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Weight Management
Weight Management

Can Ozempic Cause Joint Pain?

Sarah Hormachea, MS, RD, CDCES, BC-ADM
Author: 
Medical Reviewer: 
Sarah Hormachea, MS, RD, CDCES, BC-ADM
|
Author: 
Sarah Bullard, MS, RD
Published:
May 8, 2023
Updated on
April 26, 2024
#
min read
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Weight Management

Key Takeaways

  • Ozempic is an injectable medication that helps to lower blood sugar levels in people with type 2 diabetes.
  • Some rare side effects of Ozempic can cause fluid build-up in the legs, which may feel similar to joint pain. 
  • No confirmed cases of joint pain are associated with Ozempic. Other diabetes medications (DDP-4 inhibitors) have demonstrated joint pain side effects.
  • Additional medical testing, exercises, weight loss, and dietary changes can help relieve joint pain.

Updated by: Joy Emeh

Ozempic is an injectable medication for people with type 2 diabetes to help regulate their blood sugar levels.

This medication is generally prescribed if other medications, diet, and exercise have not effectively lowered blood sugar levels and hemoglobin A1C. 

Ozempic is a glucagon-like peptide-1 receptor agonist (GLP-1 RAs).

The generic name for Ozempic is semaglutide.

Long-acting once-weekly Ozempic has been found to work especially well at reducing overnight and fasting blood sugar levels and hemoglobin A1C.

GLP-1 RAs work in the following ways: 

  • Enhance insulin secretion in response to high blood sugar levels and help you return to healthy range blood sugar levels.
  • Stop glucagon secretion, which reduces the blood sugar generated by the body.
  • Slow the rate at which the stomach empties, preventing high blood sugar levels after meals.
  • Lower calorie intake by reducing appetite, increasing fullness, and slowing gastric transit time, leading to weight loss.

While Ozempic has positive effects, all medications can have less favorable side effects.

Ozempic works similarly to DPP-4 inhibitors (another diabetes medication) that have been found to cause joint pain.

A study on 134,488 veterans found that 8.4% were taking DPP-4 inhibitors, and 11.7% were diagnosed with joint pain. 

In this article, you’ll learn about the side effects of Ozempic, any links to joint pain, and ways to reduce joint pain. 

Can Ozempic Cause Joint Pain?

No studies have found a link between Ozempic and joint pain.

However, some rare side effects from Ozempic might cause symptoms of joint pain. 

Acute kidney injury and pancreatitis can cause a rare side effect, fluid accumulation in the legs.

This might cause someone to think they have joint pain when their legs are swelling. 

A doctor should monitor kidney function for individuals with impaired kidneys to prevent complications like acute kidney injury.

Additionally, Ozempic should be stopped if any pancreatitis symptoms occur, per the manufacturer's prescribing information. 

Why Do I Have Joint Pain While Taking Ozempic?

There are some possible reasons why you may experience pain around your joint area when you are on Ozempic.

Other medications

If you are on Ozempic and taking other medications, they may be the reason you are having joint pain.

Some medications can induce rheumatic diseases (i.e., conditions that affect the bones, joints, ligaments, and tendons, causing chronic pain and stiffness). 

For instance, medications like quinidine, estrogen, and hydralazine may contribute to the development of systemic lupus erythematosus, an autoimmune disease that causes widespread inflammation and pain in the joints.

Antibiotics like amoxicillin/clavulanate and non-steroidal anti-inflammatory drugs (NSAIDs) have also been linked to the development of vasculitis.

Vasculitis is the inflammation of the blood vessels and can also cause joint pain.

Autoimmune disorders

Joint pain is a common symptom of autoimmune conditions like rheumatoid arthritis, psoriatic arthritis, and lupus.

These conditions are caused by an impairment in the body’s immune system, which causes this defense system to attack normal, healthy cells in the body. 

If you have an autoimmune disorder and are on ozempic, it's more likely that your joint pain is a result of the autoimmune condition. 

Other health conditions

There are several other medical conditions that can cause joint pain, such as:

  • Tendinitis (inflammation of a tendon)
  • Gout
  • Bursitis (inflammation of the small fluid sac that acts as a pad between the bones of a joint)
  • Fibromyalgia (chronic condition that causes widespread pain all over the body)
  • Muscle weakness
  • Bone erosions
  • Ligament damage
  • Joint dislocation
  • Bone cancer
  • Avascular necrosis (death of bone tissue due to insufficient blood flow)

If you experience joint pain while taking Ozempic, consider speaking with a healthcare professional.

They may recommend laboratory tests and examinations to diagnose or rule out other conditions that may be causing your pain. 

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Side Effects of Ozempic

Some people may experience certain side effects when taking ozempic. However, the severity of the adverse effects varies from person to person.

Most Common Side Effects

The following were the most commonly reported side effects from individuals taking Ozempic: 

  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Abdominal pain, and 
  • Constipation. 

Between 5 and 20% of people reported some of these side effects. 

Gastrointestinal (GI) side effects are common when starting GLP-1 RAs or increasing the dosage.

Most people experience a spontaneous resolution of their GI symptoms while still taking the medication. 

Other Side Effects

Other GI side effects at a lower rate were reported, including dyspepsia (upset stomach), gas, burping, reflux, and gastritis (irritated stomach lining).  

Hypoglycemia (low blood sugar) was reported more often when taking other diabetes medications like metformin or insulin. 

Less common effects included injection site reactions (0.2% of people), increased amylase and lipase lab values (signs of pancreatitis), gallstones (0.4 to 1.5% of people), a slight 2-3 beat per minute heart rate increase, taste changes, dizziness, and fatigue. 

Adverse Reactions

Ozempic has a warning on the manufacturer's website stating severe side effects. They include:

  • Possible thyroid tumors, including medullary thyroid cancer. If a family history of MTC is noted, Ozempic should not be used.  
  • Pancreatitis (swelling of the pancreas).
  • Diabetic retinopathy complications (damage to the blood vessels of the eyes).
  • Acute kidney injury or failure.
  • Acute gallbladder disease (swelling of the gallbladder).
  • Hypersensitivity or allergic reactions.
  • Low blood sugar with the use of insulin or sulfonylureas.

Of note, joint pain is not listed as a side effect of Ozempic. But other diabetes medications have confirmed joint pain side effects.

How to Relieve Joint Pain

There are different remedies for treating joint pain, including home remedies, dietary adjustments, and clinical therapy. 

Here are some helpful and actionable tips for relieving joint pain. 

Contact Your Doctor with New or Worsened Pain

If you find yourself with new or worsening joint pain, seek the care of your doctor.

Your doctor can help look at the whole picture, including medications and health conditions.

They can order tests or lab values to determine the source of your joint pain or any new health conditions. 

At-Home Joint Pain Relief

The Arthritis Foundation provides a head-to-toe guide to help relieve different types of joint pain.

Certain types of inflammatory joint pain, like rheumatoid arthritis, require whole-body treatment to reduce the pain. 

Other types of joint pain relief include splints, moist heat, modifications to daily life or sleeping, and targeted exercises to help the problematic locations.

Safe and modified movement can alleviate pain.

A physical therapist can help you learn how to move safely and strategies for reducing joint pain. 

Weight Loss

Losing weight can help reduce joint pain.

A study of 142 overweight and obese adults with knee osteoarthritis (OA) found that four pounds of pressure on the knees were reduced for every pound of weight loss. 

Another study found that further weight loss relieved joint pain in 240 overweight and obese adults with knee OA.

The group losing more than 20% of their starting body weight had 25% less pain, improved knee function, and increased quality of life than those losing 5 or 10% of their original body weight. 

Nutrition

Changing your diet can aid in alleviating joint pain.

A systematic review of 19 studies, including 326 people with rheumatoid arthritis, found that anti-inflammatory diets resulted in lower pain levels than regular diets. 

Anti-inflammatory diets are high in omega-3 fats, fiber, fruits, and vegetables and lower in refined carbohydrates and sugars.

The diets reviewed in this study included Mediterranean, vegetarian, vegan, and ketogenic diets.

All resulted in lower pain levels.

Consider meeting with a dietitian to determine an appropriate eating style for your lifestyle and health concerns. 

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Takeaways

Managing diabetes medications and their side effects with a healthcare team is essential for your health.

Ozempic has not been associated with causing joint pain.

Some less common side effects of Ozempic can cause excess fluid in the legs, which might feel similar to joint pain. 

Joint pain should be discussed with your doctor and medical team.

Joint pain can be relieved by exercises, daily life modifications, weight loss, and nutrition changes. 

Manage Weight and Diabetes with an RD

Connect with an expert on managing diabetes, nutrition, and weight loss. Joint pain and diabetes can improve with weight loss and a customized nutrition plan. 

Find a dietitian near you that accepts insurance using Nourish.

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Frequently Asked Questions

References

View all references
  1. What Is Ozempic®? | Ozempic® (semaglutide) Injection 0.5 mg or 1 mg. (n.d.).
  2. Nauck, M. A., Quast, D. R., Wefers, J., & Meier, J. J. (2021). GLP-1 receptor agonists in the treatment of type 2 diabetes - state-of-the-art. Molecular metabolism, 46, 101102.
  3. Collins, L. (2023, January 13). Glucagon-like Peptide-1 Receptor Agonists. StatPearls - NCBI Bookshelf.
  4. Rai, P., Dwibedi, N., Rowneki, M., Helmer, D. A., & Sambamoorthi, U. (2019). Dipeptidyl Peptidase-4 Inhibitors and Joint Pain: A Retrospective Cohort Study of Older Veterans with Type 2 Diabetes Mellitus. American health & drug benefits, 12(5), 223–231.
  5. Acute Kidney Injury (AKI). (2022, August 11). National Kidney Foundation.
  6. Bartel, M. (2023, April 18). Acute Pancreatitis. Merck Manuals Professional Edition
  7. Tips to Ease Joint Pain. (n.d.). Arthritis Foundation.
  8. Messier, S. P., Gutekunst, D. J., Davis, C., & DeVita, P. (2005). Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis and rheumatism, 52(7), 2026–2032.
  9. Messier, S. P., Resnik, A. E., Beavers, D. P., Mihalko, S. L., Miller, G. D., Nicklas, B. J., deVita, P., Hunter, D. J., Lyles, M. F., Eckstein, F., Guermazi, A., & Loeser, R. F. (2018). Intentional Weight Loss in Overweight and Obese Patients With Knee Osteoarthritis: Is More Better?. Arthritis care & research, 70(11), 1569–1575.
  10. Schönenberger, K. A., Schüpfer, A. C., Gloy, V. L., Hasler, P., Stanga, Z., Kaegi-Braun, N., & Reber, E. (2021). Effect of Anti-Inflammatory Diets on Pain in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Nutrients, 13(12), 4221.
  11. Niklas, K., Niklas, A. A., Majewski, D., & Puszczewicz, M. J. (2016). Rheumatic diseases induced by drugs and environmental factors: the state-of-the-art - part two. Reumatologia, 54(4), 165–169. 
  12. Volume 47 Issue Supplement_1 | Diabetes Care 
  13. Fohle, E., Montgomery, S., Murat, J., Ness, R., & Lo, T. S. (2021). An Unusual Timing of Amoxicillin-Induced IgA Vasculitis in an Elderly Patient. Cureus, 13(6), e15757. 
  14. 5 common autoimmune diseases. (2023, April 17). NIH MedlinePlus Magazine.
  15. Joint Disorders. (2021, Dec 13). MedlinePlus.
  16. Causes of inflammatory joint pain. (n.d.). Arthritis Foundation.
  17. Causes of rheumatic diseases and pain. (2022, Aug 15) Centers for Disease Control and Prevention.
Nourish has strict sourcing policies and prioritizes primary sources, including medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about our medical review process and editorial guidelines.

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To lose weight, most people need to reduce their energy intake and increase their level of physical activity. But can undereating contribute to weight gain? Find out now.

December 8, 2023
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Weight Management

How to Keep Weight off After Semaglutide?

By Heather Smith, RN, BSN

Discover mindful eating strategies to prevent weight regain after stopping semaglutide.

December 6, 2023
Read More
Weight Management

Weight Neutral Health: What Is It & Why Is It Important?

By Jennifer Huddy, MS, RD, LD

Learn what it means to practice weight-neutral health and how to apply it to improve your health status. Discover the benefits of seeking weight-inclusive healthcare.

November 28, 2023
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Weight Management

13 Weight Loss Motivation Tips For Healthy & Sustainable Success

By Julia Zakrzewski, RD

Healthy weight loss takes time and commitment. Here are 13 tips to help you with weight loss motivation.

November 28, 2023
Read More
Weight Management

Is Creatine Good For Weight Loss?

By Julia Zakrzewski, RD

Creatine is popular in fitness circles because it promotes muscle growth, aids with recovery, and may improve exercise performance. Read our in-depth review to determine if creatine is good for weight loss.

November 28, 2023
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Weight Management

Can Inositol Help with Weight Loss? Benefits, Effects, And More

By Jennifer Huddy, MS, RD, LD

Learn how inositol may help with insulin resistance and weight management, along with dosage, side effects, and other benefits of this popular supplement.

November 20, 2023
Read More
Weight Management

Can You Drink Alcohol on Ozempic?

By Sarah Glinski, RD

If you’re taking Ozempic, you may wonder if you can combine Ozempic and alcohol. This article explains the risks and provides tips for safe drinking on Ozempic.

November 20, 2023
Read More
Weight Management

Do Stretch Marks Go Away When You Lose Weight?

By Sarah Bullard, MS, RD

Stretch marks affect up to 90% of all people. Stretch marks change after weight loss and fade with time. Learn about tips for managing and embracing stretch marks.

November 20, 2023
Read More
Weight Management

Why Does My Weight Fluctuate So Much?

By Sarah Bullard, MS, RD

Weight fluctuations are expected and normal. Many factors can impact your weight. Learn about common causes and tips for managing weight fluctuations.

November 17, 2023
Read More
Weight Management

What Happens When You Stop Taking Mounjaro?

By Heather Smith, RN, BSN

Discover the effects of stopping Mounjaro, tips for safe discontinuation, and how to maintain weight loss in this comprehensive guide.

November 15, 2023
Read More
Weight Management

Magnesium For Weight Loss: Is It effective?

By Jennifer Huddy, MS, RD, LD

Is magnesium for weight loss effective and safe? Learn more about magnesium-rich foods and supplements and how they may support your weight loss goals.

November 15, 2023
Read More
Weight Management

7-Day Bariatric Meal Plan: What To Eat After Surgery

By Julia Zakrzewski, RD

After bariatric surgery, you must adjust your diet to accommodate your smaller digestive system. Try our bariatric meal plan to help get you started.

November 7, 2023
Read More
Weight Management

Does Semaglutide Make You Tired?

By Heather Smith, RN, BSN

Discover the truth about semaglutide and fatigue. Learn how to manage your tiredness, how a dietitian can help, and when to consult your doctor.

November 7, 2023
Read More
Weight Management

Rybelsus Foods To Eat for Weight Loss

By Sarah Glinski, RD

When you’re taking Rybelsus, foods to eat are similar to those included on other weight loss plans. Read this article to see which foods to include daily.

November 7, 2023
Read More
Weight Management

Does Ozempic Cause Heartburn?

By Sarah Bullard, MS, RD

Ozempic is an injectable medication for people with type 2 diabetes. It helps to lower blood sugar levels, but a small percentage of people report heartburn as a side effect. Learn about steps to reduce heartburn with diet and lifestyle changes.

November 6, 2023
Read More
Weight Management

The Best Foods To Eat On Mounjaro

By Heather Smith, RN, BSN

Learn about the best foods to eat on Mounjaro to support a healthy metabolism and improve blood sugar control. Follow the key dietary insights in this guide.

November 1, 2023
Read More
Weight Management

How Much Does Bariatric Surgery Cost With and Without Insurance in 2024?

By Heather Smith, RN, BSN

Bariatric surgery is a procedure that may help with weight loss. Keep reading to learn how much bariatric surgery costs (with and without insurance).

November 1, 2023
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Weight Management

Why Is Saxenda Not Working Anymore?

By Heather Smith, RN, BSN

Discover why Saxenda may no longer be effective for you. Explore potential reasons, plateaus, and personalized solutions for successful weight management. 

November 1, 2023
Read More
Weight Management

How to Relieve Nausea While Taking Ozempic

By Jennifer Huddy, MS, RD, LD

Ozempic is often used for type 2 diabetes and weight loss. Digestive side effects like nausea are common. Read on to learn how to find Ozempic nausea relief. 

November 1, 2023
Read More
Weight Management

8 Best Berberine Supplements For Metabolic Health & Weight Management

By Julia Zakrzewski, RD

Berberine is a natural health product that can improve several areas of your metabolic health. Read our top five berberine supplements to find an option that’s right for you.

October 31, 2023
Read More
Weight Management

Is Oatmeal Good for Weight Loss?

By Jennifer Huddy, MS, RD, LD

Oatmeal is good for weight loss because of its fiber content, which helps you feel full. Oats have other health benefits as well, like lowering cholesterol.

October 4, 2023
Read More
Meal Plan
Weight Management

7-Day Weight Gain Meal Plan for Healthy Results

By Jennifer Huddy, MS, RD, LD

Learn how to gain weight in a healthy way with a nutritious, high-protein, high-calorie diet, including practical tips and a free 7-day weight gain meal plan.

October 3, 2023
Read More
Weight Management

How Long Does It Take for Berberine to Work for Weight Loss?

By Julia Zakrzewski, RD

Adding Berberine to your health care plan may improve blood sugar control, lower cholesterol levels, and aid weight loss. Keep reading to learn how long you must take Berberine to see results. 

September 15, 2023
Read More
Weight Management

Why Am I Not Losing Weight on Intermittent Fasting?

By Jennifer Huddy, MS, RD, LD

Discover effective tips to boost weight loss on intermittent fasting. Find out why you might not be losing weight and what to change to achieve your goals.

August 22, 2023
Read More
Weight Management

Can a Nutritionist Help Me Gain Weight?

By Jennifer Huddy, MS, RD, LD

Discover why some individuals need to gain weight and how a nutritionist can assist. Uncover the benefits of working with a dietitian for weight gain goals.

August 10, 2023
Read More
Weight Management

Can You Drink Coffee on Ozempic?

By Heather Smith, RN, BSN

It's generally safe to have coffee while taking Ozempic. Learn more about the risks and benefits in this article.

August 7, 2023
Read More
Weight Management

How Long Can You Stay on Ozempic?

By Heather Smith, RN, BSN

Learn about potential long-term effects and how long it is safe to use Ozempic for managing type 2 diabetes and weight.

August 7, 2023
Read More
Weight Management

Does Ozempic Cause Constipation? Tips for Prevention and Relief

By Jennifer Huddy, MS, RD, LD

Discover essential tips to prevent and relieve Ozempic constipation. Find relief and maintain digestive comfort with advice from a registered dietitian.

August 3, 2023
Read More
Weight Management

How Long Does It Take To Lose Weight on Ozempic?

By Jennifer Huddy, MS, RD, LD

Learn how long it takes to lose weight on Ozempic and achieve your goals with tips from a registered dietitian.

August 3, 2023
Read More
Weight Management

Why Am I Not Losing Weight on Ozempic?

By Heather Smith, RN, BSN

Discover why Ozempic isn't yielding expected weight loss results. Explore 5 possible reasons and tips for optimizing its effectiveness.

August 2, 2023
Read More
Weight Management

Does Ozempic Cause Hair Loss?

By Jennifer Huddy, MS, RD, LD

Does Ozempic cause hair loss? Uncover the potential link between Ozempic and hair loss with tips for preventing hair loss from a registered dietitian.

July 25, 2023
Read More
Weight Management

Is Steak Good for Weight Loss?

By Sarah Bullard, MS, RD

Unprocessed red meat (steak) can be helpful for weight loss and management. Learn about the nutritional value of steak, possible benefits and downsides, how much to eat, and what steak cuts to choose. 

July 24, 2023
Read More
Weight Management

Is Almond Milk Good for Weight Management?

By Sarah Bullard, MS, RD

Almond milk is good for weight loss and for those with lactose intolerance or dairy allergies. Almond milk contains slightly more calcium, vitamin D and E than cow milk. The main drawback is its minimal protein content. 

July 21, 2023
Read More
Weight Management

Is Protein Powder Good for Weight Loss?

By Jennifer Huddy, MS, RD, LD

Is protein powder good for weight loss? Read this article to learn about the pros and cons of protein supplements and how to choose a high-quality protein powder. 

July 11, 2023
Read More
Weight Management

Are There Cheaper Alternatives to Saxenda?

By Heather Smith, RN, BSN

Discover cheaper alternatives to Saxenda for weight management. Explore options like Wegovy, Xenical, Qsymia, and Contrave and learn about natural alternatives. 

June 27, 2023
Read More
Diabetes
Weight Management

How to Gain Weight With Type 2 Diabetes

By Jennifer Huddy, MS, RD, LD

If you’re wondering how to gain weight with type 2 diabetes, talk to a dietitian about a high-calorie, high-protein meal plan and how to eat more frequently.

June 27, 2023
Read More
Weight Management

Is Broccoli Good for Weight Loss?

By Jennifer Huddy, MS, RD, LD

Is broccoli good for weight loss? Not only can broccoli help reduce weight due to its low calorie and high fiber content, but it may also protect against cancer. 

June 26, 2023
Read More
Weight Management

Does Trulicity Cause Weight Loss?

By Jennifer Huddy, MS, RD, LD

Does Trulicity Cause Weight Loss? Read to learn how Trulicity may help you lose weight, the average weight loss results, and how to manage common side effects.

June 12, 2023
Read More
Weight Management

Will I Gain Weight if I Skip a Day of Exercise?

By Jennifer Huddy, MS, RD, LD

You may wonder if you’ll gain weight if you skip a day of exercise, but it’s your overall eating and exercise habits that matter for weight management. 

June 8, 2023
Read More
Weight Management

Can You Eat Dessert Every Day and Still Lose Weight?

By Jennifer Huddy, MS, RD, LD

You can eat dessert every day and still lose weight by choosing nutrient-dense ingredients, eating mindfully, and having a flexible diet plan.

June 7, 2023
Read More
Weight Management

Does Diarrhea Cause Weight Loss?

By Julia Zakrzewski, RD

Diarrhea refers to loose, watery stools that can be caused by several factors. Although you may feel “lighter” after many bowel movements, your body composition is unlikely to change. There are better (and safer) strategies that could be more beneficial, including working with a dietitian.

June 6, 2023
Read More
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, 
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40.916611, -74.172188
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, 
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34.576469, -118.116096
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, 
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California
34.697472, -118.144524
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, 
TN
Tennessee
35.845619, -86.390266
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, 
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California
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, 
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44.052151, -123.091187
Shreveport
, 
LA
Louisiana
32.523659, -93.763504
Clarksville
, 
TN
Tennessee
36.527279, -87.360336
Cary
, 
NC
North Carolina
35.7882893, -78.7812081
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, 
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44.944099, -123.040283
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, 
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Virginia
37.087082, -76.473015
Chattanooga
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Tennessee
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Akron
, 
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Ohio
41.0842496, -81.6777863
Providence
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41.823990, -71.412834
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30.438255, -84.280731
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38.627003, -90.199402
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41.499321, -81.694359
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37.804363, -122.271111
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, 
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32.248814, -110.987419
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, 
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33.875670, -117.568840
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, 
WI
Wisconsin
43.073051, -89.401230
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, 
AL
Alabama
34.7014286, -86.6597495
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, 
MO
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39.099728, -94.578568
Irvine
, 
CA
California
33.684566, -117.826508
Chula Vista
, 
CA
California
32.640072, -117.084038
Denton
, 
TX
Texas
33.215530, -97.132446
Aurora
, 
IL
Illinois
41.7571701, -88.3147539
Baton Rouge
, 
LA
Louisiana
30.4494155, -91.1869659
Columbus
, 
OH
Ohio
39.961178, -82.998795
Baltimore
, 
MD
Maryland
39.2908816, -76.610759
Detroit
, 
MI
Michigan
42.331429, -83.045753
Chesapeake
, 
VA
Virginia
36.7183708, -76.2466798
Birmingham
, 
AL
Alabama
33.5206824, -86.8024326
Scottsdale
, 
AZ
Arizona
33.501324, -111.925278
Cincinnati
, 
OH
Ohio
39.103700, -84.513610
North Las Vegas
, 
NV
Nevada
36.201946, -115.120216
Riverside
, 
CA
California
33.980602, -117.375496
Plano
, 
TX
Texas
33.019844, -96.698883
Minneapolis
, 
MN
Minnesota
44.977753, -93.265015
Salinas
, 
CA
California
,
Anaheim
, 
CA
California
33.836594, -117.914299
Springfield
, 
MO
Missouri
37.208958, -93.292297
Fort Wayne
, 
IN
Indiana
41.077469, -85.137489
Phoenix
, 
AZ
Arizona
33.448376, -112.074036
Bakersfield
, 
CA
California
35.3738712, -119.0194639
Garden Grove
, 
CA
California
33.774269, -117.937996
Anchorage
, 
AK
Alaska
61.2163129, -149.894852
Indianapolis
, 
IN
Indiana
39.768402, -86.158066
Nashville
, 
TN
Tennessee
36.162663, -86.781601
Tempe
, 
AZ
Arizona
33.425522, -111.941254
Mobile
, 
AL
Alabama
30.695366, -88.039894
New Orleans
, 
LA
Louisiana
29.951065, -90.071533
Knoxville
, 
TN
Tennessee
35.960636, -83.920738
Grand Rapids
, 
MI
Michigan
42.963360, -85.668083
Fontana
, 
CA
California
34.102890, -117.435760
Elk Grove
, 
CA
California
38.418129, -121.393257
Miami
, 
FL
Florida
25.7825389, -80.3118603
Grand Prairie
, 
TX
Texas
32.745499, -97.003532
Fort Collins
, 
CO
Colorado
40.588970, -105.082458
Killeen
, 
TX
Texas
31.117119, -97.727798
Modesto
, 
CA
California
37.639095, -120.996880
Oklahoma City
, 
OK
Oklahoma
35.468491, -97.521263
Santa Ana
, 
CA
California
33.745571, -117.867836
Ontario
, 
CA
California
34.063343, -117.650887
Brownsville
, 
TX
Texas
25.9015688, -97.4984005
Montgomery
, 
AL
Alabama
32.379223, -86.307739
Hialeah
, 
FL
Florida
25.857595, -80.278107
Springfield
, 
MA
Massachusetts
42.102051, -72.585762
Toledo
, 
OH
Ohio
41.652805, -83.537865
Pembroke Pines
, 
FL
Florida
26.007765, -80.296257
Overland Park
, 
KS
Kansas
38.974819, -94.683601
Little Rock
, 
AR
Arkansas
34.746483, -92.289597
Glendale
, 
CA
California
34.142509, -118.255074
Roseville
, 
CA
California
38.752125, -121.288010
Rancho Cucamonga
, 
CA
California
,
Wichita
, 
KS
Kansas
37.687176, -97.330055
Huntington Beach
, 
CA
California
33.659485, -117.998802
Augusta
, 
GA
Georgia
33.4709714, -81.9748429
Worcester
, 
MA
Massachusetts
42.271389, -71.798889
Virginia Beach
, 
VA
Virginia
36.852924, -75.977982
Oceanside
, 
CA
California
33.1958696, -117.3794834
Santa Clarita
, 
CA
California
34.456043, -118.571335
Philadelphia
, 
PA
Pennsylvania
39.952583, -75.165222
Corpus Christi
, 
TX
Texas
27.800583, -97.396378
Portland
, 
OR
Oregon
45.512230, -122.658722
Denver
, 
CO
Colorado
39.739235, -104.990250
Boston
, 
MA
Massachusetts
42.3554334, -71.060511
Atlanta
, 
GA
Georgia
33.7489924, -84.3902644
Chicago
, 
IL
Illinois
41.8755616, -87.6244212
Orlando
, 
FL
Florida
28.538336, -81.379234
Jacksonville
, 
FL
Florida
30.332184, -81.655647
Tampa
, 
FL
Florida
27.950575, -82.457176
Long Island
, 
NY
New York
40.757801, -73.940033
Queens
, 
NY
New York
40.728226, -73.794853
Bronx
, 
NY
New York
40.8466508, -73.8785937
Staten Island
, 
NY
New York
40.643501, -74.076202
Brooklyn
, 
NY
New York
40.6526006, -73.9497211
New York
, 
NY
New York
40.712776, -74.005974
San Jose
, 
CA
California
37.342205, -121.851990
San Francisco
, 
CA
California
37.774929, -122.419418
San Diego
, 
CA
California
32.834686, -117.130775
Los Angeles
, 
CA
California
34.052235, -118.243683
El Paso
, 
TX
Texas
31.761877, -106.485023
San Antonio
, 
TX
Texas
29.387428, -98.496574
Dallas
, 
TX
Texas
32.776665, -96.796989
Fort Worth
, 
TX
Texas
32.755489, -97.330765
Houston
, 
TX
Texas
29.760427, -95.369804
Austin
, 
TX
Texas
30.2711286, -97.7436995
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