increase the sensitivity of the joints. However, this therapy is contraindicated in patients with stable arterial hypertension, fever, blood and skin diseases.

Preventing the onset of articular complications in diabetes consists in careful glycemic control, which can not only eliminate the problem, but also prevent its occurrence in the future. To this end, you must follow a diet, exercise, avoid stress, regularly take Metformin, Metglib and other antidiabetic agents.

How diabetes affects the joints will tell an expert in the video in this article.

Watch the video: Diabetic Foot Pain Relief. Foot and Ankle Exercises for people with Diabetes (February 2020).