Metformin May Have Protective Effect Against Musculoskeletal Pain

Sarfaroj Khan 


February 16, 2021


  • Patients with type 2 diabetes (T2D) using metformin had lower odds of reporting recent back and knee pain, chronic back, knee and neck/shoulder pain and multisite musculoskeletal pain compared with those with T2D who were not taking metformin.

  • Overall, associations were stronger among women.

Why this matters

  • Findings suggest that metformin may have a protective effect for musculoskeletal pain, which appears to be stronger in women than men.

Study design

  • This cross-sectional study included 21,889 patients with T2D (metformin users, 58%) using data from the UK Biobank.

  • Funding: None.

Key results

  • Patients treated with metformin were at a lower risk of musculoskeletal pain for (adjusted OR; 95% CI):

    • back region (recent: 0.91; 0.85-0.97 and chronic: 0.87; 0.81-0.93);

    • knee region (recent: 0.91; 0.85-0.97 and chronic: 0.87; 0.81-0.94); and

    • neck/shoulder regions (chronic: 0.92; 0.85-0.99).

  • No significant association was seen between metformin intake and the prevalence of hip pain (recent: 1.01; 0.93-1.09 and chronic: 0.99; 0.89-1.08).

  • Metformin use was associated with a lower risk of recent (0.90; 0.83-0.97) and chronic (0.83; 0.77-0.90) multisite musculoskeletal pain.

  • For recent (back and knee pain), chronic (knee and neck/shoulder pain) and recent multisite musculoskeletal pain, the association was only significant among women:

    • recent back (0.82; 0.73-0.92) and knee pain (0.88; 0.79-0.89);

    • chronic knee (0.86; 0.76-0.97) and neck/shoulder pain (0.86; 0.76-0.98); and

    • recent multisite musculoskeletal pain (0.83; 0.77-0.90).


  • Study could not examine the dose-response effects of metformin on musculoskeletal pain.


Carvalho-E-Silva AP, Harmer AR, Ferreira ML, Ferreira PH. The effect of the anti-diabetic drug metformin on musculoskeletal pain: a cross-sectional study with 21,889 individuals from the UK Biobank. Eur J Pain. 2021 Feb 9 [Epub ahead of print]. doi: 10.1002/ejp.1747. PMID: 33561890.  View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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