What is an Osteophyte?
Written by Neil Badlani, M.D., Chief Medical Officer, North American Spine

Osteophytes are smooth and bony growths that can develop in many areas of the body. Neck and back bone spurs along the spinal are the most common, but an osteophyte may develop in other areas, such as:

  • Hands
  • Shoulders
  • Knees
  • Hips
  • Feet
  • Heels
  • Temporomandibular joint (TMJ)

These small, bony outgrowths are most likely to occur somewhere along the spine, either near the endplates of vertebrae or in the facet joints of the spine, typically where the cartilage has worn down. However, they can also develop at any joint between two or more bones, or wherever tendons, ligaments, or muscles are attached to bone.

The chances of developing osteophytes increase as you age. Generally, people who are 60 or older are at the greatest risk of forming osteophytes. An osteophyte is usually a symptom that indicates degeneration over time, as the ligaments in your body thicken in order to hold weakening bone together. This can cause calcification of the ligaments, which results in an osteophyte.

Osteophytes may cause neck, back, or joint pain, or they may cause no symptoms at all. They are usually a result of an underlying condition that causes the degeneration leading to bony outgrowths. In most cases where bone spurs cause health problems, it is because the spinal cord or a spinal nerve is being compressed, which can lead to radiating pain and weakness in the extremities.

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More About Osteophytes

lumbar foraminotomyWhy are osteophytes more likely to occur as you age? Spinal anatomy and function are the main contributors to this condition as related to degenerative aging. Your spine is composed of 32 segments that are separated by discs of ligaments and collagen, commonly called spinal discs, that allow for range of motion and flexibility in twisting, turning, bending, and stretching. As the vertebral segments move against the discs through normal life activity, the discs and joints degenerate over time, with bone spurs most likely to form after the age of sixty.

However, there are some contributing factors that may cause osteophytes to develop earlier. Poor posture and ergonomics are one of the major causes of early development bone spurs, but osteophyte growth can also be accelerated through poor nutrition, spinal or bone trauma, or certain hereditary or congenital conditions.

What Are the Symptoms?

In many cases, osteophytes do not come with any signs or symptoms. Often they are detected during examinations for other conditions, most typically through X-rays of the affected area. However, osteophytes can cause a number of warning symptoms depending on the location, size, and growth pattern of the osteophyte. 

  • Back or neck pain: Back and neck pain are the most common symptoms associated with osteophytes. Types of pain symptoms associated with an osteophytes typically include:
    • Pain that radiates into the shoulders, sometimes accompanied by headaches
    • Pain that radiates into the buttocks and thighs
    • Pain that radiates down the arms, sometimes accompanied with extremity weakness
    • Dull pain that occurs while walking or standing, usually in the lower back or neck

Typically, back and neck pain associated with osteophytes becomes worse when you’re engaged in activities, and better while you’re resting.

  • Other symptoms: Other common symptoms that may indicate osteophytes include generalized pain in the areas where osteophytes have developed, such as the hips, hands, knees, or feet. An osteophyte may also cause symptoms such as numbness or burning, or pins-and-needles sensations in the affected area. Muscle cramps, weakness, and spasms may also be present with bone spurs.
  • Severe osteophyte symptoms: An osteophyte that has worsened may compress the spinal cord or spinal nerves and cause more severe symptoms. This can include pain, numbness and tingling, or progressive weakness in one or both arms or legs, as a result of the cramped or pinched nerves.Limited range of motion and loss of balance can also result from the development of osteophytes, in cases where the osteophyte is exerting pressure against a nerve.

How Are Osteophytes Diagnosed?

Medical History– This includes questions about your overall condition and symptoms, family medical history, and any other existing medical problems that may be contributing factors.

Physical Examination– This will include steps such as range-of-motion testing, muscle strength checks, and tests to determine the pain levels you’re experiencing with motion.

Diagnostic Tests: These may include:

  • Radiographs (X-rays): Often an x-ray can indicate the presence of bone spurs and show whether the joint(s) have been affected by the growth.
  • Electroconductive tests: In the case of spinal bone spurs, your doctor may perform an EMG/NCV (electromyography and nerve conduction test) to examine the degree and the severity of the damage, if present.
  • CT and/or MRI scans: Imaging tests such as computerized tomography (CT) and magnetic resonance imaging (MRI) scans may also be used to aid in the diagnosis of bone spurs.

If you are experiencing back or neck pain, any osteophytes that are present may not be the actual cause of the pain. This is why imaging tests such as those mentioned above are often useful diagnostic tools because they help determine whether the pain is caused by the growths or the underlying condition that resulted in osteophytes.

What Are the Causes of Osteophytes?

low back pain

The predominant cause of osteophytes is prolonged stress or rubbing on a bone over long periods of time. This is typically caused through normal wear and tear of the body and spinal cord.

Often, osteophytes are caused as a result of another age-related, degenerative condition that affects bones, tendons, or ligaments. Common conditions that result in osteophytes include:

  • Osteoarthritis: A condition that wears away the layers of cartilage between bone joints, resulting in two bones rubbing directly against one another.
  • Spinal stenosis: A condition in which spinal bones are enlarged, resulting in a narrowing of the spaces in your spine and constriction of spinal nerves.
  • Tendonitis: Inflammation of a tendon, a condition that most often occurs in joints such as the elbows, wrists, and knees.

Aside from age-related degenerative conditions, osteophytes may is by a number of other factors and conditions. These include:

  • Joint or spinal trauma
  • Poor posture and/or poor ergonomics
  • Poor bone and joint nutrition
  • Some congenital or hereditary conditions

There are several risk factors for developing osteophytes. One primary factor is genetics — meaning those with family members who have developed an osteophyte are often at risk. In some cases, patients who suffer from diabetes may have an increased risk of osteoarthritis and related bone spur development.

How are Osteophytes Treated?

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 on several factors, especially what insurance you have and how much of your deductible has been met. IN the last two years, 90% of our patients have paid less than $2000 out-of-pocket. Some have paid literally nothing, and other have paid much more than that. It depends. The good news is: our Patient Care Managers will handle as much as they can directly with your insurance company, and all your costs will be known up-front.

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.

 

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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!

Equipment Used to Diagnose and Treat Osteophyte Growths

Aside from basic medical history questions and a physical examination, your doctor may use several different types of medical equipment in the diagnosis and treatment of osteophytes. These include:

  • X-ray machines (radiographs): Radiograph machines use x-rays, a type of electromagnetic radiation that is able to pass through the body and generate images of the interior structures, including tissues, organs, and bone. Radiographs can be used for diagnostic purposes, and may also be used to aid in administering cortisone shots to the hips or spinal column.
  • Electromyography machine: This machine is used to perform EMG/NCV tests. During an EMG, tiny needles attached to electrodes are inserted directly into muscle to record electrical activity and create a pattern called an electromyogram, which is then interpreted by your doctor.
  • CT scanner: This highly specialized x-ray machine is used to administer computerized tomography (CT) scans.
  • MRI scanner: Similar in appearance to a CT scanner, the MRI scanner uses magnetic resonance combined with radio signals and specialized computer software to create an image of the body.

How Does an Osteophyte Compare to Similar Conditions?

Several different medical conditions are often associated with osteophyte development. With osteophytes that develop along the spine, the growths may be associated with either certain spinal conditions or age-related degenerative disease, including:

  • Spinal stenosis
  • Osteoarthritis
  • Cervical radiculopathy
  • Lumbar radiculopathy
  • Ankylosing spondylitis
  • Diffuse idiopathic skeletal hyperostosis

A condition called plantar fasciitis, which causes the connective tissue along the bottom tendons of the feet to become inflamed, can be linked with osteophytes in the foot or ankle. Osteophytes present in joints are often related to aging or osteoarthritis, but can sometimes be caused by traumatic injury.

Additionally, those with diabetes may be at higher risk for osteophytes and osteoarthritis, although the connection between these is unclear.

Analogy: A 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 osteophytes 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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