Shoulders, Hands, Fingers and Feet

Learn what diabetes can do to your body and how to cope with it!

Do you ever wake up in the morning feeling stiff and tingly? Do you find that sometimes these feelings go away as the day goes on, but sometimes they don’t? For many people the problem is arthritis, but for others it is not. Did you ever wonder if these feelings are related to diabetes? Certain problems that happen in the joints of your shoulders, hands, fingers and feet are more common for people who have diabetes. Some are even caused by its long-term effects. The good news is that these joint problems can get better with specific treatments. Also, keeping your blood glucose closer to the normal range may help avoid some of these problems.


Frozen Shoulder is just like it sounds. It is a painful stiffness in one or both of your shoulder joints. This stiffness makes it difficult to move your shoulder all the way around, like it normally would. Some people with Frozen Shoulder find they can’t move their shoulders at all. It feels stuck or frozen in place. This stiffness can make it hard or even impossible to carry out simple everyday activities like dressing, eating and sleeping. Frozen Shoulder is seen five times more often among people who have diabetes than among people who do not.


  • Stage one: The affected shoulder begins to ache and feel stiff before becoming increasingly painful. It may be worse at night, especially if you sleep on that shoulder.
  • Stage two: The affected shoulder becomes stiffer, but usually not more painful. You may notice that the size of your shoulder muscles decrease. This is because you are using your shoulder less. This stage usually lasts between four and twelve months.
  • Stage three: You start to regain some movement in the affected shoulder, and the pain starts to go away, but the pain is not gone altogether. In this stage, you should be able to resume many of your regular activities. However, you may still not have full movement of your shoulder. This stage usually lasts five to twelve months.


Here are some treatment options and suggestions for your shoulders. As always, talk with your health care provider before making any changes to your health care routine. Treatment of Frozen Shoulder depends on how bad the pain is, how stiff the shoulder is and the stage that you are in. In general, it is best for you to use your shoulder as much as you can.

  • Your health care provider may prescribe simple range-of-motion exercises that you can do on your own. Or you may be referred to a physical therapist.
  • Your health care provider might also suggest a non-steroidal anti-inflammatory medicine such as aspirin, ibuprofen or naproxen to decrease the pain. Take these only if your health care provider says they are safe for you. You will find that keeping your blood glucose in your target range helps speed your recovery.
  • Other treatment options include a shoulder adjustment, heat applications, an injection of corticosteroid (cortisone) into the joint or a nerve block. These may relieve the pain, but they do not cure the problem. Beware that cortisone injections can raise your blood glucose, so check your blood glucose levels more often for the first few days after an injection.


The most common joint problem in the hands of people with diabetes is called the Stiff-Hand Syndrome. Another common nerve and joint problem is Carpal Tunnel Syndrome (CTS). CTS is not caused by diabetes, but happens more often to people with diabetes, especially those who have diabetic neuropathy, also known as nerve damage.


Stiff Hand Syndrome is painless. It usually begins in your little finger. Then it spreads over time to your thumb. This stiffness then keeps you from being able to straighten your fingers fully. The skin on the back of your hand may also become thick, tight and waxy-looking. One way to tell if you have Stiff Hand Syndrome is to hold the palms of your hands together as if you are praying. If all of the skin and joints of your palms and fingers don’t touch, you may have Stiff-Hand Syndrome.


The symptoms of Carpal Tunnel Syndrome are numbness, tingling, weakness or pain in your fingers and/or your hands. Sometimes this can even include your arms and elbows. It can feel like pins and needles. It is often worse at night and may even wake you up. These symptoms can be made worse by movements that involve your wrist, like holding a newspaper or a book, driving, writing, using a computer keyboard and even moving your hands to eat.

CTS is caused by pressure on a nerve that runs through the carpal tunnel in your wrist. High blood glucose levels can add to this pressure. CTS is more common among people with diabetic neuropathy. To find out if you have CTS, your health care provider may tap on your hand, wrist or arm or ask you to place your hands in a certain position to see if symptoms occur. He or she may recommend nerve and muscle tests, X-rays and/or blood tests.


Here are some treatment options and suggestions for your hands.

  • There are a variety of hand exercises and stretches you can do.
  • If these exercises don’t help or are too painful, ask your health care provider to refer you to a physical therapist. A physical therapist can supervise your exercises and may provide paraffin wax treatment.
  • If you have CTS, do everything you can to decrease pressure on your nerve. Splints are helpful to keep your wrists stable, especially at night while you sleep. Non-steroidal anti-inflammatory medications such as aspirin, ibuprofen or naproxen can decrease the pain. Talk with your health care provider about whether a pain reliever would be helpful and safe for you.
  • Sometimes a corticosteroid injection into the carpal tunnel can help. Be aware that cortisone injections can raise your blood glucose, so check your blood glucose levels more often for the first few days after an injection. If CTS symptoms do not improve, ask your provider for a referral to a hand surgeon. Surgery can be effective to decrease the pressure on your median nerve.


Neuropathy, or nerve damage, affects your ability to detect sensations, mainly in your feet. Neuropathy can cause numbness, tingling, increased pain or produce no symptoms at all. Having feeling in your feet actually protects them. Without feeling, you may wear shoes that are too tight or injure your feet in other ways and not even know it. If untreated, this can lead to a sore, an infection or a skin ulcer.


Charcot’s Joint or Charcot’s Foot is a foot problem that happens to people who also have neuropathy. The bones in your foot become weakened and fracture easily, but because of the nerve damage, you don’t feel the pain. If you don’t feel the pain, you may continue to walk on the foot. This causes more damage and, later, a foot deformity. If you and your health care provider don’t recognize and treat this problem early, the shape of your foot can change greatly. This can cause problems with walking and finding shoes that fit.

An early sign of Charcot’s foot is that the foot is warm to the touch. You may also have redness and swelling. There usually is no pain, but you may notice a change in the shape of your foot. The arch of the foot can collapse if the problem is not recognized and treated.


Here are some treatment options and suggestions for your feet.

  • Because Charcot’s Foot can lead to wounds, infections and even amputation, remember the best treatment for diabetes-related foot problems is prevention.
  • Be sure to look at your feet every day. Look for red areas, blisters, sores, cracks in the skin and dry callused areas. Treat any problem areas and call your health care provider right away if these do not begin to get better within two days.
  • Because not all foot doctors or orthopedic surgeons are familiar with the care and treatment of Charcot’s Foot, ask your health care provider to refer you to someone who is.
  • Treatment for Charcot’s Foot most likely will include putting your foot in a cast for six to nine months.
  • You may need to take a medicine, called a bisphosphonate, that decreases the breakdown of bone.
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Constance Brown-Riggs, MSEd, RD, CDE, CDN—an award-winning RD, certified diabetes educator, and past national spokesperson for the Academy of Nutrition and Dietetics, is the author of The African American Guide to Living Well With Diabetes, which received the Favorably Reviewed designation from the American Association of Diabetes Educators, and Eating Soulfully and Healthfully with Diabetes.

Dr. Lori Shemek, PhD, CNC, CLC, the best-selling author of “Fire-Up Your Fat Burn! and leading health and weight loss expert, is also known as “The Inflammation Terminator.” She has made it her mission to educate the public on the toxic effects of certain foods and lifestyle choices and how they create inflammation in the body. She is a leading authority on inflammation and its role in weight loss, preventing disease and optimizing health.

Rebecca Bitzer – MS, RD/LD, CEDRD is an award-winning Registered Dietitian, writer, speaker, blogger, and REBEL Dietitian business owner. Rebecca and her team of six Registered Dietitians have counseled thousands of clients struggling with diabetes for over twenty-five years. They work closely with each other along with internists, endocrinologists, therapists, and families.

Maureen Sullivan – RN, CDE has worked for many years as a Registered Nurse, most of them in emergency and trauma services. She is a Certified Emergency Nurse, Certified Diabetes Educator, and the former manager of a hospital stroke program. Maureen’s wealth of knowledge, passion for nursing and education, and ability to engage people makes her an excellent teacher and a captivating lecturer. Recently, Maureen has been concentrating on writing, speaking and teaching, as well as working on her award-winning weekly podcast, “The Health and Humor Show.”

Lauren Harris-Pincus, MS, RDN is a nutrition communications specialist, registered dietitian in private practice, social media consultant, speaker, spokesperson and corporate consultant. She is currently the owner of Nutrition Starring YOU, LLC and Lauren strongly believes that we should “Think Healthy, not Skinny”, and “EveryBODY is unique, your diet should be too”. Lauren was co-host of the Family Food Experts Kitchen radio show, available for listening on iHeart Radio and iTunes. Also known as one of the “NutritionBabes”, Lauren co-founded, a popular Health and Wellness website in 2009. was voted one of Healthline’s Top 100 Health Blogs in 2011, 2012 and 2013.

Mark Heyman, PhD, CDE is a clinical health psychologist and the director of the Center for Diabetes and Mental Health (CDMH). In addition to treating patients with type 1 and type 2 diabetes, Dr. Heyman provides training for health care providers on how to identify and address the emotional and behavioral aspects of diabetes in their patients. He also works with pharmaceutical and medical device companies to help them understand these issues and incorporate this information into their sales, marketing, and patient education materials. He is particularly interested in empirically supported behavioral interventions that promote behavior change and improve physical and mental health in people with diabetes.

Katie Ferraro, MPH, RD, CDE is a nationally-recognized registered dietitian, certified diabetes educator and author with an expertise in nutrition communications and curriculum development. She is the co-author of “Diet Therapy in Advanced Practice Nursing” (McGraw Hill, 2014) and an Assistant Clinical Professor of Nutrition at the University of California San Francisco and University of San Diego’s graduate schools of nursing.

Dr. Beverly S. Adler, PhD, CDE (aka “Dr. Bev”) is a clinical psychologist and certified diabetes educator, author and speaker. She specializes treating the emotional issues of people with diabetes. In her private practice, she provides individual, family and/or group therapy utilizing a cognitive behavior therapy orientation, combined with a spiritual approach. Her goal is to empower her patients to manage their diabetes.

Dr. Bev is the author of two self-help diabetes books. She has written numerous articles which are published in print and online – always focused on diabetes from the emotional perspective. She also speaks to audiences of people living with diabetes, as well as, to audiences of healthcare professionals and diabetes educators. Dr. Bev, herself, has been living successfully with type 1 diabetes for 40+ years.

In August 2016, Dr. Bev was honored to receive the “CDE Entrepreneur of the Year” Award from her Metropolitan NY Association of Diabetes Educators.

Jill Weisenberger, MS, RDN, CDE, FAND is an internationally recognized nutrition and diabetes expert with more than two decades experience. Through writing, speaking and one-on-one coaching, Jill empowers people to grab control of their health. She has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is known for her practical approach and caring attitude. Her no-nonsense strategies to eating well include foods that both taste good and are good for you.

Marlene Koch (pronounced ‘cook’) is a nationally recognized nutritionist, popular TV personality and New York Times bestselling author. She graduated Magna Cum Laude from UCLA with a Bachelor’s degree in Nutritional Science. She is a registered dietitian and one of a select group of dietitians to hold an advanced certificate in Child and Adolescent Weight Management from the Academy of Nutrition & Dietetics.

Marlene has taught professional chefs from the American Culinary Federation the principles of healthy cooking and eating. She has been adjunct Nutrition professor and cooking instructor for Columbus State College and the Columbus State Culinary Academy, and she is a nationally recognized expert in weight loss, diabetes, child and adolescent nutrition, and sugar substitutes.

Marlene has sold over one million cookbooks, and is a regular guest on QVC.

Barbara Ruhs – MS, RDN is a Registered Dietitian Nutritionist and owner of Neighborhood Nutrition LLC, a consulting firm focused on providing solutions to help food companies and supermarkets improve consumer health & wellness. She’s a former supermarket dietitian and has run a successful business for 17 years. A leader in the field of nutrition, her mission is to help people by impacting the way food is produced, marketed and sold. She’s a strong advocate for supermarket dietitians and believes the retail food industry has the greatest potential to impact public health.

Cheryl Orlansky has over 25 years of experience in health promotion and chronic disease prevention and management. Her first career as a registered dental hygienist led her towards a path of wellness and nutrition! Her expertise is in diabetes, weight management and cardiovascular disease for individuals and groups. She works in a large private practice including endocrinology, internal medicine, rheumatology, neurology and sleep medicine. She is an award winning dietitian with current leadership positions in state and local dietetics organizations.

She has been interviewed and quoted in media outlets for WebMD, Atlanta Sports and Fitness, Georgia Public Broadcasting, and the Atlanta Journal and Constitution. She has partnered with V-103 Radio to lead supermarket tours as part of a community outreach during National Nutrition Month.

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Jackie Newgent, RDN, CDN, is a registered dietitian nutritionist and classically-trained chef. With a passion for helping people (including her father) with diabetes, she’s author of The With or Without Meat Cookbook: The Flexible Approach to Flavorful Diabetes Cooking and the award-winning The All‐Natural Diabetes Cookbook, both published by the American Diabetes Association. Jackie is also author of 1,000 Low-Calorie Recipes and Big Green Cookbook. Her next book, The All-Natural Diabetes Cookbook—2nd Edition, was published in 2015.

Nutritionist Rania Batayneh, MPH is the author of the best-selling book, The One One One Diet. She holds a master’s degree in public health nutrition from the University of Michigan School of Public Health and is also a Wellcoaches Certified Health and Wellness Coach endorsed by the American College of Sports Medicine (ACSM).

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