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Shoulder Conditions in Diabetes

Diabetes can affect the musculoskeletal system in many ways and the shoulder is the most commonly affected joint. The severity and the risks of musculoskeletal complications and the various associated ailments can certainly inflict both physical and psychological harm on people with diabetes. Shoulder issues that affect diabetic patients are often characterized by pain and limited range of motion of one or both shoulders. Shoulder pain can get in the way of quality of life and daily activities and could also directly or indirectly interfere with control of metabolic processes.

There have been studies showing that there is a higher prevalence rate which is 27.5% of shoulder disorders in patients with diabetes when compared to the rate of 5.0% found in general medical patients. The glycosylation of the collagen within the shoulder joint triggered by the presence of high blood sugars in diabetes gives rise to most of the shoulder conditions.

Frozen shoulder also known as adhesive capsulitis that is characterized by pain and severe limited active and passive range of motion of the glenohumeral joint is the top most rheumatic conditions that is caused by diabetes. The cross-linking collagen accumulating in the shoulder capsule leads to joint stiffness and the chronic inflammatory process as a result of hyperglycemia. This can in turn enhance the inflammation reaction in the synovium leading to capsular fibrosis of the shoulder joint. The aligoneurodystrophic process, and fibrotic pathways are other possible reasons of frozen shoulder being connected with diabetes. Frozen shoulder is about 6 times more common in diabetics than non-diabetics. Frozen shoulder is more common in type 1 diabetics than type 2.

There is a higher recurrence rate of rotator cuff tears in people with diabetes and also higher recurrent tear rate among diabetic with poor glycemic control. Diabetes is also a risk factor for rotator cuff tendinitis. Reflex sympathetic dystrophy, also known as shoulder-hand syndrome, is a painful syndrome. Diabetic amyotrophy can sometimes affect the shoulder girdle leading to a painful shoulder condition.

Shoulder Osteoarthritis is another common rheumatic condition that can be brought on by diabetes. Almost 47 percent of people with arthritis were found to have diabetes so a link between both has been established. People who have type 2 Diabetes have an increased risk of osteoarthritis possibly due to obesity. In diabetics, insulin resistance can damage cartilage, bone and synovial tissue. This can in turn reduce mobility in obese subjects especially when the obesity is predominantly related to type 2 Diabetes.

The calcific periarthritis of the shoulder is another inflammatory process brought on as a complication of diabetes. As a result of the condition, there can be long term damage like deposits of calcium and collagenous fibers on adjacent tissues. Calcium and collagen deposits can compromise the joint capsule, bicipital tendon and surrounding tissue. Diabetes can also damage joints leading to a condition called diabetic arthropathy. The pain related to arthropathy happens over time and one of the symptoms of this condition is painful shoulders.

For enquiry related to Shoulder Injuries, Sports Injuries and their treatment options, send a message to www.BangaloreShoulderInstitute.com/contact

Visit the youtube channel to watch videos by Dr Ayyappan V Nair on different shoulder, sports and other orthopaedic conditions and their treatment options – https://www.youtube.com/channel/UCJldz_Osg88qFYM99IEsjew

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