Diffuse Idiopathic Skeletal Hyperostosis
("DISH" or Forestier Disease)
Medical Author: William C. Shiel Jr., MD, FACP, FACR
I have just been diagnosed with diffuse idiopathic skeletal hyperostosis (DISH). I'm currently taking antiinflammatory medications. Are there any exercises and/or nutritional suggestions that will also help?
Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Melissa Conrad Stöppler, MD
You must consult your doctor for the proper advice for your particular situation. Because DISH can cause loss of range of motion of the spine, exercises that involve stretching the spinal range of motion can often be beneficial. Physical therapists are specifically trained to provide instructions in this area.
What is diffuse idiopathic skeletal hyperostosis?
Diffuse idiopathic skeletal
hyperostosis (DISH) has also been called Forestier's disease. It is considered a form of degenerative arthritis. However, DISH is characterized by unique, flowing calcification along the sides of the vertebrae of the spine. And, very unlike typical degenerative arthritis, it's also commonly associated with inflammation
(tendinitis) and calcification of tendons at their
attachments points to bone. This can lead to the formation of bone spurs, such as heel spurs. In fact, heel spurs are common among individuals with DISH.
What are symptoms of diffuse idiopathic skeletal hyperostosis?
Symptoms of DISH include intermittent
pains in the areas of the bony changes of the spine and inflamed
tendons. Stiffness and dull pain, particularly in the upper and lower back, are common. Sometimes pains in these areas can be sharp with certain body movements, such as twisting or bending over.
DISH is only slowly progressive. Calcifications between the vertebrae occur over many years. This calcification can lead to limitation of motion of the involved areas of the spine.
Does diffuse idiopathic skeletal hyperostosis damage organs?
There is no associated threat to any internal organs with this
disorder. Rarely, large bone spurs can form in front of the spinal
vertebrae of the neck. These spurs occasionally interfere with the passage of
food through the upper esophagus (swallowing tube).
How is diffuse idiopathic skeletal hyperostosis treated?
Because areas of the spine and
tendons can become inflamed, anti-inflammatory medications
(NSAIDs), such as ibuprofen and Naproxen, can be helpful in both relieving pain
and inflammation of DISH. It is hoped that by minimizing inflammation in
these areas, further calcification of tendons and ligaments of
the spine leading to calcific bony outgrowths (osteophytes) will
be prevented.
For further information, please read the Osteoarthritis article.
Last Editorial Review: 9/26/2007
- ibuprofen, Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever, etc. - Explains the medication ibuprofen (Advil, Motrin, Nuprin, Medipren) a drug used for the management of mild to moderate pain, fever, and inflammation. Article includes descriptions, uses, drug interactions, and side effects.
- Osteoarthritis - Osteoarthritis (OA or degenerative arthritis) is a joint disease caused by cartilage loss in a joint. Pain and stiffness are symptoms. Read about diagnosis and treatment.
- Heel Spurs - Get information on heel spurs and plantar fasciitis causes, symptoms (heel pain) and treatment (cortisone injection, surgery, running shoes). Achilles tendon inflammation is associated with heel spurs.
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