How osteophytes (bone spurs) develop

Osteophytes are smooth bone growths or deposits, also called bone spurs. They grow slowly over time and usually have no symptoms. If the osteophyte hits other structures or grows so large that it restricts the movement of the joint, it can cause pain.

Osteophytes are also sometimes referred to as osteochondral nodules, osteochondrosis, and chondro-osteophytes.

osteophytes in arthritis

Osteophytes often develop in joints that show signs of degeneration. They are associated with the most common type of arthritis, osteoarthritis. Their presence can be used to differentiate osteoarthritis from other types of arthritis.

While osteoarthritis involves the degeneration of cartilage, there is also remodeling of the subchondral bone in the joint, which may include the formation of bone spurs.

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formation of osteophytes

Technically, an osteophyte is a bone growth covered by fibrocartilage that originates from precursor cells in the periosteum, the tissue that lines bone and contains cells that form new bone. Transforming growth factor beta plays a role in their development.

Osteophytes occur when cartilage remaining in a damaged joint attempts to repair after cartilage loss elsewhere in the joint. It tends to form in the joint compartment where cartilage is lost, suggesting it is a localized event. The formation of osteophytes stabilizes the damaged joint.

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That said, exactly how they form and what stimulates their formation is not fully understood. Osteophytes can also develop without significant cartilage damage.

location of osteophyte formation

Marginal osteophytes can develop on the periphery or margins of any joint. Central osteophytes are most prominent in the hip and knee.

Osteophytes can also appear in the spinal area, they are associated with back or neck pain and are considered a common sign of degenerative arthritis (osteoarthritis).

In the spine, osteophytes, or bone spurs, can cause nerve impingement (compression of the spinal cord or nerve roots) at the nerve foramen (the spaces on the left and right sides of each vertebra that allow nerves to pass from the spinal cord to other parts of the body).

Sensory symptoms in this condition include pain, numbness, burning, and pinpricks in the extremities served by the affected spinal nerve roots. Motor symptoms include muscle spasms, cramps, weakness, or loss of muscle control in related parts of the body.

The osteophyte itself is not painful, but its location and the effect it has on other structures in the body can cause pain.

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risk factor

Certain factors and conditions can lead to the formation of osteophytes. These include:

  • increasing age
  • disc degeneration
  • joint degeneration
  • Sports injury or other joint injury
  • poor posture
  • genetics
  • congenital skeletal anomalies


Osteophyte formation in the hand can be diagnosed by physical examination of the proximal interphalangeal joint (PIP), distal interphalangeal joint (DIP), and first carpometacarpal joint (CMC). In short, a lump or bump may appear on the hand during a physical exam.

For other joints, imaging studies, such as X-rays, magnetic resonance imaging (MRI), or computed tomography (CT) scans, can be used to diagnose the presence of osteophytes.

If everyone over the age of 50 is X-rayed, most will show some evidence of osteophyte formation. However, most osteophytes do not produce any symptoms.

About 40% of people with osteophytes have symptoms that require treatment.

Treatment of osteophytes

The mere presence of osteophytes has no clinical significance unless associated symptoms are present. Treatment may include:

  • physical therapy
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Analgesics (pain relievers)
  • steroid injection
  • Surgery: In the spine, osteophyte removal may be required to directly decompress the nerve impingement or to increase the width of the spinal canal to reduce osteophyte compression.
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Usually, conservative treatment is tried first. Surgery is reserved for people with severe symptoms. Activity tends to increase pain associated with osteophytes, while rest helps reduce pain.

Frequently Asked Questions

  • Can osteophytes form in the spine?

    Yes, osteophytes can form in the spine. When an osteophyte forms a bone formation in the upper region of the spine, it is called a cervical osteophyte. This can lead to obstructive sleep apnea, vocal cord paralysis (a disorder that affects one or both vocal cords), and food aspiration (when food enters the airway instead of the esophagus).

  • What Causes Osteophytes?

    Osteophytes (bone spurs) are often caused by conditions such as arthritis, osteoarthritis, and spinal stenosis. They are also common in aging, joint and disc degeneration, injury, malnutrition and poor posture. Bone spurs are thought to be common in people 60 and older.

  • How are bone spurs in the knee treated?

    There are several ways to treat a knee spur. This includes cortisone (an injectable anti-inflammatory drug), over-the-counter pain relievers, creams and ointments, physical therapy, and knee arthroscopy, a surgical procedure to remove spurs from the affected knee.

    understand more:

    What is a Knee Spur?