Many people are told they have osteophytes, aka bone spurs, when they complain of back or neck pain. More often than not, the inflammation they cause is visible, with lumps protruding from the bones. Still, bone spurs are simply a sign of bone degeneration, and not necessarily the actual reason behind the pain.
As the name suggests, they are spur-like projections that develop around bone edges, usually in the joints or on the vertebrae. They aren't exactly spur-shaped, though, and they don't stick out or poke nearby tissue. Their surfaces are smooth and rounded, and they develop over many, many years.
Osteophytes are a sign of bone degeneration, which in laymen's terms means they indicate the fact that the bone is aging. In other words, they are to be expected with age, and most elderly people's MRI scans or X-rays will show that they've developed them in time.
While they can grow from any bone in the body, they tend to occur mainly in the neck, shoulder, lower back, knee, foot, fingers and toes. Spinal bone spurs are slightly different for all the other types because of the structure of the cartilage in between vertebrae, but the principle behind it is the same throughout the body.
The shock-absorbing collagen disc between the vertebrates and the cartilage between our bones, which is like a gel that enables us to move and bend, hides nerve root openings underneath. When osteophytes develop in these nerve roots, they press on the nerves; hence the pain.
They tend to occur with joint damage, and are, therefore, linked to osteoporosis. Because they're found in places that are affected by arthritis, they're also linked to osteoarthritis. This is when the cartilage mentioned previously, which is the soft tissue at the edge of bones where joints meet and rotate in their sockets. Bone spurs can grow from the bone and pierce through this cartilage, limiting the movement of the bones.
Bone spurs can also occur due to ankylosing spondylitis, which is a type of arthritis of the spine. Another condition that osteophytes tend to develop alongside of is spinal stenosis.
The main cause of bone spurs is the natural process of aging, or more specifically, it's due to the cartilage wearing down with time. In some cases, the bone or disc degenerations can have other causes, though. Heredity, nutrition and poor posture have also been given as facilitating factors, as have injuries or congenital conditions.
Most people with osteophytes don't show any symptoms, so their condition can go undetected. However, when the spurs rub against nearby bones, other tissue or nerves, they can cause discomfort. They can also make their presence felt when they restrict movement.
Osteophytes, as such, don't normally cause any pain. In fact, it's the underlying arthritis that tends to cause the pain. Depending on their location, they can cause various symptoms.
In general, they cause burning, tingling, dull pain when standing or walking, loss of coordination and control, muscle spasms, cramps, numbness, muscle weakness, radiating pain in the thighs and buttocks when they're found in the lower back, or headaches and radiating pain in the shoulders when the affected bone is in the neck.
They can cause numbness, pain or pins and needles in your arms if they're located in the neck, for instance, where they can pinch your nerves. If you have spurs in your shoulders, you could also have rotator cuff tear or tendonitis because the spurs take up space that your tendons and ligaments need. In severe cases, the pain can lead to incontinence, or at least some degree of bladder and bowel control loss.
Those who have bone spurs in the spine have a stiff back or considerable pain because of them. When they're found in the hip or knee, they can cause pain when you extend or move your leg, or limit the amplitude of your movements and strides. Those who have this type of bone spur tend to also have arthritis. Finally, people who have osteophytes in their fingers complain of visible lumps that can be painful and can limit their functionality.
For people with osteophytes, any form of activity may make the pain worse, so they tend to rest when there's any pain. Those with back pain may find that leaning forward, in such a way as if they had a shopping cart in front of them, tends to alleviate the pain.
See your GP at the first sign of pain or stiffness in your joints. They will investigate the cause by asking for an account of your medical history, giving you a physical examination and testing your muscles and joint movements.
Should you be referred for an X-ray, you may then have a visual representation of your joints and osteophytes, but if the doctor suspects that there may be torn ligaments and tendons, they may ask for an MRI on your behalf.
Because this is a very common condition for people over 60 years of age and it doesn't usually cause pain, nothing usually needs to be done about bone spurs. Still, just above 40% of the people who develop the condition do, at some point, need some form of medical treatment in their lives.
Osteophytes may not require treatment. Because they don't usually cause any pain, more often than not, doctors will not prescribe any medicine. Also, the recommended course of treatment may depend on the location and the level of pain caused by the bone spurs.
If they cause any discomfort or pain, some over-the-counter medicine may be required to manage the pain, though. Paracetamol and ibuprofen are the two painkillers usually taken by sufferers. Because ibuprofen is an anti-inflammatory with long-lasting and nearly immediate effect, it tends to be the painkiller of choice.
People who are overweight can also find some relief in losing weight, because that takes some pressure away from the joints. If the range of movement around the joint is very limited, a physiotherapist may help strengthen the muscles to regain some of your flexibility.
If the underlying arthritis is severe, surgery may be the best option. If your pain is due to spurs at the base of the thumb, or in your hips or knees, surgery may be particularly welcomed. Removing a single osteophyte through surgery is usually not very effective, but if the bone spur pinches a nerve or seriously restricts joint movement, then it may be recommended.