From the Research
Treatment for diffuse idiopathic skeletal hyperostosis (DISH) should prioritize symptom management, focusing on non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, and lifestyle modifications to improve quality of life and functional ability. The primary goal is to alleviate pain and stiffness, prevent progression, and manage associated metabolic disorders. According to the most recent and highest quality study 1, surgical intervention may be necessary in rare cases where DISH causes severe complications, and targeted bone resections can be reasonable in elderly patients.
Key aspects of treatment include:
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or celecoxib to reduce pain and inflammation
- Physical therapy incorporating stretching exercises, posture training, and range-of-motion activities to maintain mobility and function
- Weight management for overweight patients to reduce symptom exacerbation
- Muscle relaxants like cyclobenzaprine for short-term pain management
- Corticosteroid injections for specific painful areas
- Surgical intervention for severe complications, with consideration of targeted bone resections and decompression techniques 1
It is essential to note that DISH is a progressive condition, and while treatment cannot reverse bone growths, proper management can significantly improve quality of life and functional ability. The study by 1 highlights the importance of timely decompression and targeted bone resections in determining clinical outcome, even in patients with preoperative mild dysphagia.
In terms of specific treatment approaches, the study by 2 suggests that exercise therapy can lead to small improvements in physical measures, and the study by 3 demonstrates the effectiveness of surgical treatment in improving dysphagia in the long-term. However, the most recent and highest quality study 1 provides the most relevant guidance for treatment, emphasizing the importance of timely and targeted interventions.
Overall, a comprehensive treatment plan for DISH should prioritize symptom management, lifestyle modifications, and timely interventions to improve quality of life and functional ability.