DISH Syndrome

DISH Syndrome

Bethesda : MD : USA | Jan 28, 2011 at 2:07 PM PST
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Dish Syndrome Generative Arthritis Learning About Its Effects

Diffuse Idiopathic Skeletal Hyperostosis called Dish syndrome (or Forestier's Disease) is a type of degenerative arthritis which is distinguished by exorbitant bone growth along the sides of the vertebrae of the spine. It is also linked to bone growth and inflammation at other sites of the body where tendons and ligaments attach to the bone such as knee and heel of the foot. It causes stiffness in the upper back may also affect the neck and lower back. If you do not have symptoms of DISH you may not need treatment however, some alternative treatments may aide you in maintaining your range of motion in those joints in which are affected.

Dish syndrome is in fact very common affecting between six to twelve percent of North Americans. It usually affects people age 50 and older though those younger can have it however, it is extremely rare. It affects more men by 65% in comparison to only 35% of women and it is present in 28% of men who are over age eighty.

Warning signs and symptoms

The signs and symptoms for Dish vary due to which part of the body it is affecting. The upper back (thoracic spine) is usually the most common place that becomes affected. The other symptoms can include:

Stiffness which is usually noted in the morning hours.

Pain which is felt when someone press down on the affected area. Not everyone will have pain

A sharp pain when you bend or twist the back.

Problems swallowing, hoarse voice or issue moving neck.

A tendonitis type feeling in shoulder, elbow, knee or ankle.

Loss of lateral range of motion.

Sporadic pain in the back especially with stiffness.

Even though symptoms of Dish have been documented in medical literature for at least one hundred years, this disease has just been acknowledged as a distinct disorder since 1997. Many health practitioners are still not knowledgeable of this disorder therefore, it is frequently misdiagnosed. It is also highly possibly that many patients who endure back pain could actually have DISH syndrome. The disease can be confirmed through x-rays of the upper spine.

If you have ongoing pain in your back or stiffness in any joint in the back contact your health practitioner.

The cause of DISH syndrome

DISH syndrome cause is still undetermined. Some practitioners have drawn conclusions as to what some of the causes maybe for this condition. These are the current risk factors:

People who have been overweight since childhood may have a higher risk for developing the disease.

Long term usage of certain medications referred to as retinoids like Accutane among others which are like vitamin A can increase the risk of DISH. It still not exactly known how the high amount of vitamin A seem to cause the disease.

Your sex is another factor. Being male highers your risk.

Older adults are more at risk for this disease especially in the age of 50 and above.

People who have type 2 Diabetes have a higher risk in comparison to those who do not have it.

Conditions in which can raise your insulin level in the body may also place you at a higher risk. This includes obesity, prediabetes and hyperinsulinemia.

Complications occurring from DISH

People who have DISH can be at risk for other complications due to the disease which include:

Disability: Losing range of motion in an affected joint makes it extremely difficult to move the affected area. Example if it is in your shoulder it is hard to move the shoulder and creates pain when using your arm.

Hard time swallowing: Bone spurs which are linked to DISH that are in the neck (cervical spine) could place pressure on the esophagus which makes it hard to swallow. The pressure from the spurs can also make your voice hoarse or cause problems breathing when you are sleeping (sleep apnea). In very rare cases will surgery be required to remove the spurs.

Paralysis: DISH that affects the ligament which runs up the outside of the spine could place pressure on your spinal cord. This compression on the spinal cord could end up resulting in a loss of feeling or paralysis.

Testing and diagnoses of DISH;

In order to conclude if you have DISH for sure your practitioner most likely will conduct a physical exam first that includes pressing lightly on the spine and joints to feel for any abnormalities. Any pain in which you may feel could be a valuable insight to a diagnoses. DISH may cause pain at the spot where the affected tendon or ligament attaches to the bone. The practitioner may be able to find bone spurs.

To further aide in diagnoses your practitioner may order:

X-rays to confirm the diagnoses. They could reveal hardening along the bones which make up the spine. This hardening has a very distinct appearance in which some practitioners call a cascading or flowing. Basically it resembles candle wax dripping down the spine.

At times a CT scan or MRI can be done in order to rule out certain conditions with alike symptoms such as spondylitis.

How is it treated?

Even though it cannot be cured there things in which can be done such as reducing pain and stiffness along with improving range of motion.

Conventional treatments

Conventional treatment dictates the use of NSAID'S (anti-inflammatory) medications for pain and inflammation such as Advil and Motrin. More severe pain is treated with corticosteroid injections.

Physical therapy may also be recommended for stiffness.

Surgery only occurs in rare cases. Where DISH has produced severe complications. Such as large bone spurs in the neck making it extremely difficult to swallow. It may also be ordered to remove pressure off spinal column.

Chiropractic Care

DISH generally affects two or more levels of the spine and in 97% of the cases the thoracic spine is affected.

Cox Technic Flexion Distraction and Decompression is used in order to widen the canal space to decrease the intradiscal pressure and to increase the height of the disc in order to decrease pain and promote as much mobility as possible into the scoliotic spine. The technique uses the appropriate protocols of depending upon the areas of the spine affected. Depending on how severe the pain is this technique can be used until fifty percent of pain relief or more can be applied.

The chiropractic will use a table that is especially designed in order to allow movements that pulls the tension in the spine, release pressure from the discs and decrease the pressure on the facet joints of the spine. This allows for the chiropractic to have easy movement of the spine while adjusting. The motion from the table brings the patient a feeling of calmness and relief. Each motion is smooth and rhythmic allowing each spinal segment to be able to move in its normal range of motion.

Additional therapies may also used by the chiropractor to provide reduce pain and speed up the natural healing process to give the patient a full recovery.

Cryotherapy (Ice Therapy): This may be used in order to activate the narrowing of blood vessels in order to slow down circulation in a specific area.

Heat Therapy stimulates the widening of blood vessels to promote increased blood to a specific area. Hot and cold therapy is usually done in combination. This way it allows for the activation of the blood flow by bringing circulation to an inflamed and painful area with heat and sends it out of the blood with cold. When done in office it is usually ten minutes hot then ten cold and ten hot again.

Hot/Cold/Tens therapy combination. The hot and cold therapy is used along with electric stimulation referred to as Tens. It doubles the effectiveness in decreasing pain.

TENS therapy
can also be used on its own to speed up the healing and pain reduction.

Trigger Point Therapy: Trigger points are the areas of tenderness in muscles. Pressure is applied to these areas to give pain relief and dysfunction in other areas of the body. At times the chiropractor may use massage and trigger point in combination.


Acupuncture has also been used to decrease muscle tension to provide pain relief. It has been used especially when DISH has affected the neck area causing cervical muscle strain. Many studies done were insufficient for any conclusions to be determined. Some patients have noted significant pain relief.

Regular Exercise

People with DISH need to stay active and have regular exercise. Walking is one good way. Aerobics and yoga are also great for DISH. The stretching in yoga keeps joints functioning and aerobic exercises can be modified to the patient's capabilities and their age. The goal is that these exercises provide stretching that not only keep joints functioning but aides in reducing inflammation.

There are several sources available to help you live a well and full life. These include:

National Arthritis and Musculoskeletal and Skin Diseases Clearing House

1 AMS Circle

Bethesda, MD 20892-3675


Tel: (301)495-4484

Fax: (301)718-6366

Tel: (877)226-4267

TDD: (301)565-2966

Genetic and Rare Diseases Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Debbie Nicholson is based in Detroit, Michigan, United States of America, and is an Anchor on Allvoices.
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