Osteophytes: Causes, Symptoms, Diagnosis, Treatment and Prevention

They are bony projections that develop at the edges of bones, usually where two bones meet.

Osteophytes are commonly called bone spurs .

They are usually caused by the wear of the bones over time or due to an underlying condition called osteoarthritis .

Generally, they are asymptomatic and, therefore, can not be diagnosed for years.

In general, they do not require any treatment and any treatment, if necessary, depends solely on the effect that the osteophytes have on the body of an individual.

If the painful symptoms of the osteophytes are reducing the quality of life of the patient, having a clear definition of the condition can give the knowledge and tranquility that is needed to start an effective treatment plan.

The denomination of “bony spurs”, does not adapt to the form of the affection since in fact they are not sharp nor have a spur, these are smooth growths of additional bone.

Osteophytes can have detrimental effects on the health and function of the spine.

Basically, the body produces osteophytes in response to a degenerated spine.

These bony spurs can infringe the foraminal spaces through which the spinal nerves pass and cause painful nerve compression.

Causes

Wear and tear over time and osteoarthritis are the main causes of bone spurs or osteophytes.

Osteoarthritis erodes the cartilage that provides a cushion to the bones and, therefore, the body tries to repair it by creating what are called bone spines.

Among the most common causes we can mention:

  • Degenerative disc disease: The cartilaginous discs between the adjacent vertebrae begin to deteriorate and lose elasticity.
  • Osteoarthritis: The cartilage that surrounds the facet joints (joints that connect the vertebrae) wear out.
  • Aging: As you age, the osteophytes will naturally develop along the spine and only a small percentage of patients experience the painful neuronal compression that this condition results in.

symptom

Generally, bone spurs or osteophytes are asymptomatic and are very difficult to diagnose.

They are usually diagnosed incidentally when radiographic studies are done for some other medical condition.

Rarely, osteophytes may cause some pain or discomfort in conjunction with a decreased range of motion of the affected joints.

The symptoms for different types of joints that are affected are:

  • The knees: If there is the formation of bone spurs or osteophytes in the joints of the knee, then there is a pain in the knee with a range of motion of the knee decreased.
  • Hips: The formation of osteophytes in the hips, it can be difficult for an individual to move the hip without causing pain. The range of motion of the hip can also be affected.
  • Shoulders: If osteophytes are present on the shoulders, they can cause irritation of the rotator cuff muscles when rubbed, which causes swelling and pain in the shoulders. It can also cause tears of the rotator cuff.
  • The spine: If the osteophytes have formed in the spine, these can cause narrowing of the spinal canal.

Bone spurs can produce a wide variety of symptoms, depending on the region of the spine where they develop:

  • Cervical (neck):  Pain or tingling in the neck, shoulders, upper arms and hands.
  • Thoracic (middle back):  Upset or weakness that surrounds the rib cage and kidneys.
  • Lumbar (lower back):  Numbness and compression of the nerve root, radicular pain or localized in the buttocks, legs and feet with signs of weakness of the extremities.

Diagnosis

To identify the osteophytes, the treating physician may perform a physical examination to look for the source of the pain.

Osteophytes can sometimes be felt, but it is not as common.

To confirm the diagnosis of the osteophytes, the attending physician will perform an exploratory examination, palpating the joints to locate a bone spur.

It will also order radiological studies such as radiographs, MRIs, and tomographies of the affected area to observe the joints and see if there are bone projections that, if found, will confirm the diagnosis of osteophytes.

Treatment

For most patients, the symptoms of osteophytes can be successfully managed with conservative methods, such as massage, physical therapy or medication.

However, a small percentage of patients will not find these treatments effective and may begin to consider more specific forms of pain relief.

In cases where these bone spurs or osteophytes begin to cause joint pain, then the attending physician may prescribe treatments.

Symptoms can sometimes be managed with conservative treatment.

Some examples of treatment options that can be recommended include:

Medicines:

Among the pain medications, possible treatments include anti-inflammatories, muscle relaxants and analgesics, with non-steroidal anti-inflammatory drugs, such as ibuprofen or Aleve.

Physical therapies:

In addition to rest, physical therapies can also be prescribed such as:

  • Cold / heat therapy.
  • Low impact aerobic exercises (stationary bicycle, swimming, walking among others).
  • Stretching exercises.
  • Physiotherapy.

Cortisone injections:

These treatment options can provide some relief and when these fail to resolve the problem, corticosteroid injections may be recommended.

These can reduce inflammation and pain in the joints. However, the effects of this treatment are usually temporary and sometimes it is necessary to repeat them.

Diet:

Within the nutritional and dietary recommendations are:

Avoid the consumption of fried foods, sausages, red meats, cow’s milk, refined foods such as flour and white sugar.

It should increase in the diet fresh and raw vegetables, which help to remineralize the body and help to restructure the tissues.

You should consume blue fish rich in omega-3, such as salmon and tuna, shark cartilage is excellent for joint health.

If a patient has suffered a bone spur for more than three months, the condition has restricted the normal movement of the joint, causing other serious difficulties, and conservative treatment has not been able to resolve the problem.

Surgical treatment:

These procedures offer a variety of surgical techniques for the treatment of spinal osteophytes (bone spurs) and will vary depending on the location of the bone spur.

Techniques for this type of treatment may include:

Foraminotomy or Foraminectomy:

A foraminotomy is a decompression surgery performed to increase the space of the foramen and hollow the passage where the nerve roots leave the spinal canal.

The procedure involves the removal of bone or tissue that obstructs the neuroforamen and compresses the nerve roots, which is causing inflammation and radiating pain.

Removal of part of the lamina is often necessary for the surgeon to access the affected nerve roots in the neuroforamen.

For this reason, the foraminotomy is often performed together with a laminectomy or laminotomy.

Laminectomy or Laminotomy:

A laminectomy is designed to relieve pressure (decompression) on the spinal cord or the roots of the spinal nerves through widening of the spinal canal.

The procedure is carried out by removing or cutting part of the lamina (roof) of the vertebrae in the compressed area.

The removal of part of the lamina creates an opening for the compressed nerves, relieving pressure on the nerve roots and reducing inflammation.

Partial removal of the lamina may also allow the surgeon to remove any bone spurs or other damaged tissue that causes pain and inflammation in the patient.

Resection of bone spurs:

A resection of osteophytes is a procedure that removes bone spurs or enlarged ligaments that compress the nerves.

Prevention

As bone spurs often occur due to the natural aging process, one of the first steps in prevention is changes in lifestyle.

Some ways to prevent bone spurs include:

  • Do regular exercises.
  • Eat a healthy diet, rich in vitamins and calcium.
  • Decrease the risk of injury when playing sports.
  • Properly lift any heavy object.
  • Avoid or limit the consumption of alcohol and cigarettes.

Those patients who have bone spurs can benefit from attitudes that prevent the appearance of bone spurs, such as resting, completing cold or hot water therapy at home, modifying their daily activities and using support devices for the back, among others.