Clinical observation of a patient with polymorbidity: type 2 diabetes mellitus, osteoarthritis, arterial hypertension, and osteoporosis with a compression fracture of the spine

The article presents a clinical case of a 68-year-old patient with a polymorbid profile, including type 2 diabetes mellitus in the stage of subcompensation with distal polyneuropathy, postmenopausal osteoporosis, osteoarthritis of the knee joints, and arterial hypertension with signs of target organ damage. The referral was caused by the development of acute back pain syndrome against the background of minimal trauma. At the examination, a compression fracture of the body of Th12 vertebra against the background of osteoporosis was verified. A comprehensive interdisciplinary approach to patient management is described, including the correction of antidiabetic and antihypertensive therapy, the initiation of specific anti-osteoporotic therapy, and a step-by-step rehabilitation program of physical therapy. Special attention is paid to the role of controlled increase in physical activity as a central element that allowed breaking the vicious circle of "pain-hypodynamia-progression of diseases." Diagnostic difficulties and shortcomings of previously provided care are considered.