Diffuse Idiopathic Skeletal Hyperostosis (DISH)

What is Diffuse Idiopathic Skeletal Hyperostosis?

Diffuse idiopathic skeletal hyperostosis, also known as DISH, is a condition where the ligaments that attach to your spine harden due to calcification. Another name for it is Forestier’s disease.

DISH may not have any symptoms and it might not even require treatment. It can affect the neck and lower back or even shoulders, knees, heels, and elbows. It can be a progressive conditions and it can have serious complications.

Calcium is usually used by the body to strengthen bones and teeth but it also circulates in the bloodstream. Calcium can deposit in different areas usually without creating any issues but great amounts of circulating calcium, damaged tissues and a series of underlying diseases can lead to heavy calcification in blood vessels and other random areas such as ligaments that can trigger serious diseases such as DISH.

What are the Symptoms of Diffuse Idiopathic Skeletal Hyperostosis?

Although there are many with DISH who have no symptoms at all there are many who do experience symptoms in affected areas.

Symptoms include

It can be minimal symptoms like stiffness (usually mostly in the morning).

It can also cause pain in the affected areas.  Some have a loss of range of motion that they especially notice when they are stretching from side to side.  Those who have DISH in their neck may have a hoarse voice or have difficulty swallowing.

How is Diffuse Idiopathic Skeletal Hyperostosis Treated?

Since there is not a cure for diffuse idiopathic skeletal hyperostosis, treatment aims to reduce stiffness and pain and prevent the condition and symptoms from getting worse. There are some correlations between DISH and other diseases like type 2 diabetes, obesity, and insulin resistance so treat may focus on addressing these conditions to minimize or stop the progression of DISH.

Pain for DISH can be treated with over-the-counter or pain relievers like ibuprofen or acetaminophen.  Corticosteroid injections can help deal with more severe pain.

For stiffness related to DISH, physical therapy has proven to be helpful. Doctors may also recommend exercises that you can do at home.

Finally, in instances where DISH causes serious complications, surgery may be recommended.  It may be required to remove bone spurs in the neck or relieve spinal cord pressure.

Last Reviewed:
October 05, 2016
Last Updated:
September 06, 2017