Prevalence of Musculoskeletal Problems in Type 2 Diabetes Mellitus Patients and Their Perception About Physiotherapy Management

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a global public health concern associated not only with metabolic and vascular complications but also with significant musculoskeletal (MSK) problems that often remain underrecognized and undertreated. Objective: This study aimed to determine the prevalence of musculoskeletal issues across different body regions in patients with T2DM and to explore the association between these issues and physical activity levels, while also assessing patients’ perceptions regarding physiotherapy management. Methods: A cross-sectional observational study was conducted involving 250 patients with T2DM recruited via non-probability convenient sampling from two tertiary hospitals in Sialkot. Participants aged ≥40 years with clinically confirmed MSK symptoms were included, excluding those with trauma-induced or unrelated systemic musculoskeletal diseases. Data were collected using a structured questionnaire covering sociodemographic data, diabetes characteristics, MSK complaints, physical activity, and physiotherapy perceptions. Ethical approval was obtained in compliance with the Helsinki Declaration. Data were analyzed using SPSS v26.0 with descriptive statistics, chi-square tests, and p-values <0.05 considered statistically significant. Results: Among 250 patients, 78.0% reported MSK problems, with both upper and lower extremities commonly involved (58.0%). Duration of diabetes showed a significant association with chronicity of MSK symptoms (p < 0.001), and high blood glucose levels were linked to increased MSK pain (p = 0.007). Sedentary lifestyle and low education were also associated with negative perceptions of physiotherapy. Notably, 81.6% expressed willingness to consider physiotherapy in the future. Conclusion: The study highlights a high burden of musculoskeletal complications among patients with T2DM, particularly those with long-standing disease, physical inactivity, and poor blood glucose control. Integrating physiotherapy into diabetes care plans may offer substantial clinical benefits by improving mobility and reducing pain, thus enhancing quality of life and self-management.