My Doctor Says I Have a Spinal Condition Called DISH. What Exactly Does That Mean?

The short answer from a rheumatologist

Elderly woman with lower back pain

Q: I’ve been told I have diffuse idiopathic skeletal hyperostosis. What is this, and what can be done for it?

A: Diffuse idiopathic skeletal hyperostosis (DISH) is a condition that mostly affects the spine.

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For unknown reasons, ligaments in the back where they attach to the spine calcify into a bone-like material. This process is called ossification. It mostly affects the middle (thoracic) spine, but it can also occur in the lower (lumbar) and upper (cervical) spine.

DISH may not cause any symptoms, and many people are not aware they have it. It becomes more common with age. One study estimated that it may be present in as many as 25 percent of men and 15 percent of women over age 50 in the United States.

Since many people have no symptoms, DISH is often diagnosed only when imaging studies are done for some other reason.

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Sometimes it can cause mild to moderate pain and stiffness in the back or neck, reducing flexibility in the spine. In some people with severe and widespread calcification, spine fractures can be a complication. In rare cases, the ossified structure can press on the esophagus, causing difficulty swallowing, or press on the spinal cord, causing neurologic symptoms.

There is no cure for DISH, and no medication will slow down the process. To reduce any pain, your doctor may recommend acetaminophen (Tylenol®) or a nonsteroidal anti-inflammatory drug such as naproxen (Aleve®) or ibuprofen (Motrin®, Advil®). You can also apply heat.

If you’re having stiffness, exercise may help. Talk to your doctor or a physical therapist about the most appropriate exercises.

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While the cause of DISH is not yet known, it may be linked to obesity and diabetes. If you are overweight, losing weight could reduce stress on the spine.

Rheumatologist Chad Deal, MD

This article originally appeared in Cleveland Clinic Arthritis Advisor.

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