A patient with midthoracic back pain and dysphagia: A case report

This case study reports on complaints of midthoracic back pain and dysphagia in a patient with significant osteophytes in the context of Diffuse Idiopathic Skeletal Hyperostosis (DISH). The clinical and radiologic phenomena of DISH are discussed. Despite the presence of important structural radiologic abnormalities in the thoracic spine in our patient, there was a good clinical recovery after exercise and manual therapy aimed at improvement of posture, functional scapulothoracic stability, strength of the interscapular muscles, length of the pectoral muscles, and mobility of the cervicothoracic and upper thoracic spine. We suggest that functional factors rather than structural abnormalities played a causal role in the genesis of midthoracic back pain in our patient.