Diffuse idiopathic skeletal hyperostosis (DISH) is a type of arthritis that primarily affects the spine.
DISH disease is marked by the bony growths it causes to grow along your spine or other affected bones. These growths, called bone spurs, are often visible on X-rays.
Some people with DISH disease have no symptoms at all and don’t know they have the condition until the spurs are seen on an X-ray. Other people will experience pain, stiffness, and other arthritis-like symptoms.
While there is currently no cure for DISH disease, there are treatments to help manage your pain and control the progression of this condition. In this article, we’ll cover what DISH disease is, what causes it, how it’s treated, and more.
DISH disease is a type of arthritis. It’s also sometimes called Forestier’s disease.
Unlike the inflammation that’s common in most types of arthritis, DISH disease causes your tendons and ligaments to harden. This hardening is called calcification. It can cause the formation of abnormal bone growths called bone spurs.
The calcification and bone spurs cause pain and stiffness in affected areas. The most commonly affected area is the spine, but DISH disease can occur throughout your body.
The ligaments and tendons in your body calcify when there’s a buildup of calcium salts in your body. It’s unclear what causes this buildup. A combination of genetic, environmental, and metabolic factors is likely involved, but more research is needed.
Studies have shown that there are some factors that increase your odds of having DISH disease, including:
- being older than age 50
- being assigned male at birth
- having type 2 diabetes
- having obesity
- using retinoids for many years
- taking a medication containing vitamin A for many years
- getting high amounts of dietary vitamin A from your diet
DISH disease doesn’t always cause symptoms. Some people don’t know they have DISH disease until a healthcare professional spots the abnormal bone formations on an unrelated X-ray. When signs and symptoms are present, they’re most likely to be present in your upper back. These symptoms might include:
- upper back pain
- pain that radiates to the shoulder or elbow
- back stiffness that’s worse in the morning
- difficulty stretching side to side
- neck pain
Although DISH disease may cause mild symptoms (or none at all), it’s also possible to experience serious symptoms in rare cases. Additionally, unmanaged DISH disease can progress and cause new symptoms over time. This can lead to more severe or unusual symptoms. They can include:
- tingling or numbness in your legs
- spinal fractures
- pain in your knees and heels
- compressed or pinched nerves
- compression of the spinal cord
- difficulty swallowing
- difficulty speaking
- sleep apnea
- decreased lung capacity
- hoarse voice
Untreated DISH disease can progress to significant symptoms and concerns with time. For example, nerve compression can lead to severe pain and loss of function in the affected limb. Spinal cord compression cord can lead to partial or full paralysis of the arms or legs.
If you begin to notice any of the symptoms listed above, talk with a healthcare professional.
The primary test to diagnose DISH disease is an X-ray. The bony growths caused by DISH are normally visible on an X-ray and confirm this diagnosis. In fact, since many people with DISH have no symptoms at first, an X-ray is often the only test used.
Sometimes, your doctor might order additional imaging tests to get a closer look at the growths and to rule out similar conditions, especially if you’re experiencing pain. This might include a CT scan or an MRI. These tests can show any inflammation, degeneration, fractures, and other possible sources of pain.
Although there’s no one cure for DISH disease, treatments can manage your symptoms and stop disease progression. The right treatment plan for you will depend on the severity of your symptoms and the progression of your DISH disease. Some treatment options include:
- Physical therapy. Physical therapy can help reduce stiffness and increase your mobility.
- Pain medication. Your doctor might write you a prescription for a medication to help manage your pain. Common options include pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants.
- Corticosteroid injections. Corticosteroids can help manage severe pain.
- Surgery. Surgery might be needed if the bone growths are pressing on your nerves or airways.
You can also take steps to manage your DISH disease at home. For example, applying warm compresses or soaking in a warm bath is a great way to manage stiffness and pain.
Managing your weight and diet can also help mitigate your symptoms. Maintaining a moderate weight can reduce pressure on your joints and relieve pain.
You can also ask your doctor about other ways to relieve symptoms at home. They can provide tips that are specific to your symptoms and health.
DISH disease is a chronic condition, but treatments are effective at helping people lead full and healthy lives. Many people with DISH disease are able to continue their jobs, hobbies, and lifestyles with few changes.
It’s important to note that without any treatment, DISH disease can get worse over time. Bone growths from this condition can lead to compression of the spinal cord. Left untreated, a compressed spinal cord may lead to complete paralysis.
Talking with your doctor will help you know what to expect even if you don’t have symptoms yet. They can also help work out a treatment plan that works for you.