Osteophytes on an X-Ray: What Do Bone Spurs Mean?

Osteophytes on an X-ray are bone spurs: small, smooth growths of extra bone, usually at the edges of a joint. They most often form as part of osteoarthritis or age-related wear and tear, and many people with them have no symptoms at all.

Cleveland Clinic describes bone spurs as a byproduct of the body's repair response when bone or nearby tissue is stressed or damaged. They are often found by chance on an X-ray taken for another reason. Seeing the word on a report is common and is not, by itself, a reason for alarm.

This guide is for adults reading an X-ray report that mentions osteophytes or bone spurs. It explains the wording and helps you prepare questions. It cannot tell you what is causing your symptoms or what treatment you need.

Bone spurs themselves are rarely an emergency, but spine changes can sometimes affect nerves. The NHS advises calling emergency services or going to an emergency department straight away if back pain comes with any of the following. Do not drive yourself.

With neck spurs, MedlinePlus advises contacting a provider promptly about new loss of movement or feeling, and calling right away about loss of bladder or bowel control. Ask for an urgent appointment if back pain comes with feeling hot, shivery or generally unwell, or if pain is sudden and severe or worsening quickly.

• Pain, tingling, weakness or numbness in both legs.
• Loss of feeling around the genitals or anus.
• Difficulty passing urine, or loss of bladder or bowel control.
• New changes in sexual sensation or function.
• Pain that started after a serious accident, or back pain with chest pain.

Not exactly, but they are closely linked. Osteoarthritis is a joint condition in which the protective cartilage wears down. NIAMS notes that as it progresses, small bone growths called osteophytes or bone spurs may grow on the edges of the joint.

MedlinePlus lists osteophytes as one of several X-ray signs of osteoarthritis, alongside narrowing of the joint space, wearing of the bone ends and small cysts in the bone near the joint. A report may describe one or several of these. Bone spurs can also appear with other conditions, injuries or simply age, so the full report and your symptoms matter.

If your report says something like ‘mild degenerative changes with small osteophytes’, the clinician will usually read that together with your history and examination, not as a stand-alone diagnosis.

Often they do not. Cleveland Clinic states that bone spurs often cause no symptoms. MedlinePlus also notes that some people have no symptoms even though X-rays show the changes of osteoarthritis.

When symptoms do happen, they may come from the joint as a whole rather than the spur itself. Osteoarthritis can cause pain, stiffness, reduced movement, swelling or a grating feeling. If a spur presses on a nerve, Cleveland Clinic says it can cause pain, tingling, numbness or weakness.

The size of spurs on an X-ray does not reliably predict how much a joint will hurt. Someone with obvious spurs may feel fine, while someone with a near-normal X-ray may have significant pain from another cause.

Where the spurs are found changes what the clinician thinks about. Cleveland Clinic lists the knees, spine and neck, hands, heels, shoulders and hips among common sites.

• Knee: spurs at the joint edges are a typical sign of knee osteoarthritis. Clinicians usually focus on pain, stiffness, swelling and how well you can walk, climb stairs or kneel.
• Spine: spurs on the vertebrae are part of spondylosis. MedlinePlus notes that by age 60, most people show signs of cervical spondylosis on X-ray. Spurs only matter for nerves if they narrow the spaces where nerves pass.
• Hand: osteoarthritis often affects the small finger joints. NIAMS describes bony enlargements and shape changes in the finger joints over time, which may be what the spurs look like from the outside.
• Heel: a spur under the heel is a separate topic and is usually linked to the plantar fascia rather than a joint.

Osteoarthritis is often diagnosed without any scan. The NHS says a GP can usually diagnose it from symptoms and an examination, and that X-rays are not usually needed, though they can help rule out other causes such as a fracture.

If symptoms suggest a nerve is involved, or pain is severe and not improving, Cleveland Clinic and MedlinePlus describe CT or MRI scans, and sometimes nerve tests, as possible next steps. Whether you need any of these is a decision for your clinician, based on your symptoms rather than the spur alone.

Most bone spurs need no specific treatment. Care focuses on symptoms and on the joint as a whole. For osteoarthritis, the NHS describes regular exercise, losing weight if overweight, suitable footwear and devices that reduce strain on the joint. A physiotherapist can help with a structured exercise plan.

Pain relief, injections or other options may be discussed for some people, and surgery is described by Cleveland Clinic as a last resort for serious complications or severe symptoms. It also notes that no supplement or natural remedy can dissolve a bone spur. Discuss any medicine with a clinician or pharmacist before starting it.

Bring the written X-ray report, not just a summary. These questions can help turn the wording into a plan.

• Are the osteophytes on my X-ray likely to explain my symptoms, or are they probably incidental?
• What else does the report show, such as joint space narrowing, and how mild or advanced is it?
• Is there any sign that a spur is pressing on a nerve, and what symptoms should make me seek help quickly?
• Do I need any further tests, and what would they change?
• Which exercises, activity changes or referrals, such as physiotherapy, would help my joint?
• When should I come back if things do not improve?

On SameCase, patients and verified doctors share de-identified cases. Reading how others with a similar X-ray report described their symptoms, tests and conversations can help you notice what to mention and what to ask at your own appointment.

Other people's cases cannot tell you what your X-ray means or what treatment is right for you. Use them to sharpen your questions, then bring those questions to the clinician who knows your history and has examined you.