Bone spurs (osteophytes) and back pain
Introduction
Many patients are told that they have "bone spurs" in their back or neck,
with the implication that the bone spurs are the cause of their back pain.
However, while bone spurs are an indication that there is degeneration of
the spine, these bony growths are not usually the actual cause of the pain.
The term "bone spurs" is really a bit of a misnomer, as the term "spurs"
implies that they are "poking" some part of the spinal anatomy and causing
pain. However, this is not at all true. Bone spurs are in fact smooth
structures that form over a prolonged period of time.
The medical term for bone spurs is osteophytes, and they represent an
enlargement of the normal bony structure. Basically, osteophytes are a
radiographic marker of spinal degeneration (aging) and are by and large a
normal finding as we age. Over the age of 60, bone spurs are actually quite
common.
It must be stressed that degeneration of the spine occurs in all persons to
some degree. However, for 42% of the population, degeneration and
development of bone spurs will lead to symptoms of neck and back pain,
radiating arm and leg pain and weakness in the extremities during their
lifetime.
Anatomy and formation of bone spurs
The human spine is made of thirty-two separate vertebral segments that are
separated by intervertebral discs made of collagen and ligaments. These
discs are shock absorbers and allow a limited degree of flexibility and
motion at each spinal segment. The cumulative effect allows a full range of
movement around the axis of the spine, especially the neck (cervical) and
lower back (lumbar spine).
Motion between each segment is limited by the tough outer disc ligaments and
the joints that move (articulate) at each spinal level (the facet joint).
Under each joint, just behind the disc, is a pair of nerve roots that exit
the spinal canal. The exiting hole (foramina) that surrounds the nerve (disc
in front, joints above and below) is relatively small and has little room
for anything besides the exiting nerve.
Normal life stressors compounded by traumatic injuries to the spinal
architecture cause degeneration in the discs and the joints of the spine.
With age, injury, poor posture there is cumulative damage to the bone or
joints of the spine:
        As disc material slowly wears out, ligaments loosen and excess
motion occurs at the joint.
        The body naturally and necessarily thickens the ligaments that hold
the bones together.
        Over time, the thick ligaments tend to calcify, resulting in flecks
of bone or bone spur formation.
        As the central spinal canal and the foramina thicken their
ligaments, compression of the nervous system causes clinical symptoms.
Degenerative changes to our normal vital tissue begin in early adulthood,
but usually this slow process does not present with nervous system
compression until we are in our sixties or seventies. Factors that can
accelerate the degenerative process include:
*       Congenital or heredity
*       Nutrition
*       Life-style, including poor posture
*       Traumatic forces, especially sports related injuries and motor
vehicle accidents
As always, to help avoid or minimize back pain it is generally advisable to
stay well conditioned (both in terms of aerobics and strength) and to
maintain good posture throughout one's life.
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