What is a Bone Spur?
Written by Neil Badlani, M.D., Chief Medical Officer, North American Spine

Bones spurs, also known as osteophytes, are hard outgrowths of bone that forms on the edges of some bones. While the term spur conjures images of prickly thorns, the growths are usually smooth. Spurs can grow on any bone, but often form near joints and along the spine. Bone spurs are small and grow over a long period of time. They do not hurt. The growths occur naturally with age and friction from movement. Many people over 60 years of age have bone spurs without knowing it because they have no symptoms. However, when spurs put pressure on the nearby nerves or spinal cord, they can cause severe pain.

Bones spurs are located throughout the body. Most frequently, they occur in the spine, shoulder, hip, knee, and heel. Sometimes spurs form within the jaw, wrists, hands, and feet. When bone spur pain occurs in joints, it is often the result of osteoarthritis. Joints contain cartilage to protect the ends of the bones. Arthritis wears away this cartilage and bones rub against bones. New bone forms as a spur because of the irritation. It is actually the bone’s attempt to protect itself.

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More About Bone Spurs

lumbar foraminotomy

Bone spurs located along the spine are a common cause of back pain. The spine is made up of bones, called vertebrae, that protect the spinal cord. Discs are located between the vertebrae to allow flexibility and absorb the shock of everyday activities. Openings behind the disks allow nerves to travel from the spine to the rest of the body. When bone spurs grow on vertebrae, they can partially block these entries and put pressure on nerves. The result is often severe lumbar pain, sometimes including pain and numbness of the legs or arms.

When bones have spurs with pain along the spine, it usually occurs near the neck or lower back. Spurs near the neck commonly cause dull upper back pain, headaches, and neck stiffness. However, more serious cases may include searing pain and numbness or tingling along one shoulder and arm. Conversely, spurs on the lower back can lead to leg pain and numbness.

What Are the Symptoms?

Symptoms of bone spurs depend largely on the area where the growth is located, and sometimes the cause. Often, bone spurs occur as a result of other injuries. These injuries might contribute to the symptoms as well. While some bone spurs cause no symptoms, sufferers may notice problems in many different ranges of severity.

  • Joint pain – The affected joint may be stiff, painful, and hard to move. Difficulty bending the joint is common, and pain may increase with exercise.
  • Additional injuries – Bone spurs can cause damage to surrounding areas. This is common in the shoulder. When the new bone growth rubs against tendons, it can cause irritation leading to tendinitis and possibly tear the rotator cuff.
  • Bumps or knobs under the skin – Most noticeable in hands and fingers, spurs can be seen under the skin. Fingers are often difficult to move and have a knobby appearance.
  • Searing pain – Spinal bone spurs may cause severe back pain as nerves are compressed. Pain may radiate along shoulders, neck, and arms for cervical spurs. Similar pain may occur in the lower back, with pain moving down one or both legs.
  • Tingling and numbness – When spurs compress nerves, tingling or numbness may be felt in arms, hands, legs, or feet.

How Are Bone Spurs Diagnosed?

Doctors use many different tests to diagnose bone spurs. The severity of symptoms and location of bones spurs pain are the biggest factors in determining how to proceed.

Medical History- An important factor in diagnosis. It is important to clarify the severity and exact location of pain and other discomfort for proper treatment. Patients may be required to fill out a detailed questionnaire and mark the location of symptoms on a diagram.

Physical Examination– This is performed to discover the extent of stiffness and motion loss. The physician may feel around the joint to pinpoint bone spurs pain or find a bump that signals excess growth.

Diagnostic Imaging– There are several different imaging tests to confirm the diagnosis:

  • X-ray – An X-ray will give the doctor a clear view of the bones and joints. X-rays allow doctors to see if spurs have formed around the joints.
  • Computed Tomography (CT) Scan – A CT scan is a strong X-ray that can help doctors pinpoint the bone spur.
  • Magnetic Resonance Imaging (MRI) – MRI can show the bone spur as well as the effects to the surrounding tissue. MRI can also pinpoint if other problems are contributing to symptoms.
  • Electroconductive tests like EMG – Electroconductive tests determine how fast your nerves send signals. They can also show damage to nerves from bone spurs or rule out other sources of compression.

The amount of time it takes to make a diagnosis can vary. Sometimes inflammation must be diminished before imaging tests occur. It may take more than one test to diagnose bone spurs.

What are the Causes of Bone Spurs?

low back pain

Bone spurs occur naturally with age, strain, and wear to joints. There are other factors that may increase the likelihood of bone spur development.

  • Osteoarthritis – This is the most common form of arthritis. Symptoms include the loss of cartilage between bones in joints. The resulting friction creates spurs.
  • Injury – As joints or tissue recover from injury, bone spurs can form. Inflammation from tendonitis, arthritis, and degenerating disks can stimulate the cells that form extra bone deposits.
  • Improper posture – Improper posture can add extra strain to joints and discs.
  • Obesity – Extra weight adds strain to joints and makes the body more susceptible to injury.
  • Pre-existing conditions – Certain back conditions which cause degeneration of the vertebrae or discs may cause spurs to form as the body tries to heal itself.
  • Engaging in high impact sports – Impact can cause damage to joints and disks in the spine. As these injuries heal, bone spurs may form.

How Are Bone Spurs Treated?

Treatment and procedure options for Bone Spurs range from conservative options like injections to more intensive procedures like spinal fusions.

Conservative Options

Conservative treatment options include nerve root blocks and steroid injections. These are designed to provide temporary relief (up to one year), and you may elect to have the procedure done multiple times. Other conservative strategies may include the placement of a spinal cord stimulator–or STIM–which is designed not to correct the underlying degeneration, but to lessen the pain the condition causes.

Decompression

Minimally invasive decompression surgery aims to relieve pressure on the nerves of the spine. This pressure is often caused by stenosis, bulging or herniated discs, and more. Relieving this pressure can be achieved by reducing or removing soft tissue (disc material or scar tissue) or bone (bone spurs, a section of the lamina or foramina) to decompress the affected nerve. When the compression is caused by soft tissue material, a surgical laser may be used to shrink the impinging material.

Fusion/Stabilization

Fusion surgeries are similar in goal–to remove damaged disc tissue and fuse the bones together–but differ in approach, including the use of specialized hardware to reinforce stability, and the location used to gain access to the spine. A related procedure is an artificial disc replacement, in which a damaged cervical disc is replaced with a synthetic disc, and the vertebrae are not fused.

How Much Does Treatment Cost?

Treatment cost depends primarily on what insurance you have and how much of your deductible has been met. In the last 24 months, 90% of our patients have paid less than $2000 out-of-pocket. The average out-of-pocket cost is around $1600. Your Patient Care Manager will handle as much as they can with your insurance company directly, and all your costs will be presented for your up-front review.

Important note: spine surgery often pays for itself within a year or two. Many people actually spend more money trying to live with the pain than they do getting the pain fixed. The following calculator is intended to give you a sense of what you spend on managing—rather than eradicating—your pain.

 

Calculate how much you've spent on back pain this year.
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This past year you have spent on your pain treatment:

Get surgery now. Getting surgery now is the smartest financial move. Over the last two years, the average North American Spine patient spent around $2,000 out-of-pocket for treatment. You’ve spent that much or more this year to manage your back pain than you could to fix it.

Get surgery soon. Over the last two years, the average North American Spine patient spent around $2,000 out-of-pocket for treatment. At your current rate, you will spend that much or more within the next two years. The sooner you get treatment, the sooner it will pay for itself.

Keep an eye on your spending. Currently, you are managing your pain efficiently from a financial perspective but over time, your expenses could add up. Surgery should be strongly considered if you start missing more work or spending more on treatment medication.

Great job! You are spending very little on your back pain. Keep it up!

What Equipment is Used in the Diagnosis and Treatment of Bone Spurs?

Many types of equipment can be used to help diagnose and treat bone spurs.

  • Diagnostic equipment may include imaging machines for X-ray, CT scan, or MRI. These machines may be available at the physician’s office, or the tests may be scheduled at the hospital. An EMG is a different test that may use needles and electrodes to diagnose the severity of nerve compression or muscle weakness.
  • Equipment for treatment varies widely since the span of treatments are so diverse. Equipment for conservative treatments may include orthotic inserts or braces to relieve localized pressure. When Epidural injections are necessary, the doctor will use a live X-ray as well as specialized needles to deliver contrast dye for visibility and medication for treatment. Surgical equipment includes a small camera and small instruments to completely remove the bone spur while keeping the incision as small as possible.

How Do Bone Spurs Compare to Similar Conditions?

Bone spurs can cause pain that is similar to the symptoms of other conditions. Doctors may have to rule out the following conditions before diagnosing bone spurs.

  • Arthritis
  • Tendonitis
  • Bulging or herniated discs
  • Inflammation
  • Disc degeneration
  • Spinal stenosis

Bone spurs can also lead to more severe conditions. When bone spurs damage surrounding tissue, they may cause tendinitis or torn tendons, torn rotator cuff, sciatica, and compressed spinal nerves.

Some of these conditions occur alongside bone spurs or are the cause of their formation. However, these conditions can occur independently and often carry many of the same symptoms. For this reason, medical history and imaging tests are crucial for proper diagnosis in any of these conditions.

Analogy: A Good Boat

Barnacles are the bane of every boatman. On her maiden voyage, your boat is shiny and new and perfect. In time, however, those nasty little arthropods can attach themselves to the bottom of your boat and rudder and cause a bunch of problems – especially drag. That’s how bone spurs are, too: tenacious bony outgrowths brought on by wear and stress that can cause a lot of pain and slow you down.

Good Boat

Bad Boat

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