Diffuse Idiopathic Skeletal Hyperostosis

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Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a condition that affects the spine, causing spinal stiffness, pain, limited range of motion, and other symptoms. It is characterized by the formation of bone spurs along the spine, which can lead to various complications. In this article, we will explore the symptoms, causes, diagnosis, and treatment options for DISH.

Spinal Stiffness and Pain

One of the most common symptoms of DISH is spinal stiffness. Individuals with this condition often experience difficulty in bending or twisting their spine, leading to a limited range of motion. This stiffness can cause significant discomfort and pain, especially when performing daily activities or engaging in physical exercise.

Difficulty Swallowing and Hoarseness

In some cases, DISH can affect the cervical spine, which is the upper part of the spine located in the neck region. When the bone spurs develop in this area, they can put pressure on the esophagus and vocal cords, leading to difficulty swallowing and hoarseness. These symptoms can significantly impact an individual’s quality of life and require medical attention.

Numbness or Weakness in Limbs

As DISH progresses, it can affect the nerves that pass through the spine. This can result in numbness or weakness in the limbs, particularly the arms and legs. The compression of nerves by bone spurs can disrupt the normal functioning of the nervous system, causing these symptoms. It is important to seek medical advice if you experience any numbness or weakness in your limbs.

Bone Spurs

Bone spurs are a hallmark feature of DISH. These bony outgrowths develop along the edges of the vertebrae, the small bones that make up the spine. Over time, these spurs can grow larger and cause various complications, including spinal cord compression and nerve impingement. The presence of bone spurs is often detected through imaging tests, such as X-rays or CT scans.

Causes and Risk Factors

The exact cause of DISH is unknown, but several factors may contribute to its development. Age is a significant risk factor, as DISH is more common in individuals over the age of 50. Other risk factors include obesity, diabetes, and certain genetic factors. It is believed that DISH may be influenced by both genetic and environmental factors, but further research is needed to fully understand its causes.


Diagnosing DISH typically involves a combination of medical history, physical examination, and imaging tests. Your doctor will ask about your symptoms and medical history, and perform a physical examination to assess your range of motion and identify any areas of tenderness or stiffness. Imaging tests, such as X-rays or CT scans, can help visualize the bone spurs and confirm the diagnosis.

Treatment Options

While there is no cure for DISH, treatment aims to manage symptoms, improve mobility, and prevent complications. The treatment plan may vary depending on the severity of symptoms and individual needs. Here are some common treatment options:

  • Pain Management: Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help alleviate pain and reduce inflammation. In some cases, stronger pain medications or corticosteroid injections may be prescribed.
  • Physical Therapy: A physical therapist can design a customized exercise program to improve flexibility, strengthen muscles, and enhance overall mobility. Physical therapy can also help manage pain and prevent further complications.
  • Assistive Devices: The use of assistive devices, such as braces or canes, may be recommended to support the spine and improve stability. These devices can help reduce pain and enhance mobility.
  • Surgery: In severe cases of DISH, where there is significant spinal cord compression or nerve impingement, surgery may be necessary. The goal of surgery is to relieve pressure on the affected nerves and restore normal spinal function.

It is important to consult with a healthcare professional to determine the most appropriate treatment approach for your specific condition.


Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a condition characterized by spinal stiffness, pain, limited range of motion, and other symptoms. It is caused by the formation of bone spurs along the spine. While there is no cure for DISH, various treatment options are available to manage symptoms and improve mobility. If you experience any of the symptoms associated with DISH, it is essential to seek medical advice for an accurate diagnosis and appropriate treatment.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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