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An Overview of Diffuse Idiopathic Skeletal Hyperostosis (DISH)and Treatment Options

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Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a skeletal condition in which new bone formation occurs at the junction between ligaments and tendons, and bone. Bone overgrowth and hardening also take place. DISH arises most often in the spine and does not always cause symptoms. However, for those individuals who do experience symptoms, they can progressively worsen in severity. DISH happens more often in people over the age of 50 and is more prevalent in men. Reasons for the development of DISH are currently unknown. Treatment centers on managing each person’s signs and symptoms.

DISH symptoms present in the neck and upper back; those that are most common include:

  • Pain
  • Stiffness
  • Loss of range of motion
  • Leg tingling, numbness, and weakness
  • Increased incidence of fractures in the spine and other bones affected by the disease
  • Nerve and Spinal cord compression
  • Difficulty speaking and swallowing
  • Sleep apnea
  • Decreased lung capacity and breathing problems

The reason for the development of DISH is an abnormal accumulation of calcium salts in ligament and tendinous tissue, along with an abnormal amount of new bone development. Unfortunately, medical researchers do not know why this happens but suspect a connection to the abnormal functioning of osteoblasts, the cells responsible for building new bone. Genetics, environmental factors, metabolic problems, hormonal issues, and long-term use of certain medications may all play a part in the occurrence of the condition.

The diagnosis of DISH focuses on an individual’s signs and symptoms, along with x-ray images. An MRI and CT scan also assist in eliminating the possibility of the presence of other diseases that cause similar symptoms.
Conservative treatment is used with individuals who have mild to moderate symptoms. Medications such as nonsteroidal anti-inflammatories, steroid injections, and muscle relaxants can provide pain relief. Physical therapy paired with exercise can increase the range of motion and reduce stiffness. Surgery is reserved for people with severe symptoms who do not respond to conservative care.

If you are experiencing pain, stiffness, and a loss in the range of motion and would like to learn about treatment choices, please contact our New Braunfels or Seguin offices.

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