Bone Spurs (Osteophytes)
In spite of their name, bone spurs are smooth, bony growths that form over a long period of time. They are a growth of normal bone that tends to occur as we age.
The spurs themselves are not painful. Their effect on nearby structures such as nerves and the spinal cord can be.
Our spines are made up of 33 bones (vertebrae) designed to protect the spinal cord. Gel-filled discs between the bones serve as shock absorbers. The discs also allow us to bend forwards and backwards and twist our backs in a variety of directions.
Behind each disc and under each joint are openings that allow a part of nerve roots to leave the spinal cord to go to other parts of the body. The opening (foramen) that encloses the nerve is just large enough for the nerve to go through.
Bone spurs can be a problem if they develop in the openings for the nerve roots. They make the space narrower (foramen stenosis) and press on the nerve.
Back or neck pain is the most common sign of bone spurs. The joint becomes inflamed (swollen and tender) and the back muscles become tender.
Common symptoms are:
- Burning or tingling (pins and needles in the hands or feet)
- Dull pain in the neck or lower back when the person stands or walks
- Loss of coordination in a part of the body
- Muscle spasms or cramps
- Muscle weakness
- Radiating pain in the buttocks and thighs (if the affected bone is in the back or lower back)
- Radiating pain into the shoulders or headaches (if the affected bone is in the neck)
Activity tends to make the pain worse. Rest tends to make it better. If the symptoms affect the back, the person may feel better leaning forward and bend at the waist as in leaning over a shopping cart or cane.
If there is severe pressure on the nerves, a person may have problems controlling his or her bladder or bowels.
Causes and Risk Factors
There is a variety of factors that contribute to bone spurs. These include:
- Aging. As our discs wear down, ligaments get looser and don't hold the joints as stable as they should. The body tries to thicken the ligaments to hold the bones together. Over time, the thickened ligaments start forming flecks of bone. The thickened ligaments and new bone around the spinal cord and the nerve roots cause pressure.
- Disc and joint degeneration
- Injuries, including sports-related and motor vehicle accidents
- Poor posture
- Structural problems that a person is born with
In addition, certain conditions can make it more likely that bone spurs will develop, including:
- Spinal stenosis
In persons 60 and older, bone spurs are common. Only a little more than 40% of the population will develop symptoms that require medical treatment as a result of bone spurs.
After taking the patient's medical history and performing a physical examination, physicians can rule out conditions that may have similar symptoms but different causes.
Tests that a doctor may order include:
- Electroconductive tests. These show the degree and seriousness of the spinal nerve injury.
- Computed tomography (CT) scans
- Magnetic resonance imaging (MRI)
- X-rays to highlight any bone changes
Several approaches can be taken to treatment depending on the severity of the symptoms.
A conservative approach for persons with mild or moderate pressure on the nerves or spinal cord might include:
- Cortisone shots to help reduce joint swelling and pain. The effects of these are temporary and may need to be repeated.
- Drugs to reduce swelling, relieve pain and relax muscles for four to six weeks
- Physical therapy and manipulation of joints to restore flexibility and strength, improve posture and reducing the pressure on the nerves
If this approach isn't successful, surgery may be needed, such as a laminectomy to remove bone spurs.