How an Osteophyte (Bone Spur) Develops

Bone spur may develop in joints damaged by arthritis.

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An osteophyte is a smooth bony growth or deposit, also referred to as a bone spur. They grow slowly over time and often have no symptoms. Osteophytes can cause pain if they impinge on other structures or grow so large as to restrict movement in a joint.

Osteophytes are also sometimes called osteochondral nodules, osteochondrophytes, 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 serve to distinguish osteoarthritis from other types of arthritis.

While osteoarthritis involves the degradation of cartilage, there is also remodeling of the subchondral bone in the joint, which can include forming bone spurs.

Formation of Osteophytes

Technically speaking, an osteophyte is a fibrocartilage-capped bony outgrowth originating from precursor cells in the periosteum, the tissue that lines the bones and contains the cells that form new bone. Transforming growth factor β plays a role in their development.

An osteophyte develops when the remaining cartilage in a damaged joint attempts a repair after there is cartilage loss elsewhere in the joint. It tends to form in the joint compartment where there has been cartilage loss, suggesting it is a localized event. Osteophyte formation stabilizes the damaged joint.

That said, exactly how they form and what stimulates their formation is not completely understood. Osteophytes can also develop in the absence of explicit cartilage damage.

Location of Osteophyte Formation

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

Osteophytes also may be found in the spine region, where they are associated with back or neck pain and considered a common sign of degenerative arthritis (osteoarthritis).

In the spine, an osteophyte or bone spur can cause nerve impingement (compression of the spinal cord or nerve roots) at the neuroforamen (the empty space to the left and right of each vertebra that allows nerves to pass from the spinal cord to other parts of the body).

Sensory symptoms in this situation include pain, numbness, burning, and pins and needles in the extremity served by the affected spinal nerve root. Motor symptoms include muscle spasm, cramping, weakness or loss of muscular control in an associated part of the body.

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

Risk Factors

Certain factors and conditions may contribute to the formation of osteophyte. These include:


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

For other joints, the presence of an osteophyte can be diagnosed using imaging studies, such as X-rays, magnetic resonance imaging (MRI) or computerized tomography (CT) scan.

If X-rays were performed on everyone over 50 years of age, most would show some evidence of osteophyte formation. Yet, most osteophytes don't produce any symptoms.

Approximately 40% of people with osteophytes develop symptoms that require treatment.

Treatment of Osteophytes

The presence of an osteophyte alone is not clinically significant unless associated symptoms are experienced. Treatment methods may include:

Typically, conservative treatment is tried first. Surgery is reserved for people who have severe symptoms. Activity tends to increase pain associated with an osteophyte, while rest helps to lessen pain.

Frequently Asked Questions

  • Can an osteophyte form in the spine?

    Yes, an osteophyte can form in the spine. When osteophytosis creates a bone formation on the spine's upper region, it is known as a cervical osteophyte. This can cause obstructive sleep apnea, vocal fold paralysis (a disorder that affects one or both of the 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 like arthritis, osteoarthritis, and spinal stenosis. They are also a common occurrence from aging, degradation of joints and discs, injury, poor nutrition, and poor posture. Bone spurs are considered common in people who are 60 and older.

  • How are bone spurs in the knees treated?

    There are several treatments for bone spurs found in the knees. This includes cortisone (an injected anti-inflammatory medication), over-the-counter pain relief medications, creams and ointments, physical therapy, and knee arthroscopy, a type of surgical procedure that removes bone spurs in the affected knees.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. US Centers for Disease Control & Prevention. Osteoarthritis (OA): Basics.

  2. Lepage SIM, Robson N, Gilmore H, et al. Beyond cartilage repair: The role of the osteochondral unit in joint health and disease. Tissue Eng Part B Rev. 2019;25(2):114–125. doi:10.1089/ten.teb.2018.0122

  3. Wong SHJ, Chiu KY, Yan CH. Review article: Osteophytes. Journal of Orthopaedic Surgery. 2016;24(3):403-410. doi:10.1177/1602400327

  4. Klaassen Z, Tubbs RS, Apaydin N, Hage R, Jordan R, Loukas M. Vertebral spinal osteophytes. Anat Sci Int. 2011;86(1):1-9. doi:10.1007/s12565-010-0080-8

  5. Cedars Sinai. Bone Spurs.

Additional Reading

By Carol Eustice
Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis.