Your bones, joints, and muscles don’t work in isolation—they are deeply connected to your overall health. One of the biggest influences is metabolic health, which refers to how well your body manages fuels (Carbohydrates, proteins and fats) and particularly how it regulates blood sugar, cholesterol and triglycerides, blood pressure, and body weight.

Poor metabolic health—sometimes called metabolic syndrome—includes problems like obesity, high blood pressure, diabetes (high blood sugar), and abnormal cholesterol levels These conditions can increase the risk and severity of orthopedic issues, including arthritis, bone healing, and muscle weakness.

How Poor Metabolic Health Affects Orthopedic Conditions

• Increases risk of osteoarthritis: People with metabolic syndrome are more likely to develop osteoarthritis, where joints become painful and stiff. This is not just from carrying extra weight; inflammation from unhealthy metabolism damages joint tissues.¹⁻⁸,¹⁰,¹¹
• Worsens joint pain: Central obesity (excess belly weight) and other components of metabolic syndrome are linked to more severe and long-lasting joint pain.¹¹
• Slows bone healing: High blood sugar, as in diabetes, can interfere with fracture healing. Elevated glucose and chronic inflammation disrupt the body’s natural repair processes while also increasing your risk of infection.¹²
• Weakens muscles and tendons: Poor metabolic health contributes to loss of muscle strength and quality, making movement harder and injuries more likely.³,⁹
• Starts problems earlier: People with both osteoarthritis and metabolic syndrome often develop joint problems at a younger age, with more severe symptoms.⁴,⁶

What Can Help?

The good news: improving metabolic health also benefits orthopedic health.

• Eat a balanced diet rich in whole foods.
• Stay physically active with regular exercise.
• Manage weight to reduce stress on joints.
• Control blood pressure, blood sugar, inflammation and cholesterol, with lifestyle changes and medical care when needed.
• Better metabolic health can lower the risk of joint and bone problems, reduce pain, and improve healing after injuries.³,⁹,¹⁰

Takeaway

Metabolic health and orthopedic health are closely linked. By improving blood sugar, cholesterol, blood pressure, and weight, you are not just protecting your heart, blood vessels and metabolism—you are protecting your bones, joints, and muscles too.

If you have concerns about joint pain or your metabolic health, talk with your healthcare provider about strategies to optimize your overall health.

References

1. Dickson BM, Roelofs AJ, Rochford JJ, Wilson HM, De Bari C. The burden of metabolic syndrome on osteoarthritic joints. Arthritis Res Ther. 2019;21(1):289. doi:10.1186/s13075-019-2081-x
2. Jiménez-Muro M, Soriano-Romaní L, Mora G, Ricciardelli D, Nieto JA. The microbiota-metabolic syndrome axis as a promoter of metabolic osteoarthritis. Life Sci. 2023;329:121944. doi:10.1016/j.lfs.2023.121944
3. Collins KH, Herzog W, MacDonald GZ, et al. Obesity, metabolic syndrome, and musculoskeletal disease: common inflammatory pathways suggest a central role for loss of muscle integrity. Front Physiol. 2018;9:112. doi:10.3389/fphys.2018.00112
4. Le Clanche S, Bonnefont-Rousselot D, Sari-Ali E, Rannou F, Borderie D. Inter-relations between osteoarthritis and metabolic syndrome: a common link? Biochimie. 2016;121:238-252. doi:10.1016/j.biochi.2015.12.008
5. Xie Y, Zhou W, Zhong Z, et al. Metabolic syndrome, hypertension, and hyperglycemia were positively associated with knee osteoarthritis, while dyslipidemia showed no association with knee osteoarthritis. Clin Rheumatol. 2021;40(2):711-724. doi:10.1007/s10067-020-05216-y
6. Courties A, Sellam J, Berenbaum F. Metabolic syndrome-associated osteoarthritis. Curr Opin Rheumatol. 2017;29(2):214-222. doi:10.1097/BOR.0000000000000373
7. Courties A, Gualillo O, Berenbaum F, Sellam J. Metabolic stress-induced joint inflammation and osteoarthritis. Osteoarthritis Cartilage. 2015;23(11):1955-1965. doi:10.1016/j.joca.2015.05.016
8. June RK, Liu-Bryan R, Long F, Griffin TM. Emerging role of metabolic signaling in synovial joint remodeling and osteoarthritis. J Orthop Res. 2016;34(12):2048-2058. doi:10.1002/jor.23420
9. Carreira D, Robison JW, Robison S, Fitch A. Obesity treatment in orthopaedic surgery. J Am Acad Orthop Surg. 2022;30(24):e1563-e1570. doi:10.5435/JAAOS-D-21-01083
10. Yu C, Zhao S, Yue S, Chen X, Dong Y. Novel insights into the role of metabolic disorder in osteoarthritis. Front Endocrinol (Lausanne). 2024;15:1488481. doi:10.3389/fendo.2024.1488481
11. Pan F, Tian J, Cicuttini F, Jones G. Metabolic syndrome and trajectory of knee pain in older adults. Osteoarthritis Cartilage. 2020;28(1):45-52. doi:10.1016/j.joca.2019.05.030
12. Tanios M, Brickman B, Cage E, et al. Diabetes and impaired fracture healing: a narrative review of recent literature. Curr Osteoporos Rep. 2022;20(5):229-239. doi:10.1007/s11914-022-00740-z

Lyall J. Ashberg MD

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