abetes can lead to certain complications if blood sugar levels are not kept in safe ranges. One of these potential complications is joint and muscle problems. Diabetes-related damage to the small blood vessels, connective tissue, and nerves can all cause these musculoskeletal conditions. 

The good news is that they are all treatable conditions. But the longer you have diabetes that goes untreated, the more likely you are to experience them. Here’s what you need to know about joint and muscle complications with diabetes, from head to toe.

The shoulders: tendonitis and frozen shoulder 
Rotator cuff tendonitis

The rotator cuff is made up of four muscles. Rotator cuff tendonitis occurs when a tendon from one of these muscles becomes inflamed. This is more common in people with diabetes.

Shoulder pain that worsens when the arm is raised is a hallmark of rotator cuff tendonitis. Early treatment includes icing, rest, physical therapy, and a non-steroidal anti-inflammatory drug (NSAID) like ibuprofen (Advil, Motrin). If the pain remains after 4 to 6 months, your healthcare provider may refer you to an orthopedic surgeon to talk about surgery options.

Frozen shoulder

Frozen shoulder is a condition that starts with pain in the shoulder but progresses to limited mobility and stiffness with little pain. It is more common in people with diabetes. Treatment for frozen shoulder includes home exercises, steroid injections, and physical therapy. Surgery is only necessary if the initial treatments don’t help.  

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The arms and hands: numbness, pain, and finger cramps
Dupuytren’s contracture

A Dupuytren’s contracture is a hard round knot on the palm of your hand, usually close to your ring or pinky finger. Over time the knot can become long and chord-like, and pull your fingers into a bent position. The nodules and chords are caused by a buildup of connective tissue. 

Treatment options include seeing a healthcare provider for a steroid injection and possibly surgery, if necessary.

Trigger finger (Flexor tenosynovitis)

A common symptom of trigger finger is a locking sensation when you try to bend and straighten your finger. You may also feel a hard knot due to thickening of the tissue surrounding a tendon in your finger. The ring finger, middle finger, and thumb are most often affected. Treatment starts with splinting and NSAIDs. If those options don’t help, steroid injections followed by surgery are your next steps. 

Carpal tunnel syndrome

The early symptoms of carpal tunnel syndrome start in the hand as pain, numbness, and tingling. Carpal tunnel syndrome is caused by a compressed median nerve. This is the main nerve in the front of the forearm.

Carpal tunnel syndrome is more commonly diagnosed in people with diabetes as a result of damaged connective tissue. Treatment for mild symptoms starts with nighttime wrist splints or a steroid injection and occupational therapy referral for hand therapy. Carpal tunnel release surgery is your next step if symptoms are still present. 

The feet: tingling, numbness, and pain
Diabetic neuropathy

Diabetic neuropathy is one of the potentially serious complications of diabetes. Neuropathy, or nerve damage, can cause a burning pain in the feet and lower limbs. Once your healthcare provider is certain the pain in your feet is from diabetic neuropathy, treatment is focused on pain control, although carefully controlling blood sugar levels is also important. 

Oral medication options for managing nerve-related pain in people with diabetes include:

Pregabalin (Lyrica)
Valproic acid (Depakene)
Amitriptyline (Elavil)
Duloxetine (Cymbalta)
Venlafaxine (Effexor)
Topical treatments include capsaicin cream and lidocaine (Lidoderm) patches. 

Note: Providers used to prescribe gabapentin (Neurontin) for diabetic neuropathy, but the American Diabetes Association has since updated their treatment guidelines and they longer recommended it.