I went to a chiropractor for lower back and neck stiffness. I know that I have a straight neck with next to no curve and I know that I have frequent headaches and neck stiffness. The chiropractor advised me that he believes I may have a condition know as DISH. He further advised that monthly visits to get my back and neck aligned will help to slow the progression of this condition. Am I being fed a line or is this a reasonable treatment? I am 35 years old, and my understanding of this condition is that it normally appears in men over 50.
DISH is an abbreviation for “diffuse idiopathic skeletal hyperostosis,” a form of osteoarthritis characterized by bony overgrowth. It’s cause is unknown, and there is no cure. It is simply a form of arthritis that must be treated symptomatically.
Loss of the normal cervical curve as a result of osteoarthritis cannot be corrected with manipulation. While manipulation might restore some mobility in the cervical spine, the risk of such treatment might outweigh benefit. In advanced cases, the bony overgrowth can encroach upon vertebral arteries and the spinal canal and should not be manipulated.
Since you are only 35 years old, your arthritis might be mild and might not become severe. Regardness, the progress of the disease cannot be affected or halted by manipulation. Since you have been advised to the contrary, it’s possible that you have been unnecessarily frightened in order to encourage you to continue with treatment.
Get another opinion from an orthopedist who can help you develop a self-help plan that you can follow at home. Range-of-motion and stretching exercises will help maintain mobility. When pain and inflammation are present, simple nonsteroidal antiinflammatory drugs such as aspirin can be used to ease symptoms and to inhibit the inflammatory process. You should avoid postures that place a strain on your neck. Any treatment you pursue should be approved by your physician.
Since you are a young man, it’s unlikely that you have advanced osteoarthritis. You might benefit from an occasional manipulation. But such treatment will not slow progression of the disease, which is rarely too severe to live with. Because of the risks associated with neck manipulation, it is neither necessary nor helpful to continue with neck manipulation on an ongoing basis.
Dr. Homola is a second-generation chiropractor who has dedicated himself to defining the proper limits on chiropractic and to educating consumers and professionals about the field. His 1963 book Bonesetting, Chiropractic, and Cultism supported the appropriate use of spinal manipulation but renounced chiropractic dogma. His 1999 book Inside Chiropractic: A Patient’s Guide provides an incisive look at chiropractic’s history, benefits, and shortcomings. Now retired after 43 years of practice, he lives in Panama City, Florida.
This article was posted on February 13, 2003.