A bone spur — the clinical term is osteophyte — is a smooth bony projection that grows along vertebral edges and spinal joints in response to mechanical stress or degenerative change. Bone spurs are common, not always painful, and in most cases treated without surgery. A clinical evaluation determines whether one is driving your symptoms.

  • Definition: Bony projection (osteophyte) at vertebral edges or facet joints from chronic load or disc degeneration
  • Causes: Degenerative disc disease, osteoarthritis (spondylosis), spinal instability, prior injury
  • Symptoms: Pain, radiculopathy, numbness, or weakness — only when the spur compresses a nerve or narrows the canal
  • Non-surgical care comes first: Physical therapy, injections, and biologic disc repair address the degeneration driving spur growth
  • Surgery is not the default: Back surgery carries roughly a 40% failure rate — non-surgical management is appropriate for most patients

What Is a Bone Spur?

A bone spur is a smooth, bony overgrowth along the margins of a bone, particularly at spinal joints. Osteophytes are not sharp and do not cut through tissue. They form because the body lays down new bone to stabilize a joint under repeated stress or after cartilage loss — an expanded bony surface that can encroach on surrounding structures when space is limited.

In the spine, osteophytes grow most often at the edges of vertebral bodies and along the facet joints at the back of each spinal level. They are a hallmark feature of lumbar spondylosis and cervical spondylosis, the umbrella terms for age-related degenerative spinal change.

What Causes Bone Spurs to Form?

When a spinal joint or disc faces abnormal or repetitive stress, the body activates bone-building cells (osteoblasts) at the affected margins. Over years, a visible bony projection develops. Common triggers:

  • Degenerative disc disease — As discs lose height, vertebrae bear abnormal loads. Osteophytes form along vertebral edges in response.
  • Facet joint osteoarthritis — Cartilage breakdown triggers reactive bone growth around the joint margins.
  • Spinal instability or prior injury — Abnormal segmental motion concentrates stress at specific levels, accelerating osteophyte formation there.
  • Ligament ossification — The posterior longitudinal ligament and ligamentum flavum can calcify under chronic stress, a related but distinct process.

Osteophytes appear on imaging in a large proportion of adults over 50. Their presence on an X-ray does not automatically mean they are causing pain.

What Symptoms Do Bone Spurs Cause?

Many bone spurs are asymptomatic — found incidentally on imaging. A spur becomes clinically significant when it encroaches on neural tissue:

Spinal stenosis — Osteophytes narrowing the central spinal canal compress the spinal cord or cauda equina. Non-surgical treatments for spinal stenosis are the appropriate first step for most patients. Symptoms include leg pain or weakness that worsens with walking and improves with sitting.

Radiculopathy — Osteophytes narrowing the foraminal opening compress the exiting nerve root, producing radiating pain, numbness, or weakness in a specific arm or leg distribution.

Treatment decisions are always based on symptoms and functional limitations — not imaging findings alone.

Expert Take

Our clinical team routinely sees patients convinced their imaging proves the bone spur is the problem. Imaging correlation matters, but symptoms guide treatment. A large osteophyte with no corresponding symptom pattern is not an indication for intervention. We evaluate the full clinical picture before recommending any course of care.

How Is a Bone Spur Diagnosed?

  • X-ray — Shows osteophytes on bone surfaces; good for initial identification.
  • MRI — Provides detail on nerve compression, disc involvement, and soft tissue that X-ray misses.
  • CT scan — Useful when precise bony anatomy is needed.
  • Neurological exam — Reflex testing, motor strength, and sensory assessment confirm objective nerve compression signs.
  • Symptom mapping — The provider looks for a logical anatomical match between spur location and symptom distribution.

What Are the Non-Surgical Treatment Options?

For most patients, non-surgical spine treatment controls symptoms effectively. Common approaches:

  • Physical therapy — Strengthens stabilizing muscles, reducing mechanical load on joints where spurs have formed.
  • Epidural steroid injections — Reduce nerve root inflammation. An AAFP systematic review found them not effective for chronic low back pain on their own; they work best as part of a broader plan.
  • Activity modification — Adjusting movements that load affected segments reduces pain and slows further degeneration.
  • Biologic disc repair — When disc degeneration drives osteophyte formation, addressing disc health targets the root cause. An FDA-approved fibrin sealant delivered via intra-annular injection repairs annular tears and restores disc structure. More than 13,000 of these procedures have been performed nationally, with an 83% success rate in tracked long-term outcomes. A clinical evaluation is the only way to know whether this approach fits your situation.

Expert Take

Patients with bone spurs often arrive after years of managing symptoms with medication and injections alone. When disc degeneration is the source of the mechanical stress that built those spurs, treating only the downstream nerve inflammation is incomplete care. The Valor team evaluates whether addressing the disc itself creates better long-term outcomes — starting with a consultation, not a surgery schedule.

When Should You Seek an Evaluation?

  • Pain radiates into an arm or leg and does not improve with rest
  • Progressive numbness, tingling, or muscle weakness
  • Bladder or bowel changes alongside back or neck pain (warrants urgent evaluation)
  • Conservative self-care has not improved symptoms within several weeks
  • You have been told surgery is the next step and want to understand all options first

Nearly 1 in 5 patients told they need spine surgery choose not to have it after a second opinion. A clinical evaluation is the only way to know which treatments apply to your situation. If disc degeneration is driving your symptoms, a biologic disc repair evaluation is worth discussing at your consultation.

Frequently Asked Questions About Bone Spurs

Can bone spurs be treated without surgery?

Yes. The large majority of patients respond to non-surgical care: physical therapy, targeted injections, activity modification, and biologic disc repair when disc degeneration is the driver. Surgery is warranted only for severe nerve compression or myelopathy that has not responded to conservative care.

Do bone spurs go away on their own?

No. Once formed, osteophytes do not resorb on their own. However, the symptoms they produce are often managed effectively without removing them. Many patients achieve lasting relief through non-surgical care.

Are bone spurs a sign of arthritis?

In most cases, yes. Spinal osteophytes are a hallmark finding in osteoarthritis — specifically spondylosis — the degenerative breakdown of joint cartilage and disc material with aging. They are not caused by rheumatoid arthritis, which operates through different mechanisms.

What is the difference between a bone spur and a disc herniation?

A bone spur is a hard bony projection from the vertebra. A disc herniation is a soft-tissue event — the inner disc nucleus pushes through the annular ring and contacts nerve tissue. Both cause radicular symptoms and frequently coexist in adults with degenerative spine conditions.

Can bone spurs cause paralysis?

Severe central canal stenosis can compress the spinal cord directly, producing myelopathy — weakness, coordination problems, or bowel and bladder dysfunction. Myelopathy warrants urgent evaluation. Most patients present well before reaching this severity.

Sources

This content is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified physician. Treatment decisions depend on your individual medical history and clinical findings. Schedule a consultation to discuss whether the procedure is right for you.

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