Diffuse idiopathic skeletal hyperostosis (DISH)

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Treatments and drugs

By Mayo Clinic staff

While there's no cure for diffuse idiopathic skeletal hyperostosis, there are steps you can take to reduce pain and stiffness. Treatment is also aimed at keeping the condition from getting worse and preventing complications.

Because of the relationship between DISH and conditions such as obesity, insulin resistance and type 2 diabetes, treating those conditions may slow or halt the progression of DISH.

Treatment for pain
Treatment for pain caused by DISH is similar to that of other joint ailments. Your doctor may recommend acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others). More severe pain can be treated with corticosteroid injections.

Treatment for stiffness
Physical therapy can reduce the stiffness associated with DISH. Exercises may also increase your range of motion in your joints. Ask your doctor about specific exercises you can do. He or she may refer you to a physical therapist for further guidance.

Surgery
Surgery may be required in rare cases when diffuse idiopathic skeletal hyperostosis causes severe complications. People who experience difficulty swallowing due to large bone spurs in the neck may need surgery to remove the bone spurs. Surgery may also relieve pressure on the spinal cord caused by diffuse idiopathic skeletal hyperostosis.

References
  1. Fierstein GS, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/das/book/body/194678336-3/982047756/1807/375.html#4-u1.0-B978-1-4160-3285-4..10053-1--s1130_1650. Accessed Aug. 31, 2012.
  2. Browner BD. Skeletal Trauma. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2009. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4160-2220-6..X1000-6&isbn=978-1-4160-2220-6&uniqId=357104634-4#4-u1.0-B978-1-4160-2220-6..X1000-6-TOP. Accessed Aug. 31, 2012.
  3. Imboden JB, et al. Current Rheumatology Diagnosis & Treatment. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2007. http://www.accessmedicine.com/content.aspx?aID=2728875. Accessed Aug. 31, 2012.
  4. Taljanovic MS, et al. Imaging characteristics of diffuse idiopathic skeletal hyperstosis with an emphasis on acute spinal fractures: Review. American Journal of Roentgenology. 2009;193:S10.
  5. Westerveld LA, et al. Spinal fractures in patients with ankylosing spinal disorders: A systematic review of the literature on treatment, neurological status and complications. European Spine Journal. 2009;18:145.
  6. Mader R, et al. Extraspinal manifestations of diffuse idiopathic skeletal hyperostosis. Rheumatology. 2009;48:1478.
DS00740 Nov. 2, 2012

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