DISH, the Diffuse Idiopathic Skeletal Hyperostosis is a bony hardening of the ligaments in the areas where they attach to the spine. It is also known as as Forestier's disease, and it may cause no symptoms and require no treatment. The most common symptoms are mild to moderate pain as well as stiffness in the upper back. DISH can also affect a person’s neck and lower back as well as other areas, such as shoulders, elbows, knees and heels.
DISH can be progressive as it is a non-inflammatory condition. If it worsens, then it can also lead to some serious complications. The spine doctor may begin with a physical examination of the spine as well as joints for the determination of DISH. For that they will press lightly on the spine and joints to feel for the abnormalities in there. The pain from the pressure on the spine is a hint towards further diagnosis.
The imaging tests are also ordered by the doctor that help with the diagnosis which may include tests such as X-rays, CT scans or MRIs. While there is no cure available for diffuse idiopathic skeletal hyperostosis, but there are steps one can take that can help in reducing the pain and stiffness. The treatment is also aimed at keeping the condition from worsening and preventing complications.
As there is a relationship between DISH and conditions such as obesity, insulin resistance and type 2 diabetes, treating those conditions may also slow or halt the progression of the DISH.
· Treatment for pain
Treatment for pain caused by DISH is similar to that of other joint ailments. The doctor may recommend medicines such as acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others). The most severe pain is treated with corticosteroid injections.
· Treatment for stiffness
The physical therapy helps in reducing the stiffness associated with DISH. The exercises may also increase the patient’s range of motion in their joints. The patients can ask their doctor about specific exercises they can do easily. The doctors may also refer the patient to a physical therapist for the further guidance.
In some rare cases, a surgery may be required when diffuse idiopathic skeletal hyperostosis causes severe complications for the patients. The people who experience difficulty in swallowing due to the large bone spurs in the neck may need surgery to remove the bone spurs. The Surgery may also relieve the pressure on the spinal cord caused by diffuse idiopathic skeletal hyperostosis.