Chiropractic & Diffuse idiopathic skeletal hyperostosis

Diffuse idiopathic skeletal hyperostosis (DISH) is a disease that affects elderly persons and is characterized by a bone-forming tendency with prominent radiographic findings, including proliferation of bone throughout the ligaments and tendons of the spine and extremities. Clinical symptoms are often mild and include mild pain and stiffness. However, DISH can coexist with other articular diseases, such as degenerative joint disease and rheumatoid arthritis, or can be complicated with myelopathy and fracture.

Researchers at the Department of Radiology, Western States Chiropractic College, Portland, USA undertook a pilot study into the application of Chiropractic treatment for DISH patients. Four male patients over the age of 75 diagnosed with DISH were all given chiropractic manipulative treatment; three patients showed improvement after treatment and the remaining patient was referred for a surgical consultation due to complications arising from rheumatoid arthritis.

The researchers stated that DISH is a common disease of the elderly, and clinicians should recognise its radiographic and diagnostic features. Although this was a small scale investigation it pro-vides sufficient evidence to support referral of patients suffering with DISH for chiropractic treatment and a platform for a larger, controlled study in to the application of chiropractic management of DISH.

Hoffman LE; Taylor JA; Price D; Gertz G. Diffuse idiopathic skeletal hyperostosis (DISH): a review of radiographic features and report of four cases. Manipulative Physiol Ther (UNITED STATES) Oct 1995, 18 (8) p547-53,