Woman with diabetes-related orthopedic pain clutches knee during run

6 Orthopedic Issues Associated With Diabetes

The Endocrine & Skeletal Systems: It’s All Connected. A complex set of systems and processes make the operation of the human body possible. The circulatory, skeletal, nervous, and digestive systems represent just a few of these structures. However, despite their differentiation, these systems do not actually function in an individual bubble. Many, if not most, of these systems work cooperatively to ensure the proper function and survival of the body as a whole. When it comes to diabetes, we often think of this condition as a disease of the endocrine system. This is only natural, as diabetes is directly linked to the pancreas and insulin production or regulation. This one-way thinking can obscure the fuller picture, however, as diabetes can simultaneously affect many different organ systems. Diabetes actually affects several anatomical systems. Yes, the endocrine system is key. Our pancreas—a key player in the endocrine system—regulates the excretion of insulin. But, sugar originates in our digestive system, travelling through the blood (or circulatory system) to deliver energy to the entire body. With the aid of insulin, the pancreas can deliver sugar to energy-needy cells. If our cells don’t receive this energy due to diabetes-related insulin deficiencies, problems can ensue. This is especially true with the skeletal and neurological systems. Diabetes can impact the health and development of our skeletal system and nerves. What we are not completely sure of is the exact reasoning for this relationship. What we do know: diabetes leads to inflammation, nerve damage, and can either accelerate or inhibit bone development and healing. Some clinicians believe that insulin promotes bone growth. For example, too much insulin can lead to too much bone growth, whereas not enough insulin can lead to weakened bones. Researchers also believe that the inflammation caused by diabetes leads to nerve damage, neuropathy, and joint pain. 6 Orthopedic Issues Linked to Diabetes Diabetes-Related Bone Issues Osteoarthritis: Osteoarthritis is a condition characterized by the degeneration of cartilage between the main joints in the body. The primary causes for this degeneration include age-related wear and tear, obesity, and nerve inflammation. Individuals with Type II Diabetes are also prone to obesity and inflammation, which can accelerate the development of symptoms. Osteoporosis: Osteoporosis is a disorder that leads to weakening, fragile bones. Osteoporotic bones can become so fragile that they become porous and actually resemble the structure of a sponge. Individuals with Type I Diabetes have been shown to have an increased co-occurrence of osteoporosis due to a lack of insulin to promote bone development. DISH: Diffuse Idiopathic Skeletal Hyperostosis (DISH), also called Forestier’s disease, results in a hardening of the connective tissues. This can lead to pain, stiffness and immobility, especially in the spine. Again, this hardening is most often found in those with Type II Diabetes and can be attributed to insulin-related bone growth. Increased Risk for Fractures: With osteoporosis, neuropathy, and the development of hardened ligaments, the potential for falls increases substantially. This can increase susceptibility to fractures, especially in the hips and joints of

woman sitting at computer rubs sore wrist with carpal tunnel

How to Prevent Carpal Tunnel & Wrist Pain

The Dark & Narrow Carpal Tunnel The Carpal Tunnel is not some elusive tunnel through a mountain somewhere. It’s actually an important anatomical passageway formed by the bones, ligaments, and tendons in our wrists. Why so important, you ask? This small passageway allows for the travel of not only essential ligaments, but also, your median nerve. The Median nerve is crucial to the functioning of our hand. It is crucial in the fact that it feeds nerve signals to 3 and a half of the five fingers on our hand. This includes all of the fingers from the half of the ring finger to the crucial opposable thumb. If a narrowing carpal tunnel encroaches on this median nerve, the painful and restrictive symptoms of a pinched nerve can ensue. Carpal Tunnel Syndrome Simply put, Carpal Tunnel Syndrome (CTS) occurs when compression of the median nerve causes inflammation in the hand or wrist. This compression can occur due to a number of circumstances. Some of the leading causes of Carpal Tunnel Syndrome include: Repeated Awkward Motion: Flexion and extension while using the hand can lead to inflammation, especially when these hand positions are prolonged. One of the most common sources of prolonged flexion and extension results from typing. Construction, sewing, working on the hands and knees, and painting are just a few additional examples of activities that involve repetitive hand extension or flexion. Traumatic Injury: In addition, trauma to the hand and wrist can result in inflammation, swelling, and median nerve compression. This is especially prevalent with damage to the tendons and ligaments in the wrist. Injuries to the wrist are common results of falls. (When falling, we have an instinctive urge to reach out to catch ourselves with our hands.) Medical Conditions or Illness: There are a number of medical situations that lead to swelling in the body. Some of these conditions include diabetes, rheumatoid arthritis, osteoarthritis, kidney disease, and hypothyroidism. Over time, this swelling can cause median nerve compression and CTS. Pregnancy: Furthermore, hormonal changes during pregnancy can lead to edema, or the retention of water. This water retention naturally leads to swelling in the limbs and joints. And, as we know by now, swelling in the joints can lead to compression of the median nerve in the wrist. Preventing The Pain Although CTS is a fairly common consequence of our normal, everyday lives, we can take several preventative steps to avoid this problem. Ergonomics of the Workplace: Posture and desk organization can play a large role in the development of Carpal Tunnel Syndrome. Make sure you are sitting at a height that allows your elbows to bend at a 90-degree angle and leaves your wrists laying straight. They even make little pillows to go in front of your keyboard to help support a straight wrist. The internet is also chock-full of info on workplace ergonomics. Take some time to do some research. Take Breaks: Take short 3-5 minute breaks every hour or more to give those wrists a

older couple biking on vacation in europe after beating thoracic disc herniation

Your Handbook to Thoracic Disc Herniation

Your Ultra-Stable Thoracic Spine Your thoracic spine consists of 12 vertebrae, which extend from the base of your neck to the beginning of your lower back. While your cervical and lumbar spine segments enable movement and flexibility, your thoracic spine offers stability. Correspondingly, this ultra-stable design enables your thoracic spine to serve as the main supportive pillar for your rib cage. In fact, each of your ribs sprouts from one of these thoracic vertebrae. Your ribs then arch around to the front of your body where they meet at your sternum. This strong cage formed by your ribs makes your thoracic spine more static, stable, reinforced, and less prone to injury. This does not, however, mean that your thoracic spine is incapable of sustaining an injury or generating pain. There’s also a hidden downside to this stability: Your rigid thoracic spine contains less built-in spaces than other spinal segments. This translates to smaller intervertebral discs for shock absorption, less wiggle room between vertebrae, and a narrower spinal canal. And, with less wiggle room naturally comes increased chances for injuries, damage, and discomfort. A leading cause of this discomfort? Thoracic disc herniations. Why Do Thoracic Disc Herniations Occur? In essence, our intervertebral discs serve as shock-absorbing cushions between each vertebra in our spine. These rubbery discs absorb forces from bodily activity and permit smooth movement of the vertebrae as we navigate our day. Structured like a jelly donut, our spinal discs consist of a tough exterior filled with a viscous jelly-like interior. With less space existing between each thoracic vertebra, our thoracic discs compensate by adopting a thinner design. Under normal circumstances, our thoracic discs do not need to absorb as much shock from spinal movement as do other spinal segments. However, as a result, these discs possess less lubricating and cushioning properties. Combined, these two factors can result in damage to thoracic discs. Often this occurs in the form of thoracic disc herniations. A herniation occurs when the exterior of an intervertebral disc cracks open, expelling the gelatinous contents of the disc. This material can protrude into adjacent nerves, resulting in anywhere from a slight ache to excruciating pain. The smaller canal of the thoracic spine also leaves the spinal cord susceptible to the entrapment (sequestering) of herniated disc material. Additional Risk Factors A number of conditions and events can lead to thoracic disc herniation. However, the two most common triggering events include degenerative disc disease and traumatic injury. A particularly common condition, degenerative disc disease usually results from the aging process, as the effects of wear and tear accumulate on the spine. Unfortunately for many, disc degeneration is virtually impossible to avoid. Especially, when we take into consideration the sheer number of workers who earn a living from careers that place chronic strain on the back. Nurses, construction workers, and athletes… All of these workers rely on their back for their wages. In addition, sudden, traumatic injuries to the back can also lead to thoracic disc herniations. Car accidents…

man with myofascial pain and inflammation

The Connection Between Fascia & Chronic Pain

Fascia: What Exactly Is This Stuff? You’ve probably heard the term fascia—pronounced /fa-shuh/—popping up more and more in medicine these days. Although certainly not a “new” discovery, fascia has achieved buzzworthy status as we come to understand more about its significance. Composed of firm but flexible collagen, fascia forms a complex system of connective tissue that permeates every corner of your body. More specifically, your fascia coats the underside of your skin, muscles, brain, and each and every vein in your body. We can get a better understanding of fascia by visualizing the structure of a grapefruit. (Although this may not be the most appetizing visual, it will definitely help in understanding the purpose of fascia.) Okay … now, back to the grapefruit! The rind of the grapefruit represents our skin. And, the fruit inside of the grapefruit symbolizes all of our internal organs and muscles. The white pith that coats the underside of the rind and the exterior of each sliver of fruit? That connective pith is your fascia. In addition, this white pith even contains strands that extend down between each piece of fruit. Likewise, the thin skin on the outside of each juicy fruit section mimics fascia in both appearance and function. And, if you take a closer look, a group of small tear-shaped particles unites to compose each sliver of fruit. The white pitch (aka. the fascia) also encapsulates each of these miniscule particles. Long story short, if the grapefruit didn’t contain its own form of fascia, it would dissolve into a ball of mush. Essentially, fascia is the substance that binds your organs—and organ systems—together. It’s the glue that holds you and me together! What Does Fascia Actually Do? On a fundamental level, fascia functions as the cellophane wrap for every part of our internal body. Its primary objective? Firm yet flexible support while creating and maintaining the basic form and structure of the body. Moreover, your fascia promotes the smooth and pain-free movement of your tissues and organs. Your fascia accomplishes this by wrapping around your muscles to prevent friction as these structures shift against your bones. Likewise, your fascia coats your veins and arteries to reduce any abrasion from smooth muscles that power your circulation. And, your fascia also encapsulates your fragile organs to enable fluid, non-abrasive shifts in position as we move about our day. What Does Fascia Have To Do With Pain? Up until now, we have been led to believe that fascia functions purely as a supportive tissue. Although fascia helps to hold things together and aids in movement, the reality is far more complicated. In truth, our fascia also plays a key role in our movement and exists as some of the most innervated tissue in our body. Yes, fascia also coats your nerves. What does this translate to? Unfortunately, for a select few—chronic pain. And, because we can find fascia in widespread locations throughout the body, irritated fascia can cause lower back pain, neck discomfort, and joint inflammation. Indeed,

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6 Orthopedic Issues Associated With Diabetes

How to Prevent Carpal Tunnel & Wrist Pain

Your Handbook to Thoracic Disc Herniation

The Connection Between Fascia & Chronic Pain

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