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What is diffuse idiopathic skeletal hyperostosis? — Diffuse idiopathic skeletal hyperostosis ("DISH") is a condition that causes bone to form in places where it is not usually found.
DISH affects strong bands of tissue that connect bones to other bones in the back. These bands of tissue are called ligaments (figure 1). New bone growths form on the ligaments. The new bone growths are called bone spurs.
Bone spurs can also form in other parts of the body, where ligaments and tendons (strong bands of tissue that connect muscles to bones) attach to bones. This can happen on the ankles, heels, knees, hips, shoulders, elbows, or hands.
Doctors don't know what causes DISH.
What are the symptoms of DISH? — Some people have no symptoms from DISH. They find out that they have the condition when they have an X-ray done for another reason.
When people have symptoms from DISH, the most common ones are pain and stiffness in the upper back. People can also have pain in their neck or other joints, depending on where the bone spurs are.
Symptoms can also happen when bone spurs press on nearby organs or parts of the body. For example, bone spurs can press on the esophagus (the tube that carries food from the mouth to the stomach) and other structures in the neck. This can cause trouble swallowing, hoarseness, or noisy breathing.
Bone spurs in the lower back can press on the bundle of nerves that run down the back. Pressure on these nerves can cause tingling, pain, numbness, or weakness in the legs.
Is there a test for DISH? — Yes. Your doctor or nurse will ask about your symptoms and do an exam. To check for bone spurs, they will order X-rays of your back or other parts of your body. Some people have an imaging test called a CT scan. Imaging tests create pictures of the inside of the body.
How is DISH treated? — There is no cure for DISH, but different treatments can help reduce pain and stiffness. Treatment usually involves 1 or more of the following:
●Physical therapy – A physical therapist (exercise expert) will teach you exercises and stretches that can help stretch your joints and ease stiffness. They can also show you ways to do your daily activities so they don't cause as much pain.
●Heat – Heat, especially in the morning, can help reduce pain and stiffness. Do not use heat for longer than 20 minutes at a time. Also, do not use anything too hot that could burn your skin.
●Pain-relieving medicines – You can take a pain-relieving medicine, such as acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), or naproxen (sample brand name: Aleve).
●Shots of steroid medicines into the affected joint – These medicines help reduce pain.
●Special shoe inserts (called orthotics) – These can help with walking if you have painful bone spurs on your heels.
In rare cases, people with DISH get surgery to remove bone spurs. Surgery is done only when the bone spurs cause serious problems.
Is there anything I can do on my own to feel better? — Yes. One of the most important things you can do to feel better is to stay as active as possible. You might want to avoid being active because you are in pain. But this can make your muscles weak and your joints stiffer than they already are.
Find physical activities you like to do. Even gentle forms of exercise, like walking, are good for your health. If you have not been active for a while, start by doing just a few minutes of activity a few times a week. Then, slowly do more.
Ask your doctor, nurse, or physical therapist if you need help starting an exercise program.
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