If your doctor informs you that an X-ray or MRI has revealed the presence of bone spurs in your back or neck, it’s understandable that you might be concerned. Even the term itself – “spurs” – sounds intimidating and may conjure an image of sharp, jagged protrusions of bone forming up and down your spine.
However, the reality of bone spurs is not nearly as foreboding as what you might imagine. You may even find comfort in the fact that many, many people have bone spurs in their necks, backs, and even throughout other areas of their body, such as the toes, heels, shoulders, hips, or knees – and don’t even realize it because no symptoms are present. The condition is not uncommon in older people and is usually an indicator of osteoarthritis. Bone spurs and osteoarthritis are often a natural development during the aging process, especially in the back and neck where the spinal facet joints are tasked with supporting a large amount of weight and maintaining the flexibility of the spine.
Although osteoarthritis and bone spurs are extremely common conditions, it can still be leave you with more questions than answers after you receive this diagnosis. Learning about what bone spurs are, how they form, and the symptoms they cause will likely help you to combat this fear of the unknown and reassure you that the presence of bone spurs need not relegate you to the sidelines of life.
The Anatomy of Bone Spurs
The medical term for bone spurs is “osteophytes,” stemming from the Latin “osteo,” meaning “bone.” Bone spurs are not sharp, as their name implies, but are smooth, bony growths that form along existing bones, primarily in and around joints. Yet, while bone spurs can grow on virtually any bone in the body, they often produce no symptoms at all.
One place that bone spurs are frequently found is on the vertebrae that create the framework of the spinal column. There are 24 individual stacked bones, or vertebrae, in the spine, and you may be surprised to learn that there are joints located in between these vertebrae, providing the spine with its ability to bend and twist. Below is a closer look at the anatomy of the spine:
Facet joints – The facet joints of the spine are one of the most common areas of the body for bone spurs to form. The facet joints are hinge-like structures where the inferior process of one vertebra articulates with the superior process of the vertebra beneath it. The joints are coated with a layer of smooth cartilage.
Foramen (or plural, “foramina”) – Beneath each facet joint is a hollow canal called a foramen that provides space for nerve roots to branch off the spinal cord and exit the spinal column.
Vertebral bodies – The anterior, or frontal, portions of the vertebrae are called the vertebral bodies. The vertebral body is the largest part of each vertebra and is somewhat flat and round in shape.
Intervertebral discs – On the top and bottom of each vertebral body is a cylindrical, spongy intervertebral disc, creating a vertebra-disc-vertebra-disc construction that helps to absorb shock in the spine and provides flexibility in the back and neck.
In addition to the facet joints, foramina, vertebral bodies, and intervertebral discs, the remainder of the spine’s structure includes muscles, ligaments, tendons, and, of course, the spinal cord.
Now that we know more about the spinal anatomy, the next question is, why do bone spurs form in the spine? In many cases, the body may produce bone spurs along the facet joints of the spine in an attempt to stabilize an area that has become weak due to degeneration like osteoarthritis. As the body’s natural response system interprets it, more bone mass will naturally make the joint stronger. However, regardless of the body’s intentions, the opposite is typically true. Instead of strengthening joints, bone spurs can cause their own set of problems.
Due to the limited space available for the many anatomical elements that make up the structure of the spine, bone spurs often have little room to grow, which means they may press on nearby bones, muscles, ligaments, tendons, intervertebral discs, and spinal nerve roots. Consider the following examples of bone spur complications:
If an intervertebral disc degenerates and loses height, the vertebral bodies on either side of the disc may eventually move close enough to grind against each other. The friction caused by this bone-on-bone contact may cause bone spurs to form along the edges of the vertebral bodies, possibly interfering with proper facet joint function.
It’s also possible for bone spurs to develop in the foramina, causing these passageways to narrow and compress nerve roots passing through. This condition is referred to as foraminal stenosis.
If bone spurs cause the spinal canal itself to narrow, the condition is called canal stenosis and puts the spinal cord at risk of being compressed.
You may be wondering how the body knows that a joint has become unstable or arthritic. Essentially, healthy joints in the spine are coated with cartilage and a synovial membrane, and are lubricated by synovial fluid. These materials facilitate smooth joint movement and help absorb the daily jolts and shocks that the spine undergoes on a daily basis. However, over time joint cartilage can begin to wear away and eventually the facet joints may start to grind against each other. This grinding, often referred to as “crepitus,” indicates a sort of injury to the bone that the body tries to heal with more bone, a bit like the way a raised section of scar tissue can form over a laceration.
While bone spurs can form at any level of the spine, they most commonly appear in the cervical spine (neck) and the lumbar spine (lower back). These are the two areas of the spine that support the most amount of weight and supply the spine with the majority of its flexibility. Remember that every time you sit, stand, bend over to tie your shoe, or turn your head to check for oncoming traffic, the cervical and lumbar regions of the spine are hard at work, so you can imagine the toll that four or five decades or movement could take on the back and neck.
Causes and Risk Factors
The most common cause of bone spurs in the back and neck is degeneration due to age. As we’ve already learned, years of wear and tear can exert huge amounts of pressure on the spine, resulting in unmistakable changes within the spinal anatomy:
Discs may dry out and flatten over time, causing vertebrae on either side to shift into an abnormal position, and making movement of the facet joints awkward and painful.
The smooth cartilaginous lining of the facet joints simply begins to wear away as a part of the natural aging process, also making facet joint movement stiff and painful.
Disc collapse and facet joint cartilage deterioration sometimes have a cause-effect relationship. As discs dry up and flatten, vertebrae move closer together. Abnormal movement between vertebrae puts stress on the facet joints, causing joint cartilage to wear away and reactive bone growth (bone spurs) to form.
However, there are certainly a variety of factors that can accelerate the degenerative process, in addition to age. For instance, standing with poor posture for a prolonged portion of your life puts a great deal of stress on both the neck and back and may exacerbate the degenerative process. Having a genetic predisposition to bone spurs also plays a large role in their development, and patients with a family history of osteoarthritis may experience bone spur formation as early as their 40s.
Premature degeneration can also occur if you:
Play contact sports or take part in high-impact exercise, such as football, hockey, rugby, diving, or gymnastics, among others
Smoke, as the chemicals introduced to the body through the use of tobacco products can inhibit healthy circulation and prevent oxygen and nutrients from reaching the anatomical components of the spine
Are overweight, since excess body mass puts all parts of the spine under extreme pressure, especially the facet joints of the lumbar spine
Have ever sustained any sort of spine trauma, such as a vertebral fracture from an auto accident or a sports injury
Many of the factors that can contribute to spinal degeneration and bone spurs simply aren’t predictable or avoidable. You can’t just decide that you don’t want a genetic predisposition to osteoarthritis and bone spurs, just as there’s no way to avoid the aging process. It’s also not realistic to say that you’ll never play sports or never get into a car accident. However, certain factors are controllable. Maintaining a healthy body weight, being aware of your posture, and not smoking are all possible ways to prolong the health of your spine.
Overall, the most important thing to remember about bone spurs is that they typically do not form spontaneously. They form over an extended period of time due to an underlying condition like osteoarthritis. Almost everyone experiences some symptoms of osteoarthritis by the age of 70, but even so, there are ways to maintain healthy joints and possibly delay the progression of osteoarthritis and bone spurs. This often will involve eating a healthy diet, staying active, stretching gently, and knowing your physical limits so that you don’t overexert yourself.
Spinal Bone Spurs – Symptoms
Only about 40 percent of people who have bone spurs experience symptoms. If you’re currently one of those patients suffering from symptomatic bone spurs, you’re probably no stranger to the aches and pains that can accompany this condition. These bony protuberances can produce symptoms like crepitus (a grating or popping sound in the joints), joint stiffness, and joint instability. You may experience spontaneous joint lockage when you stand up after sitting or lying down for long periods of time as a result of the excess bone growth and diminished cartilage.
If bone spurs around your facet joints, neuroforamina, or vertebral bodies come into contact with other elements of the spinal anatomy, you may experience different sets of symptoms. The most common types of symptoms to develop as a result of spinal bone spur formation, however, are called radiculopathic symptoms. These are symptoms specifically caused by damage to or pressure on a spinal nerve root. Radiculopathic symptoms will vary from patient to patient and will depend largely on which level of the spine is affected by the bone spurs.
The cervical spine, or neck, consists of seven vertebrae (C1-C7) separated by five intervertebral discs. This portion of the spine begins at the base of the skull with the occipital bone and the two uppermost vertebrae, the atlas and the axis. No intervertebral disc exists between the atlas and axis. The atlas is shaped like a ring and the axis pivots inside of this bone; together, these two vertebrae form several atlanto-axial joints. The remaining five neck vertebrae are relatively small but have the normal round shape of the other vertebrae below them, articulating via the posterior facet joints. Bone spurs can form in or around these joints, possibly pressing on any of the eight cervical nerve root pairs (C1-C8) that branch off from the spinal cord on either side of each vertebra, just beneath the vertebral joint. Compression of these nerve roots due to bone spurs could produce any of the following symptoms:
C1 and C2 – headaches, pain in the temples, problems moving the head and neck, or a tingling form of discomfort throughout the neck and at the base of the skull
C3 and C4 – headaches behind the eyes and ears, pain at the base of the neck, or a pins-and-needles sensation in the upper shoulders
C5 and C6 – pain or weakness that radiates through the upper arms, biceps, forearms, wrists, and thumbs
C7 and C8 – weakness, numbness, or a pins-and-needles sensation that spreads throughout the triceps, hands, and fingers
Just as symptoms of nerve compression in the neck can spread as far as the fingers, so can nerve compression in the lower back cause discomfort in many regions of the body below the waist. This is a phenomenon called “referred symptoms” and is characteristic of radiculopathy. In other words, if a bone spur presses on the root of a nerve, the pain frequently is “referred” along, or follows, the entire path of the nerve as it extends and branches off to innervate other areas of the body.
Similar to the neck, the lumbar spine (lower back) is another region of the spine that is prone to the development of bone spurs. Because the pairs of nerve roots extending from between the lumbar vertebrae are tasked with innervating the lower half of the body, symptoms usually will appear in the hips, buttocks, legs, and feet. The lumbar spine contains five lumbar vertebrae (L1-L5), though some people do have a sixth lumbar vertebra. Lumbar nerve root pairs branch off the spinal cord at each level of the lumbar spine, and compression of these nerves due to bone spurs can produce any of the following symptoms:
L1 – tingling or weakness that spreads through the upper thighs and groin areas
L2 – pain in the buttocks and around the mid-thighs
L3 – numbness or a pins-and-needles sensation in the knees and distal thighs
L4 – tingling or weakness in the buttocks, thighs, knees, lower legs, and big toes
L5 – pain radiating through the buttocks, legs, feet, and toes
It is also worth noting that the lumbar region of the spine is the location where the sciatic nerve – the largest and longest nerve in the body – begins. Formed by nerve roots coming out of the spinal cord in the lower back, the sciatic nerve travels down through the buttocks, the back of the legs, the ankles, feet, and toes. If the sciatic nerve is compressed by a bone spur or other tissue, a group of symptoms known as sciatica may occur. Sciatica can include any of the following symptoms:
Constant aching that begins in the lower back or buttock and extends through the leg and foot (usually on one side of the body)
Muscle weakness that may prevent you from bringing your foot upward
Cramping in the thigh
Difficulty walking on tiptoes
Reduced knee-jerk reflexes
Pain or numbness on the top, or outer, foot
An electric shock type of pain that stops you from taking a step or bending over
Burning or tingling in the leg
Sharp pain that makes it difficult to walk or stand up
Pain that gets worse at night; when standing, sitting, or walking; or when sneezing and coughing
While no two patients will have exactly the same symptoms as a result of spinal bone spurs, the above descriptions may help you to identify the forms of discomfort that you yourself have experienced. Compression of the spinal nerve roots can sometimes be difficult to diagnose just based on symptoms because, as you might imagine, tingling or numbness in the leg isn’t intuitively linked with an abnormality in the lower back. That’s why many doctors, even though they suspect the presence of arthritic spinal joints and possible bone spur-related nerve compression, will order an X-ray or MRI to confirm their suspicions.
At AOMSI diagnostics, we provide the most accurate spinal imaging available in the healthcare marketplace. This imaging has been proven in peer-reviewed medical journals to be the most accurate, reliable and specific spinal imaging when compared to traditional spinal imaging modalities.
Contact us today to see if AOMSI diagnostics is right for you!