When bone spurs cause back pain, the symptoms can be similar to generalized arthritis, rheumatism, back strain, and muscle fatigue, as well as acute disc ruptures with nerve compression. The only way to get an accurate diagnosis—and appropriate treatment recommendations—is to consult with a medical professional.

Medical History and Clinical Exam

When a patient reports back pain, a physician will begin by taking a medical history and doing a clinical examination.

The physician may ask the patient to perform certain movements in order to test the spine’s range of motion and assess nerve function and muscle strength in the legs or arms. These clinical tests can help determine if symptoms are caused by spinal nerve and/or spinal cord compression or something else.


Medical Imaging

Diagnostic medical imaging may also be ordered:

  • X-rays of the spine can show bone spur formation and signs of spinal degeneration. X-rays can also help the physician determine if additional medical imaging, such as a CT or MRI scan, is needed.
  • Computerized tomography scan (CT scan) is the preferred test to accurately assess bony anatomy, especially in a spine that has had prior surgery. A CT scan provides multiple cross-sectional x-rays of the body. When used with contrast injected into the fluid that normally bathes the spine, the cerebrospinal fluid (located in the intrathecal space), CT scans better demonstrate nerves and soft tissue in addition to bone. A CT scan with contrast is called a CT myelogram.
  • MRI scan is the preferred test to observe soft tissues such as discs, nerve roots, ligaments, muscles, tendons and cartilage. Unlike x-rays and CT scans, MRIs do not involve radiation. MRIs take more time and tend to be more expensive than x-rays and CT scans.

Bone spurs may show up on these imaging tests, but that does not mean bone spurs are the cause of a patient’s pain. Rather, the results of medical imaging tests provide additional clues, allowing the physician to consider or rule out certain diagnoses.


Electrodiagnostic Tests

Occasionally, electrodiagnostic tests are ordered in addition to medical imaging. These tests are used to confirm the location and gauge the severity of a nerve injury.

The EMG and nerve conduction (EMG/NCV) tests may help determine if symptoms are due to compression of the spinal nerve or peripheral nerve. For example, the test may show whether symptoms affecting the hand stem from problems in the cervical spine or the compression of peripheral nerves in the wrist.

Dr. Ehsan Saadat is an orthopedic surgeon practicing with RasouliSpine at Cedars-Sinai Spine Center in Los Angeles, CA, where he is also the Director of Research. Dr. Saadat has been published in numerous peer-reviewed medical journals, and from 2015 to 2016 he was the Editor-in-Chief of The Orthopaedic Journal at Harvard Medical School.