Diffuse idiopathic skeletal hyperostosis (DISH) is a condition that causes bone hardening formations in abnormal places. DISH most often affects areas such as the spine; however, it can also affect the neck, lower back, hips, heels and other areas. Also known as Forestier's disease, diffuse idiopathic skeletal hyperostosis is more common in men, may cause no symptoms and requires treatment if the condition produces bothersome symptoms. DISH can be progressive and as it worsens, it can cause severe complications.



Signs and symptoms of DISH may include:

  • Back pain or pain in other affected areas (shoulder, elbow, knee or heel)
  • Stiffness
  • Decreased range of motion
  • Difficulty breathing or trouble swallowing
  • Hoarse voice



DISH has been linked to changes in the metabolic system; however its exact cause remains unknown. A variety of factors connected to its development include:

  • Obesity
  • Diabetes
  • Abnormal levels of growth hormone
  • Metabolic conditions


Some researchers feel that the extra bone is made because of excess blood supply near the spine. Growth factors that affect the formation of calcium likely play a role as well.


Risk factors

Factors associated with increased risk of developing DISH include:

  • Being male
  • Being of older age (over 50)
  • Diabetes and other conditions (any conditions that may raise insulin levels)
  • Certain medications (Retinoids)



Complications of DISH can include:

  • Loss of range of motion in the affected areas (Affected joints such as arms/shoulders can be painful and difficult to use)
  • Difficulty breathing or trouble swallowing (Bone spurs in the neck can put pressure on the esophagus)
  • Spinal fracture (Bone spurs can increase the risk of breaking bones in the spine)

In severe cases, the extra bone growth around the spine can cause complications with the spinal cord or nerves. Pressing on the spinal cord can cause loss of feeling and paralysis in the affected areas.



Although there is no way to prevent diffuse idiopathic skeletal hyperostosis from occurring, individuals with obesity and diabetes are linked to the condition and thus, are at greater risk of developing it. A few measures to help reduce the risk of DISH include:

  • Maintaining a healthy diet high in vegetables, fruits and meats
  • Staying at a healthy weight