Diagnosed with type 1 diabetes at the age of nine, Chris Drake, 39, first started having issues with his back in his late twenties. It sidelined his much-loved golf habit, which Chris, an entrepreneur, had played competitively and continued to play multiple times a week, often with business clients.

Although he was in good shape and controlled his diabetes fairly well, Chris’ back pain continued off and on. If he played a lot, it would flare up and he’d have to rest. But he never recovered to the point where he could swing a golf club properly and be confident it wouldn’t hurt his back.

Musculoskeletal (MSK) conditions, such as back pain, limited joint mobility or neck and shoulder disorders, can often prevent people living with diabetes from exercising. That lack of exercise, complicated by trouble with weight management, negatively impacts their ability to control blood sugar levels. While research is ongoing, it does show MSK conditions and diabetes are often interrelated.

“I know people with diabetes have a higher incidence of low back pain,” says Chris, who sees an endocrinologist every six months. “With type 1 diabetes, musculoskeletal issues are complications that are somewhat under-recorded because they’re not as well-known as kidney damage, stroke or retinal eye issues. People with diabetes often have trouble with their hands and feet from the degeneration of the nerves, plus there are vascular issues. Their blood flow can become impeded over time, which makes it harder to heal because that flow is needed.”

His endocrinologist suggested Chris see a chiropractor, and a neighbour recommended Dr. Alex Pessoa, a sports-focused chiropractor who runs Peak Performance Health Centre in Cambridge, Ont.

“Knowing that I wanted to continue golfing, Dr. Pessoa put me through an intensive exercise routine to strengthen my core to try to prevent a reoccurrence of injury,” says Chris. “He also had me getting into position with a golf club to show me what to modify to avoid strain on my lower back. It got me playing again.”

Chris Drake lives with both type 1 diabetes and chronic back pain, but now adheres to an exercise routine from his chiropractor to keep up the golf he loves.

Chris recently moved from Kitchener to Santa Barbara, Calif., after his wife, Kelly, accepted a job there, so now he can golf year round. “When I play a lot, I make sure I’m hammering those exercises to keep my core strong and ready to play,” he says. “You’ve got to stick to it.”

“We don’t typically think of chiropractors when we’re caring for people with diabetes, but more and more we’re realizing that’s another group we need to pull into the circle of care,” says Debbie Hollahan, director of Waterloo Wellington Diabetes, a diabetes resource centre in Cambridge, Ontario. “They’re important because they’re seeing many patients with back pain and neuropathic pain that may be a result of diabetes.”

This story is adapted from this article: Impact of diabetes: What you didn’t know, which was produced by Globe Content Studio and published as an advertising feature in The Globe and Mail.