context: It's natural to feel a little discomfort in your hands, fingers, feet, and ankles from time to time. Joint pain is a part of getting older and can have a number of causes. But that ache in your foot or arm could also be a problem with a nerve caused by your diabetes. And that's an issue that could be serious and require quick attention. So how do you tell the difference? It's the leading cause of disability in the U. S. It affects more than 50 million adults. Often referred to as arthritis, it's broadly defined as discomfort where two or more bones meet. Though often mild, sometimes sporadic, and rarely an emergency, the pain can be severe, making it hard to move the joint. If you have it, you'll probably notice changes to your joint like: Stiffness Less range in motion Swelling Redness Tenderness or warmth A tougher time using it A difference in shape The causes of joint pain vary greatly. It could be: Muscle strains or sprains A broken or dislocated bone Gout Hypothyroidism Leukemia Lupus Osteoarthritis Rickets Lyme disease Rheumatoid arthritis Your doctor might call it diabetic neuropathy. It's pain in your nerves, not in your bones. It happens when high blood sugar harms the nerve fibers. You can get it anywhere in your body, but it most often affects your legs and feet. Anywhere from 60%-70% of people with diabetes have some sort of neuropathy. Most get it after having the disease for 10 years or more. There are many types. But the two most likely to cause problems with your joints are peripheral and autonomic neuropathy. This is the most common form of diabetic joint pain. It can affect your legs, arms, hands, feet, fingers, and toes. With ongoing diabetes, joints can no longer respond like they should to the strain and stress placed on them. As a result, they sustain small traumas and even tiny breaks called microfractures. The symptoms, which are usually worse at night, include: Numbness Less sensitivity to pain or temperature Tingling Burning Sharp pains Cramps More sensitivity to touch Loss of reflexes Muscle weakness Loss of balance and coordination Foot problems like ulcers and infections Wasting of muscle in hands and feet These symptoms are largely feelings and sensations. That means they're different from the outward body changes that come with regular joint pain. This affects the part of your nervous system that controls your heart, lungs, bladder, digestive tract, sex organs, and eyes. It also goes after your blood vessels and can increase blood flow to your limbs. That could result in swelling and weakened bones. Symptoms include: Bladder problems, including incontinence and urinary tract infections Constipation Diarrhea Nausea and vomiting Trouble swallowing Erectile dysfunction in men Vaginal dryness in women Increased or decreased sweating Lack of awareness of lower blood sugar levels Sharp drops in blood pressure Increased heart rate So if you have joint pain and one or more of the above symptoms, diabetic autonomic neuropathy might be the culprit. Many things can cause peripheral neuropathy. They include: Metabolic causes: Not only is high blood sugar a trigger, so is the length of time you've lived with diabetes and the amount of fat in your blood. Low insulin levels can also play a role. Nerve and blood vessel causes: This includes damaged blood vessels that carry oxygen and nutrients to the nerves. Immune system causes: Immune system problems can cause inflamed nerves. Genetics: Some inherited traits make you more likely to get nerve disease. Lifestyle: Smoking and alcohol use can also cause problems.