If spinal bone spurs are determined to be the likely cause of back pain and other symptoms, there are a wide range of possible treatment options.
Nonsurgical Treatment for Bone Spurs
Most patients with mild or moderate nerve compression and irritation from bone spurs can manage their symptoms effectively without surgery. The goal of nonsurgical treatment is to stop the cycle of inflammation and pain.
Nonsurgical treatments include:
Medication, such as nonsteroidal anti-inflammatory medications (NSAIDs) and muscle relaxants may be recommended. Because of the risk of side effects, long-term use of medications should be approached with caution.
Short periods of rest
Activity may flare up inflammation in the joints. Short periods of rest can give inflammation time to recede.
Physical therapy and exercise
Physical therapy, exercise, and manipulation (performed by chiropractors [DC], osteopaths [DO], and physical therapists [PT]), may alleviate back pain associated with bone spurs. These rehabilitation therapies attempt to restore flexibility and strength to the spine, improve posture and decrease nerve root compression.
If the pain and inflammation caused by bone spurs is related to abnormal alignment and movement patterns in the spine, a spinal adjustment may help relieve symptoms. Chiropractors, osteopaths and physical therapists use their hands or small instruments to apply pressure over the skin of vertebrae and manipulate the spine. The goal is to increase range of motion, reduce nerve irritability, and improve function. Spinal manipulation is not appropriate for everyone. A careful medical history, physical examination, and discussion of the risks and benefits of manipulation should occur prior to this type of treatment.
Losing excess weight can take pressure off the spine, reducing friction between the vertebrae’s facet joints and decreasing the likelihood of pain. Achieving an appropriate weight is especially effective in taking pressure off the lower back.
Fluoroscopically guided, contrast enhanced spinal injection procedures that target the presumptive source of spinal pain can help decease pain and inflammation. In addition, depending on whether local anesthetic is used as part of the injection into the spine, the procedure can help an astute clinician identify or narrow down the source of a patient’s pain.
A spinal injection may not completely relieve a patient’s pain, but may provide enough relief to allow progression of rehabilitation. Patients should avoid receiving more than 3 injections into any one joint over a short period of time. In addition, if the first injection provides no relief, there is no evidence that further injections into the same structure will provide a better result.
If these nonsurgical treatments fail to treat pain due to bone spurs, a patient may be referred to a spinal surgeon.
Read more about Non-Surgical Osteoarthritis Treatments
Spine Surgery for Bone Spurs
Spine surgery may be recommended if nerve or spinal cord compression is causing unremitting pain and/or loss of motor/sensory function. Surgery for bone spurs involves removing tissue to relieve pressure on the spinal cord and/or nerves roots. For example:
Bone spur removal
During this surgery special tools are used to remove bone spurs from the vertebra(e).
Since it is possible for the bone spurs to grow back, and because there may be more than just bone spurs contributing to symptoms, a surgeon may suggest another surgical procedure, such as a laminectomy or foraminotomy.
A laminectomy is designed to relieve pressure on the spinal cord caused by central spinal stenosis. During surgery, a portion of the affected vertebra, called the lamina and spinous process at the back of the spine, is removed. With this small piece of the spinal canal wall removed, there is more room for the spinal cord.
A foraminotomy is designed to relieve pressure on a nerve root. Every nerve root passes through an intervertebral foramen, a bony, hollow archway between 2 adjacent vertebrae. During a foraminotomy, bone tissue around the foramen is cut away or shaved down, enlarging the foramen space. This procedure creates more space for the nerve root, relieving nerve root compression.
Whether or not a surgery will reduce or eliminate back or neck pain and other symptoms depends on the extent of the spinal degeneration; the patient’s overall health; and the patient’s commitment to rehabilitation; and other factors. The surgeon’s expertise and experience also play a role.
Patients considering surgery are advised to have maximized nonsurgical care options first and then, if surgery is considered, to have a detailed discussion with a spinal surgeon about risks and benefits.
Read more about Surgery for Osteoarthritis