bone spur symptoms

Bone Spurs: What Are They and Where Do They Come From?

Bone spurs can occur all throughout the body, including our hands, feet, spine, and any other joints within the body. However, you may or may not notice they’re there.

So what are bone spur symptoms, what causes them, and can they be removed? These are all common questions we receive from patients who receive a diagnosis, which is why we put together one cohesive blog to answer them all.

What are Bone Spurs?

A bone spur is when additional bone growth develops along the edges of your bones. Typically they occur around the areas where two bones join together, such as your joints or between the vertebrae in your spine.

They usually develop in response to wear and tear between your joints. Whether they’re harmful or not simply depends on how they grow and whether or not they impact the mobility of your bones.

What Causes Bone Spurs?

The most common cause of bone spurs is osteoarthritis.

Osteoarthritis is a degenerative bone disease that affects around 27 million Americans. Those with osteoarthritis experience a breakdown in the cartilage between the joints, which leads to friction between the bones.

This causes a host of different problems, including swelling, joint pain, and reduced mobility.

However, osteoarthritis isn’t the only cause of bone spurs. With age, injury, or wear and tear, the spine can develop spondylolithesis. Spondylolithesis is when an individual experiences damage or develops weakness in the facet joints and discs within the spine.

If this weakness is left untreated and continues to develop, it can lead to instability within the spinal structure. This creates stress within different parts of the spine, including the tendons, discs, and ligaments.

The body responds to this form of stress with new bone growth in an attempt to bring stability back to the spine. However, the development of these bones spurs can lead to other problems, including compression and pinched nerves.

Other causes of bone spurs include obesity, overuse of the joints, genetic predispositions, poor diet, and the narrowing of a patient’s spine.

What are the Most Common Bone Spur Symptoms?

As we stated before, some bone spurs may be completely asymptomatic. The only time symptoms occur is when the bones spurs impact the mobility of your joints or exacerbates them in some manner.

The type of symptoms you have depend on where the bone spurs are located.

Common bone spur symptoms include:

  • Difficulty bending or extending your leg due to pain within the knee
  • Feelings of numbness or weakness in your extremities due to pinched nerves or a pinched spinal cord
  • Difficulty controlling your bowels or your bladder due to pressure on your spinal nerves
  • Reduced or painful movement in your hip
  • Muscle spasms
  • Muscle cramps
  • Muscle weakness
  • Bumps that you can feel under your skin

You may discover these symptoms become exacerbated with exercise or joint use.

It’s important to keep in mind that experience these symptoms is not a guaranteed diagnosis. Because these symptoms can be indicative of other medical conditions or problems, you must receive a proper diagnosis from your doctor.

If you suspect bone spurs, your doctor will likely have you undergo tests in order to confirm or debunk this diagnosis. These tests usually include a physical examination as well as X-rays, CT’s, or MRI’s.

Your doctor may also conduct an electroconductive test to see if there is any nerve damage.

If you have questions about your diagnosis, symptoms, or causes, don’t be afraid to ask your doctor. He or she is responsible for answering any questions you may have regarding your health, treatment options, and any concerns associated with them.

How Do You Treat Bone Spurs?

If your doctor identifies that you have developed bone spurs that require treatment, he or she will provide you with options. Those options can vary depending upon where the bone spurs are located.

Depending upon the severity of your case, this treatment may be as simple as over-the-counter pain relievers to help with the side effects or therapy. In severe cases, you may require surgery in order to remove them.

Therapy options include steroid shots and/or physical therapy.

If you develop bone spurs within the spine, you may be required to undergo pain mapping prior to any surgical procedures. This is where a numbing agent is inserted into the area of the spine where the patient is experiencing pain.

Typically, this will temporarily relieve or stop the pain if your symptoms are caused by bone spurs. However, if your pain continues in spite of non-invasive treatment your doctor may recommend endoscopic foraminotomy.

Endoscopic foraminotomy is different from the more traditional means of bone spur removal. Safer and less invasive, it involves a very small incision as well as the use of a micro camera in order to remove the bone spur compression.

While this may sound indimidating, endoscopic foraminotomy is a much easier procedure than traditional surgery. It only requires a light, twilight sedation, and the incision is approximately the size of a fingernail.

This means less post-op pain and a significantly decreased recovery time for the patient. It is highly recommended for patients who require a spinal surgery in order to remove bone spurs causing nerve compression.

Explore Your Options for Bone Spur Removal in the Spine

If you have tried the more conservative options to bone spur treatment, but are still suffering from bone spur symptoms in the spine then it may be time to consider surgical options.

Make sure that you select a spinal surgeon with a good reputation and positive testimonials. Quality matters, especially when it comes to any sort of operation on the spine.

This area of your body houses multiple nerves and nerve endings that a good surgeon navigates with the utmost care. Careless or improper execution can lead to serious, and possibly permanent side effects.

If you are a patient within the Hackettstown or Newton, New Jersey area, give us a call. Dr. Carl Spivek is the President of Executive Spinal Surgery P.C. and he specializes in minimally invasive spinal surgeries.

These surgeries are safer and easier on the patient, making it the best available option today.

prolapsed disc

How to Know If You Have a Herniated Disc

Do you suspect you have a prolapsed disc in your back?

A herniated disc, also known as a slipped or prolapsed disc often causes intense back pain. If you’re not sure what the cause is, a prolapsed disc might very well be the culprit for your pain – but how can you tell?

A medical doctor is always needed for a certain diagnosis, but there are a few herniated disc warning signs to watch out for. In this guide, we’ll go over how to know if you have a herniated disc, as well as potential ruptured disc treatment and everything else you may need to know. Keep reading to learn how to make the pain disappear!

What is a Prolapsed Disc?

A slipped disc is often the cause of intense back pain with a sudden onset. It hurts because the disc usually presses a nerve in the spine, which can cause pain not just in the back, but in a leg or other body part.

The pain will often let up over the course of a few weeks, with rest and painkillers. However, if it doesn’t stop, you might need surgery or more intense treatment.

“Slipped” discs are somewhat misnamed: they don’t actually slip out of place. Instead, a part of the soft, inner part of the disc bulges through a weak point in the outer part of the disc. That’s why they’re called prolapsed or herniated discs.

The bulge of the disc is what pushes on the nerve, causing pain. Sometimes, the herniated area also becomes inflamed. This inflammation can further irritate a nerve and create swelling, adding even more pressure.

Any disk along the spine can become herniated. However, the issue happens in the lower back most often. The prolapse can be larger or smaller, but the larger ones tend to be more severe.

The Structure of the Spine

To understand how this can happen, it helps to understand more about how the back and spine work.

The spine is made up of small bones, or vertebrae. Each vertebra has a kind of flat, cylindrical shape and a disc rests between each one of these bones.

These discs are made of a kind of rubbery material, which gives our spine its flexibility. Each of these discs is constructed the same way: with a strong outer layer and a softer center.

Within the spinal cord are our nerves, which come from the brain and lead to every other part of the body. The spine keeps our nerves safe from damage, so they can do their job of sending messages from the brain to the body and vice versa.

We also have ligaments attached to our vertebrae. They offer more strength and support to the spinal structure. Muscles surround and attach to the spine as well.

When a disc becomes herniated, this seemingly small issue affects all of these different parts that work together. That’s why the symptoms of a prolapsed disc are often so severe.

Prolapsed Disc Symptoms

Is a herniated disc the cause of your back pain? Let’s take a look at the common symptoms that offer clues.

1. Back Pain

The most common prolapsed disc symptom is simple: pain in the back. However, this pain is usually severe and starts all of a sudden. If you have mild back pain or pain that starts out gradually, it’s probably not due to a herniated disc.

Laying still will usually make the pain feel better, but moving, sneezing, or coughing will increase the pain.

2. Nerve Pain

If you have pain in your nerve roots, that’s often another giveaway that the culprit is a slipped disc.

Nerve root pain happens because the slipped disc is pressing on a nerve that comes out from the spinal cord. It can also happen because the inflammation of the prolapsed disc is irritating the nerve root.

Even though the problem stems from the spine, you might feel pain at any or all points along the nerve’s pathway. For example, if the nerve extends down the leg, you might feel pain in your foot, calf, or knee.

The nerve root pain can be mild, severe, or anywhere in between. However, most of the time, it feels worse than your back pain does. This type of pain usually feels like a burning sensation.

Other nerves can be affected, but the nerve that’s affected the most often by a slipped disc is the sciatic nerve. This nerve is actually comprised of a number of smaller nerves that come from the lower back and extend down the backs of the legs.

3. Nerve Symptoms

In addition to pain, you might feel other symptoms because of the pressure of the prolapsed disc on your nerves. These symptoms can include numbness, weakness, or a “pins and needles” sensation. Again, the sciatic nerve is most often affected, so you’ll probably feel these symptoms in your foot or leg.

4. Cauda Equina Syndrome

In very rare cases, your nerve root issue could become cauda equina syndrome. This doesn’t happen often, but when it does, it’s a medical emergency and you must seek ruptured disc treatment right away.

In this disorder, the nerves being pushed on by the slipped disc are at the base of the spinal cord. In addition to pain in the lower back, the symptoms of this syndrome can include leg weakness, numbness between the legs, and issues with the bladder and bowels. For example, you might find yourself completely unable to use the bathroom.

If you don’t seek herniated disc treatments right away, this disorder could cause your nerves to sustain permanent damage, so don’t delay if you have these symptoms.

How to Treat a Herniated Disc

Minor prolapsed disc symptoms often go away on their own, with time. However, if you have this problem frequently or the symptoms don’t go away, you might need ruptured disc treatment.

Looking for reliable treatment for this and other spinal issues? Check out our treatment options here.

spinal injections

Spinal Injections: What Are They and How Do They Work?

The Bureau of Labor Statistics reports that one million back injuries sustained at work account for 20% of all workplace-related injuries and illnesses. This is second only to the common cold. In general, about 80% of the population has suffered from back pain.

For people who have radiculopathy (inflammation or damage to a nerve) or a herniated disc, spinal injections have proven to be one of the most effective treatments.

Needles can be scary, especially if they are meant for the spinal column. But they can be a lifesaver when it comes to back pain management.

Read on to find out what spinal injections are and why you might need one.

What Are Spinal Injections?

Spinal injections are also known as epidural injections. They are similar to the ones pregnant women get during childbirth. These injections are introduced into your epidural space, a space just outside the membrane protecting your spinal cord.

Epidural injections are also given during or after surgery as anesthesia and for treatment of chronic pain. Different medications are administered through these spinal injections including steroids, to manage pain and reduce inflammation in the back, legs, arms, and neck.

Doctors use an X-ray and a special dye to introduce the needle in the right place. This procedure is known as fluoroscopy Depending on where you’re experiencing pain, he or she will choose a location along the length of your spine closest to the inflamed and painful nerve.

The entire procedure takes about fifteen minutes and if you’re being medicated with a steroid, you should start to see the benefits in about 3 days. Pain relief differs in different people but on average it can last for months.

Who Can Get Treated with Spinal Injections?

There’s a wide variety of treatments available for back pain management. But there are certain conditions that are treatable by an epidural injection. They include pinched nerves, radiating pain from the spine, herniated disc and spinal stenosis.

Who Can’t Get Treated with Spinal Injections?

People with certain conditions should avoid spinal injections due to the risk.

These conditions include infections, diabetes mellitus, and blood clotting disorders. Also, people with the bleeding disorder, allergies to anesthetic agents or certain medications, and drug addictions should avoid it.

Depending on your condition, another treatment or pain relief option may be sought for you. Or the doctor may defer your injection until a favorable time.

How Do Spinal Injections Work?

Spinal injections deliver steroids and anesthetic directly into the epidural space. Occasionally, doctors may use a saline solution to flush the area and rid it of inflammatory chemicals in the space that causes the back pain.

Typically, doctors use a combination of cortisone, which is an anti-inflammatory medication and lidocaine, a quick-acting local anesthetic.

In general, spinal injections have two uses.

First, they are a diagnostic tool used to find the source of the pain. This can be in the back, leg, arm or neck.

Second, they help in pain relief. They are usually part of a comprehensive therapeutic program which almost always includes physiotherapy to improve spinal mobility and stability. This can include strengthening and stretching exercises.

Types of Spinal Injections

Spinal injections come in the following categories.

Epidural Injections

These relieve pain that radiates from the spine to an arm or leg. This occurs when a spinal nerve gets compressed or pinched.

Facet Joint Injections

They have both diagnostic and therapeutic value. They are commonly used when pain results from arthritic conditions or injuries. They are also used for pain relief in the neck, middle and lower back.

As a diagnostic procedure, the anesthetic gets injected into a joint or into the nerves that carry the pain signals. If the anesthetic reveals the nerve as the source of pain, then the pain signals get blocked permanently through radiofrequency ablation.

Sacroiliac Joint Injections

These are much like the facet joint injections. The sacroiliac joints are in the lower back, between the sacrum and ilium (pelvic) bones. These joints do cause lower back pain, usually unilaterally.

This injection also has both diagnostic and therapeutic value. To diagnose the pain, the SI join gets anesthetized with X-ray guidance.

This is the gold standard for diagnosing SI joint pain. If the pain improves with the anesthetic, then the pathology is confirmed.

As a therapy, a steroid injection will be given to relieve pain.

Provocation Diskography

This is a spinal injection only used for diagnosing pain. It does not relieve pain but rather causes it. This test gets done for those who have chronic back pain which doesn’t improve with conservative treatment.

Because of its ability to worsen back pain, it’s not performed commonly. But it can be useful for providing information if a surgery is being planned on the lower back.

Risks of Spinal Injections

All invasive procedures carry a certain amount of risk. With a .01 to .001% risk, infections are rare but possible. Bleeding can occur in patients taking certain medications or in people who have clotting, bleeding, and liver disorders.

Dural punctures do occur in 0.5% of the injections, where a doctor may breach the dural space leading to a wet tap that leads to a headache.

Direct trauma from the needle can also cause nerve damage. Yet, this is very rare since the procedure is done under visual guidance.

There may be some side effects of the steroid medication depending on which ones get used instead of the injection itself.

Some of them include severe localized pain which is temporary, headaches that resolve in 24 hours, insomnia, facial flushing, and fever (usually on the day of the injection).

You may also experience elevated blood sugar, anxiety, gastric ulcers, cataracts and a decreased immunity for a brief period.

Following your injection, if you experience a headache that improves on lying down then you may have a Dural puncture. You must relay this to the doctor.

Similarly, if you spike a fever of 101 degrees or more for over 24 hours, lose function or sensation in the extremities, or lose bowel or bladder control, speak to your doctor immediately.


Injections have never been a patient’s best option for getting treatment. But when you overcome your fear, it can be your best bet at getting healed. So, make sure that you consult your doctor about the various options that you have.

If you have any questions regarding the management of your back pain or need information about spinal injections, contact us.

JOIMAX Introduced New Advanced Endoscopic Surgical Equipment for Spinal Stenosis

Last weekend (April 29, 2016), I had the pleasure of attending and presenting at the JOIMAX Senior Faculty Meeting. This meeting is made up of renowned surgeons from all over the world, many of whom I hadn’t seen since the last Senior Faculty meeting over 5 years ago. This was a special weekend of excitement where JOIMAX introduced new advanced endoscopic surgical equipment that allows treatment of spinal stenosis, spondylolithesis and instability.

When I started with the JOIMAX system in 2010, I was wondering what type of patients and diseases I could treat. Initially, I was treating disk herniations (slipped disks) which caused back pain and sciatica (leg pain). Endoscopic surgery was a very exciting advancement for me and my patients.

We reviewed my initial patients when treated for disk herniations and reported this in the Journal of Spine in 2013. We found that endoscopic surgery was as effective as traditional surgery but was associated with significant reduction in length of hospital stay, operating time, estimated blood loss and potentially postoperative infections when compared to open techniques.

I now treat many spinal diseases and pathologies including complex disk herniations, spinal stenosis, facet arthropathy, synovial cysts, infections, radial tear, spondylolithesis and instability.

Carl Spivak, MD is a neurosurgeon who specializes in minimally invasive endoscopic spine surgery. He is senior faculty member for JOIMAX and has taught over 25 courses to surgeons throughout the United States. He is president of Executive Spine Surgery, PC located in Hackettstown, NJ at Hackettsown Medical Center, which is part of the Atlantic Health Network.

Dr. Spivak Imports Cutting Edge German Technology for Spine Repair

Dr. Carl Spivak, board-certified Neurosurgeon and specialist in minimally invasive spine surgery, has returned from Germany with the latest techniques and technology. Dr. Spivak dedicates himself to keeping up with the latest innovations in spine repair and disk regeneration.

Back and neck pain is often caused by the herniation of spinal disks. Traditional methods to repair damaged disks involve a large incision and retraction of the muscle around the spine so that the disk can be removed and replaced or fused. When performed on the neck, there is even more potential for damage, as the voice box and the esophagus must be retracted as well. This can cause unpleasant side effects such as difficulty swallowing and a hoarse voice, as well as scarring. In the case of disk fusion, rather than replacement, there is potential need for future neck surgery, as the remaining disks must compensate for the missing disk and may eventually become damaged by the strain.

To avoid these and other complications, much research has been done in the realm of endoscopic and other minimally invasive techniques. Endoscopic spine surgery is a becoming a popular alternative to more invasive procedures. The pen-size endoscope is a high-definition camera that is inserted with x-ray guidance. The endoscope allows the surgeon to remove the herniated section of the disk with tiny instruments. This relieves pain and suffering with minimal tissue damage and a same day discharge.

Endoscopic spine surgery has become a popular alternative to traditional spine surgery. The endoscope is a pen-sized, high-definition video camera that is inserted into the spine under x-ray guidance. The endoscope allows the surgeon to find and remove the herniated portion of the disk under direct visualization with very tiny instruments,relieving pain and suffering. Advantages of endoscopic surgery include a tiny skin incision, minimal tissue damage and pain, quicker recovery and same-day discharge.

German doctors and research scientists have been refining and perfecting endoscopic techniques. Dr. Spivak has spent the past week meeting with them and furthering his knowledge of endoscopic spine surgery. His newly acquired knowledge of pioneering German technology will help him perform even more advanced endoscopic techniques, minimizing tissue damage and potential complications.

Upon his return from Germany, Dr. Spivak also celebrated the launch of his new Manhattan office. He will now be available at the new Manhattan location, which features an on-site surgical center.

Study Finds Endoscopic Spinal Surgery Early Discharge

New Jersey-based Executive Spine Surgery alerts spine surgery patients to a recent academic study that showed patients treated with endoscopic spine surgery were discharged quicker then after open traditional spine surgery or minimally invasive microscopic spine surgery.

Back pain suffers who need spine surgery now have evidence that patients who undergo endoscopic spine surgery have quicker recovery and discharge home, say physicians at West Orange-based Executive Spine Surgery. They point to a recently presented academic study that showed patients treated with endoscopic discectomy recovered and were discharged home 94% earlier then open surgery.

Presented at International Society of Advancement of Spine Surgery (ISASS) meeting in Vancouver, BC on April 3, 2013, the study led by the University of Columbia’s Reginald Knight, MD examined the results of almost 300 lumbar decompression patients from Prospective Spine Registry at Bassett Healthcare, a rural multispecialty employed physician-hospital.

Drs. Knight and Spivak and their colleagues used the database to review 283 consecutive elective lumbar degenerative spine cases from years 2010 to 2012, looking at outcomes after traditional-open surgery, minimally invasive tubular microscopic surgery and endoscopic surgery.

The results: All three treatment groups showed remarkable improvements in back pain, leg pain and disabilities scores over the course of the study, but there was significant differences in the length of stay after these surgeries. Patients who underwent open-traditional surgery, minimally invasive surgery and endoscopic surgery had average stays of 1.8, 1.0 and 0.1 days respectively.

“This study emphasizes that endoscopic spine surgery is extremely minimally invasive even for minimally invasive surgery. The exact reason for early discharge is unknown, it is likely due to less tissue damage and pain from the surgery” comments Dr. Carl Spivak. “This is why I make every effort to provide the least invasive, cutting-edge surgical techniques available.”

New Minimally Invasive Endoscopic Treatment for Neck Pain!

JOIMAX, a world leader in minimally invasive spinal surgery technology will be launching a new endoscopic system for neck surgery on April 3rd to 5th at the International Society of the Advancement of Spine Surgery (ISASS) meeting in Vancouver, BC. This advanced surgical system called CESSYS (Cervical Endoscopic Surgical System) will provide an alternative to traditional open neck surgery and will change how neck surgery is done in the future!

Cervical disk herniation is a common cause of pain, stiffness, numbness and weakness. Traditional neck surgery involves a large incision, retraction of the voice box and food tube, removal of the entire disk, and fusion that may produce ugly scars, hoarse voice, swallowing difficulty and stiffness at the fused level. Cervical fusion also may involve future neck pain and surgery because the remaining disks must compensate for the fused level and may become damaged from excessive movement. An enormous amount of research has been focused on this adjacent level disease.

The artificial cervical disk was developed to avoid fusion and prevent adjacent level disease and future surgeries. Even though the artificial disk was welcomed with great enthusiasm, long-term results are unknown, and there is concern for the longevity of these man-made disks. Minimally invasive posterior cervical discectomy was another approach developed to avoid fusion and subsequent adjacent level disease, although unfortunately, most disks are not approachable through the back of the neck. This has led to development of an endoscopic discectomy through the front of the neck, similar to, but less invasive than the traditional open neck surgery.

Endoscopic spine surgery has become a popular alternative to traditional spine surgery. The endoscope is a pen-sized, high-definition video camera that is inserted into the spine under x-ray guidance. The endoscope allows the surgeon to find and remove the herniated portion of the disk under direct visualization with very tiny instruments, relieving pain and suffering. Advantages of endoscopic surgery include a tiny skin incision, minimal tissue damage and pain, quicker recovery and same-day discharge.

JOIMAX designed the CESSYS cervical endoscopic surgery system to minimize tissue damage and be versatile enough to remove most disk herniation without the need of fusion, with the objective of decreasing the need for future surgery. The CESSYS cervical endoscopic surgical system will be available in the United States in the fall of 2013 to select JOIMAX instructors and faculty, including Dr. Carl Spivak.

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