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Diabetes and Tendonitis

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Adelekitten77

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Relationship to Diabetes
Type 1
Hi all,

Im new here but been t1d for over 30 years and well controlled.

I’ve been having problems with tendons thickening and it affecting a lot of my body now. It started with trigger fingers to which I had surgery but I have painful knuckles which they are injecting with steroids.

I’ve a painful neck and shoulders and have had the most painful plantar fasciitis for 10 months. Tonight I have been getting pain in my forearm and Dr Google tells me it is medial tendonitis.
I’ve done the exercises they told me to, cold pack, NSAIDs, insoles, everything but nothing has helped. I’m so worried it’s going to take over my whole body and I’m only 43. Anyone else experienced this and what helped?
 
Multiple tendinitis is a well known rheumatic syndrome, totally unrelated to diabetes. You would be better asking your doctor for referral to a rheumatologist.

It’s often an inherited disorder, so has anyone else in the family ever been troubled with “rheumatics”?
 
Luckily I’ve pushed for that referral and will see the rheumatologist in a couple of months. There have been other rheumatic problems within the wider family but not as young as me. I’m 43 and hobbling round like an elderly person :(
 
Oh bless you. But yes push for a rhuematology referral. I have fibro that presents with similar issues although not limited to tendons and I find seeing a chiro regularly helps me so it might be worth exploring if good massage/chiro/osteo or other hands on therapies help
 
So sorry to hear about the problems you have been having with your tendons and joints @Adelekitten77

Hope you get some clarity from your upcoming appointments, and are able to find a combination of physical therapies and medications that offer you some help, relieve your symptoms, and give you a practical way forward.

Let us know how things go.
 
Hi. Just wanted to say welcome from me too and ask if you can keep us updated with your progress/result of consultations.

I have just started to have problems like this. It started with my hands getting stiff and sore and if I bump the knuckles at all even on something quite soft, it is really painful and I have lost a lot of strength in my hands as a result. My morning insulin injections are sometimes a little challenging as a result. Other joints like knees are also getting sore and whilst I can still run, they are really quite painful for the first 3-400yards and my shoulders and elbows have also started to complain. Keeping them moving and working seems to help for me but painful to start with. Last night my right shoulder locked up with rather dramatic pain but subsided once I held it to my body and supported the arm. Thankfully it hasn't done it again yet but I am aware of a dull ache in both the shoulder and elbow if I am sitting still, My middle right finger locks up quite frequently now especially on a morning when I wake up, so pretty sure something is amiss more generally in my joints/tendons. Hoping it is transitory and I can work through it, but may need to seek medical help if it continues, so I will be interested in how you get on.
 
Hi there, I think I have almost exactly the same issue as you. I am 47 and have been type 1 diabetic for 20 years, always well controlled. In December 2018 I got pins and needles in one hand. I went to the GP who said it was a frozen shoulder and should get better on its own over time. This developed into numbness and ultimately pain in both hands during 2019/2020. I had a nerve conduction study in Sept 2020 which concluded I had carpal tunnel syndrome in both hands. I also have tendonitis (can feel the swollen tendons in my hand) and a trigger thumb. In July this year I had surgery on my right hand and at the same time the surgeon injected steroid into my thumb. Whilst this has removed the numbness in my hand and has helped slightly with my thumb (I can now bend it where I couldn't before) I feel it has been treatment of the symptoms and not the underlying cause. I still have pain in my fingers and this has developed into extreme pain in my elbows in both arms. I have started a diary of what I am eating and drinking to see whether worse pain correlates with anything in particular, but nothing obvious yet. I take ramipril for blood pressure, wondered if it might be caused by that so after stopping eating salt and losing weight have now halved the ramipril dose from 5mg to 2.5mg with Dr's agreement. I don't have high cholesterol so i also stopped taking atorvastatin about 9 months ago in case it was that. No improvement yet from reducing these medications so probably not related. Did wonder whether it might be caused by smart phone usage (I've just typed this long message on my phone for example!) so have tried to cut down on that too! I've recently started trying to eat fewer carbs and take less insulin, but maybe too soon to tell whether that helps. Sorry I don't have any solution for you, I am very much trying to find out the cause myself. Would be very interested to hear anything you find out and to stay in touch. Ross
 
Welcome to the forum @RossN

A new piece of research published at the DUK Professional Conference this year has found a causal relationship between T1D and a variety of musculoskeletal conditions including frozen shoulder and trigger finger (an association had long been observed, but new analysis has shown that these should now be considered complications of T1D.

There’s a writeup of the research findings here: https://medicine.exeter.ac.uk/news/articles/type1diabetescancausemusc.html

Dr Harry Green, Independent Research Fellow at the University of Exeter, said:​
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“Many conditions are known to be associated with diabetes, but it is often unclear whether diabetes has a direct causal role or is associated for other reasons. We hope that understanding more about the causal role that type 1 diabetes and long-term high blood sugars play in the development of musculoskeletal conditions will pave the way for these conditions to be recognised earlier in patients with diabetes.”​
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Dr Elizabeth Robertson, Director of Research at Diabetes UK, said:​
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"Dr Green’s research has shown, for the first time, that several musculoskeletal conditions can be a direct complication of type 1 diabetes. People with type 1 diabetes should now be made aware of these conditions, alongside established complications such as heart and kidney disease.​
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“These results are a reminder of the importance of supporting people with type 1 diabetes to manage their blood sugar levels so that they can live well with the condition and avoid future complications.​
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“It is crucial that healthcare professionals are aware of these complications, so they are armed with the knowledge to facilitate early diagnosis and treatment, ensuring the best possible care for people with type 1 diabetes.”​
 
Thanks, that is very interesting. However, my regular check ups (HbA1c) have always indicated that my diabetes is very well controlled so I don't recognise the link to sustained high blood sugar in my case. Is there a full academic paper for this, or just the summary article? I'd like to see the detailed data on sugar level v prevalence of the conditions, or is it simply a correlation between being type 1 diabetic and these conditions (and hence could be another causal factor)? Also the article doesn't seem to indicate whether anything can be done to reverse the 'complications'. Is the conclusion that I will have pain in my hands/arms for the rest of my life? At 47 you'll appreciate that's a pretty depressing prospect... Thanks again for the information, I will discuss with my Consultant, much appreciated.
 
Great, thanks Mike. So the relationship is simply between being type 1 diabetic and the prevalence of these conditions, the association with chronic hyperglycaemia is inferred by the researchers, not based on an analysis of HbA1c results or similar. To me this suggests that while type 1 diabetics have greater risk of these conditions more information is needed to explain the exact mechanism of why people get them e.g. is there a correlation with HbA1c, sedentary desk jobs, computer and smart phone usage or what? Seems to me that information is needed to determine suitable prevention/treatment. I will maybe try and get in touch with the research team to enquire if they are looking to take this further. Thanks again.
 
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