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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

Find out about exercises and supplements that can help with DISH symptoms.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




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Diffuse Idiopathic Skeletal Hyperostosis

What is a heel spur? What are symptoms of a heel spur?

A heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone). They are attributed to local inflammation at the insertion of soft tissue tendons or fascia in the area. Heel spurs can be located at the back of the heel or under the heel, beneath the sole of the foot. Heel spurs at the back of the heel are frequently associated with inflammation of the Achilles tendon (tendinitis) and cause tenderness and pain at the back of the heel made worse while pushing off the ball of the foot.

How do heel spurs relate to plantar fasciitis? What causes heel spurs and plantar fasciitis?

Heel spurs under the sole of the foot (plantar area) are associated with inflammation of the plantar fascia (fasciitis), the "bowstring-like" tissue stretching underneath the sole that attaches at the heel. Plantar heel spurs cause localized tenderness a...

Read the Heel Spurs article »




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