Dr. Kaixuan Liu with Atlantic Spine Center discusses bone spurs, how they're removed and what to expect during recovery.
Bone spurs can develop in several parts of the body, but when they grow on the spine and cause severe symptoms, removing them is an option. Luckily, the recovery time from this surgical procedure usually proceeds quickly and smoothly, according to Endoscopic Spine Surgeon Dr. Kaixuan Liu. Typically developing over time due to stresses in the spine, for example those that occur with injury, aging or arthritis, bone spurs in the back or neck can become painful if they grow inward, pressing on nerve roots. When that happens, nerve pain can range from mild to severe and should be evaluated by a doctor, says Dr. Liu, who is fellowship-trained in minimally invasive spine surgery.
"As a bone spur develops and starts to compress surrounding nerves and blood vessels, symptoms such as numbness, tingling and pain often follow," he explains. "When the condition worsens, severe nerve compression can even result in muscle weakness and a loss of coordination that make bone spur removal surgery a logical choice. In rare cases, the compression can affect bowel and bladder function as well as cause numbness in and around the groin area, signaling a medical emergency that requires immediate surgery."
What are spinal bone spurs?
The name "bone spur, or osteophyte," would imply that they are sharp but smooth bony growths that occur over a long time. The bone spurs or osteophytes alone are not painful, but their effect on other structures, such as nerves or the spinal cord, causes pain. Your spine contains 33 vertebrae, and between each one is a gel-like disc that cushions the area between the bones. If the discs become worn, the bones will wear on each other. This causes bone spurs to grow to repair the damaged bone. There are small openings in each disc and vertebrae, called foramen, that enables a path for nerve roots to leave the spinal cord and go to other parts of the body. These openings are just large enough to allow the nerves to go through. Bone spurs or osteophytes can narrow the gaps and cause nerve pressure, causing pain and reduced function.
How are bone spurs removed?
After a thorough diagnostic process that may involve a physical examination, nerve sensation tests and imaging scans, spinal bone spurs are typically treated conservatively at first, Dr. Liu says. Non-surgical treatment often includes measures such as taking NSAIDs (nonsteroidal anti-inflammatory drugs) and other pain medications, physical therapy, rest, activity modifications, and sometimes epidural steroid injections.
If after 6 to 8 weeks of conservative treatment fail to relieve spinal bone spur pain and it's severely limiting your activities, bone spur removal surgery may be warranted, Dr. Liu says. The go-to surgical procedure for the problem is known as an "endoscopic foraminotomy", a minimally invasive, same-day procedure that doesn't require general anesthesia. "The surgeon makes a small incision in the back to insert an endoscopic tube, through which the surgeon can access the bone spur and clean it away using surgical tools," he explains. "Endoscopic foraminotomy is a highly effective surgery for bone spur removal and comes with a high success rate."
Causes
The most common cause of bone spurs is joint damage from injury or disease. When the cushioning between your joints becomes damaged and bone-to-bone contact, bone spur growth is likely. Rheumatoid arthritis, osteoarthritis, lupus, gout, or other joint damaging diseases can lead to bone spurs. Other causes include.
- Genetics: If they run in your family, you may be at risk for bone spurs
- Overuse of the joints: soft tissue damage from overuse and arthritis can cause bone spurs
- Poor posture: excessive lifting or twisting
- Narrowing of the spine: If the opening of the spinal column narrows, friction and inflammation can lead to bone spurs
- Obesity: Extra weight puts pressure on the bones in your spine
Dr. Kaixuan Liu with Atlantic Spine Center discusses bone spurs, how they're removed and what to expect during recovery.
Bone spurs can develop in several parts of the body, but removing them is an option when they grow on the spine and cause severe symptoms. Fortunately, the recovery time from this surgical procedure usually proceeds quickly and smoothly, according to Endoscopic Spine Surgeon Dr. Kaixuan Liu. Typically developing over time due to stresses in the spine, for example, those that occur with injury, aging, or arthritis, bone spurs in the back or neck can become painful if they grow inward, pressing on nerve roots. When that happens, nerve pain can range from mild to severe and should be evaluated by a doctor, says Dr. Liu, who is fellowship-trained in minimally invasive spine surgery.
"As a bone spur develops and starts to compress surrounding nerves and blood vessels, symptoms such as numbness, tingling and pain often follow," he explains. "When the condition worsens, severe nerve compression can result in muscle weakness and a loss of coordination, making bone spur removal surgery a logical choice. In rare cases, the compression can affect bowel and bladder function and cause numbness in and around the groin area, signaling a medical emergency requiring immediate surgery."
Spinal bone spur and osteophyte symptoms
- Burning, tingling, "pins and needles" in hands or feet.
- Dull pain in your neck or back when you stand or walk.
- Numbness, muscle weakness.
- Loss of coordination in a part of your body.
- Radiating pain in your buttocks or thighs.
- Muscle spasms or cramps.
- Radiating pain in your shoulders.
- Headaches.
- Difficulty controlling your bladder or bowels.
How can they cause pain?
- Bone spurs can cause vertebrae to grind, causing inflammation and pain.
- If the nerves become inflamed, pain can result.
- If the osteophytes grow into the spinal canal and cause pressure on the spinal cord, pain and other symptoms may occur.
Spinal bone spur diagnosis
- X-rays of the spine can not only portray bone spur formation but may show if other diagnostic tests are needed.
- CT scans can show bone and soft tissue, such as nerves.
- MRI scan allows for observation of soft tissue such as discs, cartilage, muscle, tendons, nerve roots, and ligaments.
- Electrodiagnostic tests to show the severity of nerve damage.
Non-Surgical Treatment for bone spurs
- Spinal injections can relieve pain to allow you to start an exercise and activity regimen to help strengthen your spine. Physical therapy for bone spurs usually begins with cold compresses in the first 24-48 hours in conjunction with over-the-counter NSAIDs that can reduce inflammation and lessen pain. Short-term rest followed by physical therapy and exercise may improve mobility and strengthen the spine, which can help take pressure off the vertebrae and reduce symptoms. Weight loss can also help by taking the added strain off your bones.
- Physical therapy for spurs in the shoulder is treated much the same as bone spurs in the spine. The arm can be more easily isolated from daily activity, so short-term rest for the limb should be easier to achieve.
- Physical therapy for bone spurs in the neck is treated much the same as bone spurs in the spine.
Bone spur removal surgery
- If after 6 to 8 weeks of conservative treatment fail to relieve spinal bone spur pain and it's severely limiting your activities, bone spur removal surgery may be warranted, according to Dr. Liu. The go-to surgical procedure for the problem is an "endoscopic foraminotomy," a minimally invasive, same-day procedure that does not require general anesthesia. "The surgeon makes a small incision in the back to insert an endoscopic tube, through which the surgeon can access the bone spur and clean it away using surgical tools," he explains. "Endoscopic foraminotomy is a highly effective surgery for bone spur removal and comes with a high success rate."
Risks of non-treatment
- Not treating spinal bone spurs can lead to chronic pain, numbness in limbs, loss of movement, activity loss, and loss of bladder and bowel control, and can even cause permanent nerve damage.
What can you expect from recovery?
Because an endoscopic foraminotomy to remove spinal bone spurs doesn't require general anesthesia or an overnight hospital stay, patients get a head start on recovery. "Many patients remark that their bone spur symptoms in their leg or arm are already improving even as the procedure is being completed," Dr. Liu says. A Full recovery from bone spur removal can take roughly 10 days to a few weeks, he notes. And much of that recovery timeline is up to the patient. "Following your doctor's guidelines for activities to avoid or exercises to do to help your spine heal properly is very important," Dr. Liu says, noting that recovery time would be longer if a more invasive type of surgery is necessary to remove the bone spur. "It's key to be patient as you recover,' he adds. 'Doing too much too soon can slow your recovery time and make getting better much harder. But the good news is that bone spur removal surgery in the spine greatly helps the vast majority of patients quickly get back to living with no pain and more enjoyment of everyday activities."
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