The spine in diabetes

Do you have back ache? Over a year 15–20% of adults will have back pain, and during their lifetime 50–80% will have at least one episode of back pain.1 In 2014 the Global Burden of Disease Study concluded that ‘low back pain causes more global disability than any other condition’.2 The musculoskeletal complications of diabetes get much less attention than microor macrovascular disease. Yet they may trouble patients more in their daily lives. There seem to be few studies of back pain in diabetes. Among 5106 people in the NHANES study, 515 had diabetes among whom the prevalence of chronic low back pain was 19.8% vs 12.9% in those without diabetes (age-adjusted odds ratio [OR] 1.46; 95% CI 1.00–1.94). Correcting for the older age, greater obesity, lower educational levels, lower income, past smoking and reduced activity of those with diabetes still showed the increased prevalence – OR 1.39; 1.02–1.92.3 Hidden among the thousands of patients with back pain are some with uncommon but potentially lifechanging conditions.