Dear Doctors: I had severe pain in my neck and couldn’t turn my head. I saw an orthopedist, and she diagnosed bone spurs on my vertebrae. Apparently, my choices are physical therapy, seeing a pain specialist or having surgery. Can you talk about these options?
Dear Reader: Bone spurs, also known as osteophytes, are rounded, bumpy or knobby overgrowths that can develop on the surface of a bone in response to injury, skeletal instability or as a result of arthritis.
Osteophytes typically form at or near the juncture of a bone and a joint and in areas where a ligament or tendon attaches to a bone. When bone spurs occur in the vertebra of the neck, which is the cervical spine, they are known as cervical osteophytes.
These bony growths aren’t painful. But, depending on their size, number and location, they can crowd or touch a nerve or the spinal cord. This can cause numbness, tingling, weakness, headache and dull, sharp or radiating pain.
Treatment for cervical osteophytes usually begins with medications, ice packs and rest to reduce inflammation and manage pain. When over-the-counter drugs don’t bring relief, prescription pain relievers and stronger anti-inflammatories might be recommended. Another option is corticosteroid injections, which also can be effective for inflammation.
Problems with posture and alignment and deficits in structural support often play a role in the development of bone spurs in the neck. So physical therapy to strengthen muscles that support the neck can be helpful. A physical therapist also can evaluate your posture as you sit, stand and move, identify bad habits and pinpoint movement triggers that make symptoms worse.
For some, several physical therapy sessions can bring relief. For others, it can become an ongoing part of managing the condition.
Your doctor also might recommend integrative treatments such as acupuncture or chiropractic adjustment, which can increase mobility and help manage pain.
When symptoms are severe and have failed to improve with conservative treatment, surgery might be an option, including some approaches that are minimally invasive. Each involves removing excess tissues impinging on nearby nerves or the spinal cord. Sometimes, a compressed or damaged disc might need to be removed.
While surgery can offer significant relief, there are risks, including the possibility of nerve damage, blood clots, infection and injury to surrounding tissue. Get a second opinion when opting for surgery, and select a surgeon who’s experienced in the procedure.
Dr. Eve Glazier and Dr. Elizabeth Ko are UCLA Health internists.
