Bone Spurs (Osteophytes) and Back Pain

See Osteoarthritis of the Spine

The term “bone spurs” is really a bit of a misnomer, as the word “spurs” implies that these bony growths are spurring or poking some part of the spinal anatomy and causing pain. However, contrary to this implication, bone spurs are in fact smooth structures that form over a prolonged period of time.

The medical term for bone spurs is osteophytes, and they represent an enlargement of the normal bony structure. Basically, osteophytes are a radiographic marker of spinal degeneration (aging), which means that they show up on X-rays or MRI scans and are by and large a normal finding as we age. Over the age of 60, bone spurs on the spine are actually quite common.

Bone Spurs and Spinal Anatomy

The human spine is made of thirty-two separate vertebral segments that are separated by intervertebral discs made of collagen and ligaments. These discs are shock absorbers and allow a limited degree of flexibility and motion at each spinal segment. The cumulative effect allows a full range of movement around the axis of the spine, especially the neck (cervical spine) and lower back (lumbar spine).

Motion between each segment is limited by the tough outer disc ligaments and the joints that move (articulate) at each spinal level (the facet joint). Under each joint, just behind the disc, is a pair of nerve roots that exit the spinal canal. The exiting hole (foramina) that surrounds the nerve (disc in front, joints above and below) is relatively small and has little room for anything besides the exiting nerve.

Normal life stressors, possibly compounded by traumatic injuries to the spinal architecture, cause degeneration in the discs and the joints of the spine. With factors such as age, injury, and poor posture, there is cumulative damage to the bone or joints of the spine. For example:

1. As disc material slowly wears out, ligaments loosen and excess motion occurs at the joint
2. The body naturally and necessarily thickens the ligaments that hold the bones together
3. Over time, the thick ligaments tend to calcify, resulting in flecks of bone or bone spur formation
4. As the central spinal canal and the foramina thicken their ligaments, compression of the nervous system causes clinical symptoms.

Degenerative changes to normal vital tissue begin in early adulthood, but usually this slow process does not present with nervous system compression until we are in our sixth or seventh decades. Factors that can accelerate the degenerative process and bone spur growth in the spine include:

• Congenital or heredity
• Nutrition
• Lifestyle, including poor posture and poor ergonomics
• Traumatic forces, especially sports related injuries and motor vehicle accidents.

As always, to help avoid or minimize back pain it is generally advisable to stay well conditioned (both in terms of aerobics and strength) and to maintain good posture throughout one’s life.

Back pain or neck pain is very common as the facet joints are inflamed and the neck and back muscles become irritated. Typical symptoms reported by patients include:

• Dull pain in the neck or lower back when standing or walking
• Radiating pain into the shoulders (often including headaches) if the cervical spine is affected (See Cervical Bone Spurs)
• Radiating pain into the rear and thigh if the lumbar spine is affected.

The symptoms of bone spurs are made worse with activity and often improve with rest. Typical symptoms of lumbar bone spurs often improve when an individual is bending forward and flexing at the waist, such as leaning over a shopping cart or over a cane.

As the nerves become compressed, patients with bone spurs complain of several neurological symptoms including:

• Pain in one or both arms or legs
• Numbness or tingling in one or both arms or legs
• Progressive weakness in one or both arms or legs
• In very rare cases, bowel and bladder incontinence may occur.

Symptoms described above can also be caused by medical conditions other than bone spurs, including but not limited to diabetes, poor blood circulation to the arms and legs, spinal tumors, fractures, and spinal infections.

Many of the symptoms of bone spurs are similar to generalized arthritis, rheumatism, back strain and muscle fatigue, as well as acute disc ruptures with nerve compression.

Because typical bone spur symptoms are often similar to many other possible conditions, it is important for the patient to consult with appropriate medical professionals to obtain a thorough and accurate diagnosis.