Are Bone Spurs Dangerous? Understanding Facet Joint Osteophytes
Your MRI report comes back, and somewhere in the findings is a line about “osteophytes” or “facet joint osteoarthritis.” Or maybe your last appointment ended with someone saying “you have a bone spur” and not much else.
These are some of the most common words on a spine report, and some of the most poorly explained. They sound permanent, and they sound like something has gone wrong.
In this post, we’ll cover what a bone spur on a spine scan really is, why almost everyone ends up with them, the two situations where they can genuinely matter, and what actually helps. We’ll also be straight about one thing: unlike a disc herniation, a bone spur isn’t going anywhere, and why that matters far less than you’d think.
First, let’s deal with the fear that shows up the moment people hear those words.
The fear
A bone spur isn’t a shard. It’s reinforcement.
“I have sharp bone shards digging into my nerves.”
“Bone spur.” Just hearing those two words can make you wince, right? It conjures up images of jagged shards poking at your soft tissues. But here’s the unexpected truth: what a radiologist calls a “bone spur” is your body’s way of reinforcing itself, much like building muscle to get stronger. It’s an outgrowth of bone that forms gradually, and most are surprisingly smooth on your scan. Even when one looks a bit “sharper” in the image, it rarely behaves that way inside your body. The term “spur” often just overstates what’s actually happening.
Side view of two stacked vertebrae with a disc between them. The front of the body is on the left, the back on the right.
Think callus, not shard. The same way skin thickens where a tool presses against your palm, bone thickens where a joint takes repeated load.
Why your bones grow a little extra
Joints under load reinforce themselves
Your spine isn’t one big bone. It’s a stack of vertebrae, and at the back of each one are small, paired connections called facet joints. These little joints let your spine bend, twist, and move through your day.
Like any part of your body that handles a lot of work (think of a callus forming on your hand from gripping a tool), facet joints respond to years of daily load by remodeling and reinforcing. This is governed by a principle called Wolff’s Law: bones adapt and thicken where they need to be stronger.
Over decades, the edges of these joints might build up a little extra bone, an osteophyte. It’s an active, adaptive process, a slow build-up rather than a sudden injury. Research even suggests these outgrowths may help stabilize the joint, and in animal studies, removing osteophytes made a joint less stable.
Facet joint changes by age
One study of hundreds of spines.
So it isn’t a question of if you’ll have these changes, but how many. They show up as often in people with back pain as in people without, following the same pattern as other common MRI findings: usually silent, often a normal part of life, and only sometimes a direct source of symptoms. A large community study even found no link between facet joint arthritis and back pain on its own.
What about “facet joint osteoarthritis”? That word, “arthritis,” carries a lot of weight and can sound terrifying. We aren’t disputing the anatomy: cartilage can thin and bone remodels. But unlike the hip or knee, which can wear out to the point of needing a replacement, spinal facet joints aren’t routinely replaced in the same way. Here, it often describes a slow, normal adaptation your body is handling, not a countdown to joint failure.
When these changes actually matter
Two situations worth paying attention to
1. They narrow a nerve’s exit ramp
Nerve roots leave the spine through small tunnels. If a disc loses height, more weight shifts to the facet joints, they may thicken, and that extra bone can nudge into the channel (foraminal narrowing, covered in another guide).
If the channel becomes significantly narrowed, the spur can genuinely compress and inflame the nerve root. This is a real cause of radiculopathy: shooting pain into the leg or arm, numbness, or weakness. Occasionally it warrants injections or surgical decompression.
The key word is “significantly.” Compression only tends to become common past a critical point, and even then a compressed nerve doesn’t always cause symptoms.
2. The joint itself gets cranky
Irritated facet joints often show up as pain that depends on position:
The same pattern is common with foraminal symptoms, because the tunnel is tightest when you lean back. It’s also why real symptoms can exist even when a lying-down MRI looks unremarkable.
It’s a helpful clue, but just one piece of the puzzle. No single movement can pinpoint a facet joint as the sole source of your pain.
Get seen the same day if leg or arm symptoms are rapidly worsening: progressive weakness, a foot that starts dragging, loss of bowel or bladder control, saddle numbness, or weakness in both legs. See the red flags in Disc Bulge vs. Extrusion vs. Herniation. It’s a same-day assessment, not wait-and-see.
Neither situation usually means the bone needs to be “removed” or “fixed.” The joint and surrounding tissues generally need help calming down and regaining comfortable movement. Only the minority with significant, persistent nerve compression go on to need a procedure.
Will that “bone spur” ever go away?
No, and it matters far less than you’d think
It’s important to be direct about this. Some disc herniations can be cleared away by your body, as covered in our disc bulge vs. herniation guide. Bone doesn’t work that way.
Can be cleared
Your body can sometimes break down and clear exposed disc material.
Permanent feature
Once it forms, it’s a structural feature your body won’t reabsorb.
The good news: pain and stiffness from an irritated facet joint typically improve substantially with the right care, even though the bone on your next scan will look exactly the same. You’re not waiting for the finding to disappear. You’re working toward a joint that moves and tolerates load comfortably, regardless of what the image shows.
This applies everywhere in your spine. Facet joints are at every level, so a “cervical facet” in your neck follows the same principles as a lumbar one. If neck pain is your main concern, Dr. Notley’s video on cervical facet syndrome goes into more detail for that area.
What actually helps
When your facet joints are cranky
Restore gentle joint mobility
Targeted, gentle movements for the specific segment that’s irritated, without trying to change the bone itself.
Address posture and movement habits
Certain prolonged positions, especially leaning backward, can aggravate these joints. We look at how you move through your day.
Strengthen your core and hips
Strong core and hip muscles share the load, reducing stress on any single facet joint.
Return to confident movement
The goal isn’t to avoid movements that once hurt. It’s to reintroduce them slowly and safely, building capacity.
A facet joint that has thickened with age isn’t a faulty joint. It’s a joint that has been doing its job for decades. Our goal isn’t to reverse that adaptation, but to help it move comfortably and confidently again, so you can live your life without fear.
Struggling with back pain or neck pain?
Book an assessment with Winnipeg Chiropractor & Athletic Therapist Dr. Chris NotleyPart of our MRI Translation Guide series
More from the series
Sources and further reading (9)
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- Kalichman L, Li L, Kim DH, et al. Facet joint osteoarthritis and low back pain in the community-based population. Spine. 2008.
- Gellhorn AC, Katz JN, Suri P. Osteoarthritis of the spine: the facet joints. Nat Rev Rheumatol. 2013.
- van der Kraan PM, van den Berg WB. Osteophytes: relevance and biology. Osteoarthritis Cartilage. 2007.
- Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and management of lumbar spinal stenosis: a review. JAMA. 2022.
- Abe H, Kato S, Takami H, et al. Expert consensus-based criteria for identifying lumbar facet joint pain in primary care. Pain Ther. 2026.
- Cinotti G, De Santis P, Nofroni I, Postacchini F. Stenosis of lumbar intervertebral foramen: anatomic study on predisposing factors. Spine. 2002.
- Cha TD, Moore G, Liow MHL, et al. In vivo characteristics of nondegenerated adjacent segment intervertebral foramina in patients with degenerative disc disease during flexion-extension. Spine. 2017.
- Hasegawa T, An HS, Haughton VM, Nowicki BH. Lumbar foraminal stenosis: critical heights of the intervertebral discs and foramina. A cryomicrotome study in cadavera. J Bone Joint Surg Am. 1995.
