Symptoms of DISH include intermittent back pain and particularly stiffness of the back, especially in the area from below the neck to the middle of the back. Stiffness is often worst in the morning and after long periods of sitting. It can also increase with wet weather. Pain is sometimes sharp, especially with certain movements such as twisting or bending. Back pain associated with DISH is often relieved through mild activity.

Some people with DISH may have difficulties with swallowing and moving their necks. And because DISH can affect the points where tendons insert into the arms and legs, some people with DISH experience recurring bouts of what seems like tendonitis in such places as the shoulder, elbow, knee or ankle. This “tendonitis” of course, is due to DISH.

Although the symptoms peculiar to DISH have been noted in medical literature for almost 100 years, the disease has only been recognized as a distinct disorder since 1997. For this reason, many physicians are still unfamiliar with the disease and it is often misdiagnosed.

It is likely that many patients who experience regular back pain may have DISH without knowing it. The disease is usually confirmed through x-rays of the thoracic (upper) spine or chest, which reveal the characteristic bony outgrowths of DISH along the vertebrae.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Naprosyn) or high dose ibuprofen (Advil, Motrin) are often used to treat the inflammation of tendons and ligaments and the pain that occur with DISH. The hope is that minimizing inflammation of the tendons and ligaments will help the patient to maintain their mobility. NSAID use, however, is associated with a problematic side effect: stomach bleeding. And because people over 60 are at higher risk of bleeding from the stomach and most people with DISH are over 60, some doctors prefer using NSAIDs together with drugs which are known to reduce this side-effect. Such drugs include Cytotec, the proton pump inhibitors, and the newer cox-2 selective drugs.

People with DISH are encouraged to stay active and to get regular exercise. Walking is considered a good form of exercise for the disease. Stretching or yoga can also help, as can aerobic exercise programs suited to the patient’s age and capabilities. Individualized physiotherapy programs appear to help some people with DISH when their symptoms are particularly bad. 

Overall, the objective of exercise for people with DISH is to regularly stretch the ligaments affected by the disease in order to keep them functioning properly and to help reduce inflammation.

Along with the physical symptoms of arthritis, many people experience feelings of helplessness and depression. Learning daily living strategies to manage your arthritis gives you a greater feeling of control and a more positive outlook. To get the best results, people affected by arthritis need to form close ties with their doctors and therapists, and become full partners in their treatment. From our perspective, it's all part of 'living well with arthritis.' There are several resources you can use in finding out how best to manage your own arthritis. Here are a few:

• The Arthritis Self-Management Program (ASMP) is a unique self-help program offered by The Arthritis Society to help you better control and manage your arthritis.
• The Open Forum within this Web site is an opportunity to discuss and share information with other visitors - people who, through their own experiences, may be able to offer some useful insights.

Of course, there are many other valuable resources for people with arthritis. If you're unclear about where to look for help, be sure to call The Arthritis Society at 1-800-321-1433.