Bone spurs in the neck (osteophytes) are bony growths that can be responsible for neck pain and back pain. These bone spurs may occur following a fracture of the vertebrae, due to rheumatoid arthritis, ligament degeneration, whiplash, or through general wear and tear resulting in spondylitis. When the spine is destabilized for some reason, be it an acute injury, degenerative disc disease, or other cause, this can cause the bones in the spine to grow in an effort to provide a wider surface to relieve instability. The downside of this bone growth is that the nerves and blood vessels in the spine may then become trapped or compressed leading to neck pain, ischaemia, and progressive muscle weakness when not addressed.
Causes of Bone Spurs in the Neck
Those who have suffered a whiplash injury are more likely to develop bone spurs in the neck over time due to the long-term damage that whiplash can cause to the ligaments and muscles that support the neck, as well as the bones in the spine themselves. Bone spurs are also more likely to occur in those with certain professions, such as gymnasts, surfers, construction workers, and some pilots who spend years experiencing excessive G-force and neck strain. Carrying excess body weight is another trigger for bone spur development as more pressure is exerted on the skeleton to hold up the bigger body mass. Where ligaments and tendons become inflamed or calcified these can also lead to bone spur growth as they may rub against the bones in the cervical spine causing damage and leading to osteophyte development as the bone tries to repair itself. Conditions such as plantar fasciitis are an example of this sort of degeneration.
Symptoms of Bone Spurs in the Neck
The symptoms of bone spurs in the neck can include neck pain itself, along with numbness or altered sensation in the neck, shoulders, jaw, face, upper back, and down into the arms and hands. A bone spur causing a pinched nerve in the neck will elicit different symptoms according to the nerve that is being put under duress. Some people may develop difficulty swallowing, or even breathing problems, if the laryngeal nerve becomes trapped and damaged, whereas others may develop an odd burning sensation in their little finger, followed by a numbness and weakness of the digit. Where bone spurs are causing blood vessel compression a patient may become dizzy or experience more frequent headaches if brain circulation is affected. Pain maps are helpful to physicians in determining the likely cervical spinal level at which a problem exists and this can then be confirmed by diagnostic imaging such as X-ray or magnetic resonance imaging (MRI) scan. In some cases the bone spur may itself be asymptomatic with a disc bulge or herniation the actual culprit of neck pain or radicular pain.
Treating Bone Spurs in the Neck
Neck pain due to bone spurs in the neck is unlikely to be alleviated by anti-inflammatory medications such as NSAIDs as the problems is mechanical rather than inflammatory. These drugs may reduce symptoms for some patients but neck surgery is usually the preferred method of treatment as it is important to decompress the cervical spine to allow nerves to heal before the damage becomes intractable. Where NSAIDs offer significant relief for the patient’s symptoms it is often a sign that the bone spur is not actually the cause of pain but, rather, another problem exists which is inflammatory in nature. A physician may use a selective nerve root block to determine whether a specific nerve in the neck is pinched and causing symptoms, although many surgeons are reluctant to carry out such a procedure due to the complex and tightly packed nature of the cervical spine.
In cases where a bone spur in the neck is deemed the cause of neck pain and/or radicular pain a foraminotomy may be carried out in order to open up the channel through which the cervical nerves exit the spine. The foramen are common sites of osteophyte growth and some minimally invasive back surgeries such as a microforaminotomy may be available to patients. More extensive bone spur growth, where multiple levels are implicated in neck pain, will generally require more invasive surgery to ensure the full removal of the osteophytes. The majority of patients who experience failed back surgery syndrome do so because of inaccurate diagnosis initially, or because not all of the compressing material in the spine was removed during surgery.
Other Causes of Bone Spurs in the Neck
Conditions such as Diffuse Idiopathic Skeletal Hyperostosis (DISH) can also be to blame for bone spur growth in the neck. In this condition, which involves abnormal cell division, the osteophytes actually occur in the ligaments of the neck causing them to harden and lose flexibility. In extreme cases the ligaments may need severing and the spine stabilizing through fusion, especially where tightened neck ligaments are causing an abnormal curvature of the spine to develop. Spinal curvature may also be a result of scoliosis, spondylosis, and ankylosing spondylitis, although scoliosis is usually more pronounced lower down in the spine.
In some cases the growth of bone spurs in the neck can actually be advantageous in slowing down or halting cartilage degeneration as they may stabilize the neck as the body itself intended. On occasion however, osteophytes may detach from the normal bone and these loose fragments from bone spurs in the neck can cause blockages in the synovial fluid or obstruction of proper joint movement, therefore requiring removal by surgery.