Introduction

A bone spur, also called an osteophyte, is an abnormal growth of bone on top of normal bone. Although it is called a spur, a bone spur is not sharp. It is actually smooth to the touch. But because a bone spur grows on top of normal bone where it doesn’t belong, it can press on other bones as well as on ligaments, tendons, and nerves, wearing them down and causing pain. One of the most common places for a bone spur to occur is on the spine.

Causes

Bone spurs are usually caused by a disease or condition that results in degeneration of the vertebrae and cartilage in your spine. The extra bone that grows and forms the bone spur is your body’s way of trying to heal the affected area. Often the degeneration that causes bone spurs to form are the result of the normal aging process. As you get older, the cartilage that covers the ends of the vertebrae that make up your spine wears down. This process is called osteoarthritis.

As the discs between your vertebrae wear out from normal wear and tear – a process called degenerative disc disease–this may also cause bone spurs to form. In middle-aged and older people, degenerative disc disease can cause bone spurs to form around the nerve roots. This usually occurs inside the foramen , which is the opening in the spine where the nerve roots leave your spine to travel to other parts of your body. If these bone spurs get large enough, they may begin to rub on the nerve root and irritate it.

Diffuse idiopathic skeletal hyperostosis (DISH) is a condition that can cause bone spurs to form on the ligaments of your spine.

Bone spurs can also develop in older people who do not have another condition affecting their spine.

Bone spurs can also lead to other spinal conditions such as:

• Spondylosis– a condition in which osteoarthritis and bone spurs cause degeneration of the vertebrae in your cervical spine (neck) or lumbar spine (low back)
• Spinal stenosis– a condition in which bone spurs cause narrowing of the spinal canal, which puts pressure on your spinal cord

Symptoms

Many people have bone spurs on their spine without even knowing it, because most bone spurs do not cause pain. When a bone spur presses on a nerve root, it can cause the same symptoms as a herniated disc including pain, numbness in the part of your body where the nerve provides sensation, and weakness in the muscles that the nerve supplies.

Diagnosis

If you are experiencing symptoms that indicate there may be something wrong with your spine, your doctor will begin with a complete history and physical exam. Because bone spurs do not usually cause problems, your doctor will likely order an X-ray to help diagnose what might be causing your symptoms. Your doctor will likely be looking for a cause other than bone spurs, such as arthritis, and discover the bone spurs on your X-ray results.

Treatment Options

Conservative Treatment

Bone spurs are usually not treated unless they are causing problems. If treatment is warranted, your doctor may prescribe rest, ice, stretching, and pain medications such as nonsteroidal antiinflammatory drugs or NSAIDs including ibuprofen. Your doctor may also have you work with a physical therapist. A well-rounded rehabilitation program assists in calming pain and inflammation, improving your mobility and strength, and helping you do your daily activities with greater ease and ability.

Epidural steroid injection (ESI)

An epidural steroid injection (ESI) can be used to relieve pain caused by a bone spur, as well as to decrease inflammation. Injections can also help reduce swelling from a bulging or herniated disc. Steroid injections are a combination of cortisone (a powerful anti-inflammatory steroid) and a local anesthetic that are given through your back into the epidural space. ESI is not always successful in relieving symptoms of inflammation. They are used only when conservative treatments have failed.

Surgical Treatment

If a bone spur is causing pain that cannot be treated conservatively, your doctor may perform surgery to remove the bone spur. If you have another condition that is contributing to your spinal problem, such as osteoarthritis, your doctor may choose to remove the bone spur at the same time surgery is being performed to address the other problem.