There are more than 100 joints connecting the body's 206 bones. Most of the major bone connections in the body are joints designed to allow a broad range of motion. There are different kinds for different functions: ball-and-socket (hips and shoulders), saddle joints (which connect thumb to hand), hinge joints (fingers and knees) or pivot joints (wrists).
Tied together by ligaments, the bones of joints are capped with a smooth substance called cartilage. This tough elastic material acts as a shock absorber and allows the bone ends to glide smoothly across each other. If the cartilage is destroyed (as in osteoarthritis), the bones of a joint can grind against each other causing pain, loss of mobility, deformity and dysfunction.
Between the bones is a joint cavity, which gives the bones room to move. The joint space between two bones is enclosed by a capsule that's flexible, yet strong enough to protect the joint against dislocation. The inner lining of this capsule, the synovium, produces a thick fluid that lubricates and nourishes the joint. In many forms of arthritis, the synovium becomes inflamed and thickened, producing extra fluid which contains inflammatory cells. The inflamed synovium and fluid can damage the cartilage and underlying bone.No one knows what causes arthritis, though scientists have uncovered a host of clues. Something can be done to manage most forms of arthritis, but it's very important that a correct diagnosis is established early. Most therapies work best when started early in the disease process.
Symptoms related to the development of bone spurs include:
Osteoarthritis;
Medical providers often refer to the changes as spinal arthritis or osteoarthritis of the facet joints, and this condition is a common cause of back pain in the older patient population (over 55 or 60). This condition can cause stiffness and lower back pain that is usually worse in the morning, gets better after moving around, then gets worse again at the end of the day.
The most common root cause of cervical and lumbar arthritis is repetitive trauma to the spine from recreational or work related excessive strains. Patients may typically develop symptoms of osteoarthritis in their mid 40’s to early 50’s. Men are more likely to develop arthritic related symptoms earlier in life, however postmenopausal women with stiffening spines (accelerated bone spur formation) rapidly approach men in incidence and severity of osteoarthritis.
Spinal stenosis;
Also, enlargement of the bone can sometimes lead to narrowing of the spinal canal and result in spinal stenosis. This condition can cause nerve pinching, leading to pain down the legs that is worse when the patient stands and walks, and is better when sitting. Spinal stenosis cannot be prevented but it certainly can be cured.
Clinical symptoms of bone spurs;
Back pain or neck pain is very common as the facet joints are inflamed and the neck and back muscles become irritated. Patients usually complain of:
Dull pain in the neck or lower back when they stand or walk
Radiating pain into the shoulders (often including headaches) if the cervical spine is affected, and rear and thigh if the lumbar spine is affected
The symptoms of bone spurs are made worse with activity and often improve with rest. Lumbar arthritis symptoms often improve when an individual is bending forward and flexing at the waist, such as leaning over a shopping cart or over a cane.
As the nerves become compressed, patients with bone spurs complain of several symptoms including:
Pain in one or both arms or legs
Numbness or tingling
Progressive weakness
If the arthritic processes and stenosis is severe, progressive bowel and bladder dysfunction occurs
Symptoms described above can also be caused by medical conditions other than bone spurs, such as diabetes, poor blood circulation to the arms and legs, spinal tumors, fractures, and spinal infections. Many of the symptoms of bone spurs are similar to generalized arthritis, rheumatism, back strain and muscle fatigue, as well as acute disc ruptures with nerve compression.
Diagnosis of bone spurs;
Diagnostic evaluation begins with the clinical examination. Your health care provider should perform a detailed neurological and spine evaluation assessing for spinal nerve and spinal cord compression.
Common diagnostic tests include:
Electroconductive tests are commonly performed to document the degree and severity of spinal nerve injury. The EMG and nerve conduction test (EMG/NCV) tests will exclude peripheral nerve compression such as carpal tunnel syndrome.
Radiographs begin with an x-ray of the spine to determine the extent of arthritic changes and bone spur formation. With these films the physician may determine if destructive changes are present or further radiographic images are indicated.
Computerized tomography (CT scans) with myelography and/or MRI scans can provide details about change in the spinal architecture and the degree of nervous system compression. With these films the clinician will correlate clinical symptoms with radiographic findings and recommend the corrective course of action, often seeking the consultation of the spine surgeon.
Treatment options for bone spurs;
Non-surgical treatment for bone spurs
Most patients with mild or moderate nerve compression and irritation from bone spurs can manage their symptoms effectively with conservative care, such as:
Medication, such as anti-inflammatory medications and muscle relaxant pain medications, for approximately 4 to 6 weeks.
Activity may flare up inflammation in the joints, thus rest is initially appropriate.
After 1-2 weeks, physical therapy, exercise and manipulation often alleviates the painful joint conditions. These modalities attempt to restore flexibility and strength to the neck and back, improving posture and possibly decreasing the compression on the nerves. However, nerve compression with radiating pain into an arm and leg should be clinically investigated before beginning any form of rehabilitation therapies.
Cortisone (epidural steroid) injections have potential therapeutic value for some patients with facet joint inflammation by reducing the joint swelling and improving spinal pain and radiating extremity pain syndromes. The results are usually only temporary, but repeat injections maybe indicated.
Spine specialist consultation is appropriate if these conservative measures to treat bone spurs fail. Early referral is appropriate if patients suffer from severe pain or there is clinical evidence of nerve compression and damage.
Spine surgery for bone spurs;
Surgery (such as a laminectomy) relieves the pain and neurological symptoms by removing the bone spurs and thickened ligaments causing painful nerve compression. The majority of patients who undergo surgery for bone spurs experience good results, often gaining years of relief and improved quality of life. Studies have shown that age is not a major factor in determining whether a person will benefit from spine surgery for bone spurs. Medical conditions often associated with age, such as high blood pressure, diabetes and heart disease can influence surgical risks and slow the recovery processes.
Spine surgery for bone spurs becomes necessary if nerve or spinal cord compression is either causing unremitting pain or motor loss is documented on examination. Discuss the risks and benefits of the various approaches to spine surgery with your surgical consultant.
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