Are there any successful disease modifying therapy for diffuse idiopathic skeletal hyperostosis (DISH)?

Therapy for DISH is largely supportive: PT, NSAIDs/pain relievers, and control of contributing metabolic conditions, nutrition, exercise, and lifestyle changes; when necessary surgical interventions such as surgical resection of osteophytes and spinal fusion are required.

Clinical research in DISH is limited. Because of their use in ankylosing spondylitis, TNFis have been tried in DISH. An audit of such therapy in DISH patients reported that 67% had a reduction in disease activity. Again, because...

There are no disease modifying agents for DISH and there is no available evidence that controlling the associated metabolic diseases has a disease modifying effect.

Most patients with DISH, in spite of the sometimes exuberant changes on imaging, are asymptomatic. Many patients are diagnosed on the basis of an incidental finding on an imaging study done for other reasons. When symptoms do occur, they are generally mild and related to pain and stiffness in the spine and in and around joints often ...