Ask Dr. Santos: What Causes Bone Spurs on the Spine?
Learn about the causes of bone spurs—and find out when they should be treated.
The phrase “bone spur” conjures up images of pointy, painful growths. Certainly, bone spurs aren’t something that anyone wants growing on their spine. But these projections of bone, called osteophytes, are more common than you might suspect. And you may be surprised to learn that many osteophytes cause no symptoms at all. Spine surgeon Dr. Edward Santos describes what a bone spur is and explains the conditions that cause them to develop.
What is a bone spur?
“A bone spur is a bony growth that develops on the edge of a bone,” says Dr. Santos. “When we find them on the spine, they are typically a reaction to some form of instability along the facet joints. The body reacts to instability by laying down additional bone to stabilize the affected section of spine. Unfortunately, this attempt by our body to heal itself can backfire. If the additional bone begins to press against vulnerable nerve tissues, it can cause pain and even nerve damage.”
Who develops this condition?
“Everyone gets bone spurs,” states Dr. Santos. “Universally, all of us will develop them to varying degrees as we get older. Osteophytes are a byproduct of the normal aging process. As we get older, our spines undergo degenerative changes. Most of the changes take the form of some type of narrowing of the space between the bones in the spine. As the space between these bones, or facet joints, narrows, arthritis can develop. Arthritis triggers inflammation, and inflammation signals our body to lay down additional protective bone.”
What conditions increase formation of bone spurs?
Acknowledging that bone spurs are a normal part of the aging process, Dr. Santos notes that there are a number of conditions, in addition to age, that cause spurs to develop.
- Natural degenerative aging of the spine. “We have talked about the fact that bone spurs are universal,” says Dr. Santos. “All of us will develop them on our spines as we age.”
- “If you have arthritis, it can lead to the development of spurs,” notes Dr. Santos. “When we develop arthritis in our back, it’s often accompanied by some form of instability—or hypermobility—in the back. Your body responds by laying down more bone to stabilize the arthritic segment.”
- Genetic predisposition. “There’s evidence that lumbar disorders may run in the family,” Dr. Santos points out. “Research tells us that some individuals are born with a predisposition to developing osteophytes.
- Behaviors over a lifetime. “There is also literature suggesting that our activities throughout our entire life can actually accelerate the development of bone spurs,” notes Dr. Santos. “For example, people with physically demanding jobs that involve a lot of bending, twisting, or lifting may be predisposed to earlier degenerative spine changes. Manual activities can cause more loading and abnormal stress on the structures in lower back. Over time, this leads to earlier spine break down and degeneration.
- Traumatic injuries. “Spine trauma can also predispose people to bone spurs,” states Dr. Santos. “Examples of trauma include a fall or a motor vehicle accident. Injures like these can lead to an initial tear in a disc. Over time, with repeated wear and tear, the body may respond with a bone spur.”
What are the symptoms of a bone spur?
We will all get spurs eventually, but that doesn’t mean that all spurs cause symptoms. “Not everyone has pain with this condition,” states Dr. Santos. “Just because you have a spur doesn’t mean you’ll have pain or other medical problems as a result. The critical factor in symptom development is the location of the bone spur.”
If bone spurs form in a noncritical location where there are no nerves and no vulnerable structures, you may never know you have them. However, if they develop in a location where they press on vital structures like nerves, you may not be so lucky. “When spurs pinch nerves and other tissue structures, they become symptomatic,” explains Dr. Santos. “There are three main clinical symptoms: pain, numbness, and weakness in the extremities.”
Do asymptomatic bone spurs pose a risk?
“In general, if you have bone spurs that are not accompanied by any clinical symptoms, you aren’t at risk and you don’t need any treatment,” states Dr. Santos. “This is true even when spurs are clearly present on an X-ray, MRI, or CT scan. If the spurs aren’t causing symptoms, we do not need to treat them. Treatment decisions aren’t made based on imaging; they are made based on your entire clinical picture. That clinical picture includes your medical history, what you tell me about your symptoms, and the information provided by imaging. Together, this information gives me a holistic picture of your background and health.”
When should this condition be treated?
“If you have symptoms, I think it’s best to seek treatment,” advises Dr. Santos. “Pain should be evaluated so we can determine its source. It’s true that when you delay treatment for pain, there’s always a risk of permanent irreversible damage. However, it takes time for bone spur symptoms to cause permanent nerve damage. When people are in pain, they don’t typically delay medical intervention. Our Summit spine team is here to evaluate your symptoms, develop a comprehensive clinical picture, assess the risk of nerve injury, and recommend a treatment plan that’s right for you.”
Summit Orthopedics offers comprehensive spine expertise
Summit Orthopedics’ Spinecare program is recognized by the National Committee for Quality Assurance for the comprehensive expertise of our patient-centered care. Our back specialists diagnose spine problems and design custom treatment plans built on a conservative, nonsurgical approach. Most patients find relief through treatments including guided injections, specialized physical therapy, biofeedback, exercise, activity modification, and medication. When conservative care does not relieve symptoms, our highly skilled surgeons offer proven, evidence-based surgical options. Together with you, we will determine the right course of action.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Plymouth, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
More resources for you
- Meet Dr. Santos
- Learn more about how injections help diagnose back pain
- Check out Santos’ tips for fast back pain relief
“I am committed to providing the best care possible for all of my patients with spine disorders. I treat each and every patient as I would treat any member of my family. I believe that patients’ concerns and expectations deserve to be heard. I also believe in the importance of having a thorough discussion of both surgical and nonsurgical options, with the goal of relieving pain and restoring function.”
Ask the Expert: Injections Video Series
Ask the Expert: Spine Video Series
Time is not kind to the discs in our spine. Fortunately, most of us do not experience pain as our discs become less flexible over the years. When disc degeneration is accompanied by painful symptoms, Dr. Santos walks us through the medical evaluation we can expect.