Most of the mechanical problems, postural problems, and diseases that cause enthesitis have no easy cure or treatment, other than medications and injections available to manage the stiffness and pain. Enthesitis is inflammation of the enthuses, the location where the ligaments or tendons insertion into the bone. The result of inflammation to these areas may be pain and stiffness, and eventually cause calcification in these areas and excess bone growth. Usually, the cause of Enthesitis will not be linked back to one specific disease or injury or nutritional deficiency. On the other hand, there are some factors that may put people more at risk for this condition, including age, gender, and genetic predisposition. In the case of Diffuse Idiopathic skeletal Hypertosis (DISH) older men are more likely to develop this disease.
Symptoms of Enthesitis may vary from person to person and based on the cause of the condition. Some people may feel stiffness around the affected specific structures but little pain. Other people may experience stiffness, tenderness, as well as pain.
Cause. There is no one cause for Enthesitis, though there are some risk factors associated with Enthesitis conditions such as idiopathic skeletal hyperostosis. Men 50 and older are more likely to develop DISH, as well as people with obesity, hyperinsulinemia, and type 2 Diabetes. Long term use of certain medications may predispose a person to Enthesitis and other spondyloarthropathies (arthritis of the spine) such as idiopathic skeletal hyperostosis. Long term use of isotretinoin (e.g. Sotret, Claravis, Amnesteem, Accutane) may predispose people for DISH. Isotretinoin is a synthetic substance similar to Vitamin A that is used to treat severe acne. It is currently unknown whether a diet high in natural vitamin A would predispose a person to and Enthesitis condition.
Treatment. The treatment gives to those suffering from Enthesitis may depend of the severity of symptoms. For DISH patients suffering from stiffness or tenderness, no medication or treatment would be prescribed. For individuals suffering from DISH, the physician may recommend NSAIDs , acetaminophen, or ibuprofen for mild to moderate pain, and corticosteroid injections for people suffering from moderate to severe pain. Medications and steroid injections are used to pain. Physical therapy is often used to treat stiffness associated with Enthesitis. Physical therapy may increase your range of motion in stiff joints responsible for movement. Ask your physician about what specific exercises or activities you can do to treat your stiff joints. Your doctor may refer you to a physical therapist, or encourage you to do low impact exercises such as swimming, yoga, or walking.
Surgery. Though Enthesitis may cause some pain and diminished mobility, it will usually be a condition that you can live with if you follow a healthy program of diet and exercise, as well as some pain medications such as nonsteroidal anti-inflammatory drugs. Though in some cases, the pain levels may be too high, or the patient may have lost too much mobility to function comfortably. In either of these two instances, surgery may be appropriate. People who experience dysphagia (painful or difficult swallowing) as a result of bone spurs in the neck may need surgery to remove these bone spurs. If the amount of bone thickening or calcification on the spinal bones actually causes pressure on the spinal cord itself, the patient will need surgery to protect the spinal cord.