Hi to everyone,
Today I want to share with you the story of a 53 years old man, suffering from type 2 diabetes and high blood pressure (hypertension) for 5 years now, presented with a history of 6 months progressively worsening back pain and stiffness.
He describes that at the beginning, he felt a mild back discomfort, which has progressed to continuous pain that impedes him to bend forward or side-to-side. At the moment, he cannot sit cross-legged, stoop or rise from the bed without support.
He also reports of stiffness that is slightly relieved when he moves. 3 months ago, he had the same pain and stiffness experience with his neck; while he denies to have fallen, or had a previous significant trauma, any unusual weight lifting, or bone pain.
He also describes not to have had any history of fever, ocular or urinary symptoms, oral ulcerations or rash. His body mass index (BMI) was 28.1 kg/m2, with fasting blood sugar level of 102 mg/dL, postprandial level of 159 mg/dL; A1C level of 6.5%; a total cholesterol of 230 mg/dL; LDL of 157 mg/dL;HDL of 41 mg/dL; triglycerides of 154 mg/dL.
Based on his radiological findings, where osteophytes were seen with no other damages to the vertebrae or any sign of ankylosis; the diagnosis was “diffuse idiopathic skeletal hyperostosis” (DISH). Actually, this is one of the musculoskeletal complications of diabetes.
The recommendations were to lose weight (bring his BMI back to normal again); balance his blood sugar and lipid profile (for this Atovarstatin 20mg once daily was initiated), aerobic exercise (of flexibility type) to make the spine mobile, and pain killer (Naproxen 250 mg twice daily).
After 3 months check-up, LDL level was 98 mg/dL, and he reported to be pain-relieved and his spine mobility was increased.
To sum up, pay attention to these musculoskeletal problems, especially when you are at your mid-aged and diabetic. Be persistent to find out what is happening to take right precautions together with your physician.
All the best!
Written by Dr.Albana Greca Sejdini, Md, MMedSc
Medically reviewed by Dr.Ruden Cakoni, MD, Endocrinologist