Uncovertebral osteophytes are bone spurs that grow on small ridges at the sides of the neck vertebrae, and they are one of the most common findings on neck scans in adults. Seeing them on a report usually describes ordinary age-related change, not a rare disease. Whether they cause symptoms depends less on the spur’s size than on what sits right next to it: the nerves heading into the arm. That is why the classic symptom of a troublesome spur is often felt in the arm and hand rather than only in the neck.
What the Phrase on Your Scan Report Means
Most of the seven neck vertebrae have a small raised lip of bone on each upper side edge, called the uncinate process. These lips meet the vertebra above to form a small joint on each side, which your report may call the uncovertebral joint. From here on, this article calls them the side ridges and the side joint. They help keep the neck stable and guide how it bends and turns.1PubMed. Anatomy and clinical significance of the uncinate process and uncovertebral joint: A comprehensive review When you tilt your head sideways, the ridges on that side help hold open the gap where nerves exit the spine.2PubMed. Analysis of the uncinate processes of the cervical spine: an anatomical study They also tend to be taller in the lower neck, below the third vertebra.3PubMed. Analysis of the uncinate processes of the cervical spine: an anatomical study
An osteophyte is a bone spur: a smooth growth of extra bone at a joint edge. It is not a tumor and not a sharp spike. So “uncovertebral osteophytes” or “uncovertebral hypertrophy” on a report means these side joints have thickened or grown spurs. “Hypertrophy” simply means enlargement of the joint, and it overlaps with spur formation.
A spur grows slowly over years as part of the body’s response to strain. It is joined to the bone, so it does not float loose or cut tissue.
Reports often name a level like C5-C6, meaning the joint between the fifth and sixth neck vertebrae. Words like “mild,” “moderate” or “severe” usually describe how much an opening is narrowed.
Radiologists use “uncovertebral joint arthropathy” and “uncinate spurring” for overlapping findings, so a different phrase on a second report does not mean a different diagnosis. If two reports use different terms, the useful question is whether the narrowing has changed, not whether the label has.
A radiologist reads the images without examining you, so the report lists what is visible and usually does not say whether it explains your pain. A line such as “foraminal narrowing” describes shape, and many narrowed openings never bother the nerve inside. Your doctor combines the report with your symptoms and exam to decide what matters.
Why These Bone Spurs Form
With age, the cushioning discs between vertebrae lose water and get thinner.45-Minute Clinical Consult. Cervical Spondylosis The supporting ligaments weaken and more load shifts toward the back of the spine.55-Minute Clinical Consult. Cervical Spondylosis The neck loses some of its natural forward curve, and the side and back joints get overloaded.65-Minute Clinical Consult. Cervical Spondylosis Those joints respond by growing bone spurs and thickened ligament.75-Minute Clinical Consult. Cervical Spondylosis This article calls that process neck wear.
The side ridges sit close to the disc, so when the disc thins and the vertebrae settle closer together, these joints are pressed together harder than before. Bone responds to extra pressure by laying down more bone, much as skin thickens into a callus where it rubs. The spur is best seen as the body’s attempt to stabilize the joint.
In one CT study of adults, degenerative neck changes appeared in under half of the youngest group but in almost everyone in the oldest group.8Forensic Medicine and Anatomy Research. Evaluation of Age Related Changes in Cervical Spine in Saudi Arabian Adult Population: Using CT Scan Images Finding spurs on a scan after middle age is the norm rather than the exception.9PubMed Central. Preventing the progression of text neck in a young man: A case report
Long hours with the head bent forward over a phone or desk increase load on the neck. Past neck injuries can speed up wear on the joints, and jobs with repeated overhead work or heavy lifting add strain. Age remains the biggest factor, and spurs are not a sign you did something wrong.
Symptoms When a Spur Presses on a Nerve
Spurs that grow from the back of the side ridge push into the nerve opening, the small opening where a nerve root leaves the spine. The nerve root can get bent and irritated by the spur.10Pain Physician. Uncinate Process Area as a New Sensitive Morphological Parameter to Predict Cervical Neural Foraminal Stenosis The main problems these spurs can cause come from pressing on a nearby nerve root, or less often an artery.11Pain Physician. Uncinate Process Area as a New Sensitive Morphological Parameter to Predict Cervical Neural Foraminal Stenosis12PubMed Central. Anatomy and clinical significance of the uncinate process and uncovertebral joint: A comprehensive review
A pinched nerve root typically causes pain that shoots from the neck into the shoulder, arm or hand on one side. It often brings tingling, pins and needles, numbness or weakness in a specific part of the arm or fingers. Turning or tilting the head toward the painful side often makes it worse, because that narrows the opening further.
Spurs often grow more on one side than the other, so the nerve on the more crowded side is the one more likely to be affected. Symptoms in both arms are less typical for a single pinched root and deserve a closer look.
Where you feel symptoms is one clue to the level. A C5-C6 nerve often sends symptoms to the thumb side of the hand and forearm. A C6-C7 nerve often affects the middle finger and back of the arm, and lower levels can affect the ring and little fingers. This pattern helps your doctor decide whether the spur on your scan fits your symptoms.
Muscle strain pain tends to stay in the neck and shoulder and feels achy and tender when pressed. Nerve pain more often travels along a line into the arm or hand and may feel burning, electric or like pins and needles. Both can occur together, which is why the pattern matters to your doctor.
Symptoms often come and go, flaring with certain postures or activities. Pain can be worse at night or after looking down for a long time, and some people find relief by resting the hand on top of the head. Occasional tingling is less significant than constant numbness or growing weakness.
Weakness usually shows up in specific tasks, such as difficulty lifting the arm, gripping a jar, or extending the wrist. Because each nerve root feeds particular muscles, the pattern of weakness helps pinpoint the level. Mild weakness can be hard to notice alone, so doctors test strength directly during the exam.
Rare but Serious Warning Signs
The vertebral artery, which carries blood to the back of the brain, runs through small openings right beside these side joints. In reported cases, a spur from the side ridge at C5-C6 squeezed the artery when the person turned their head.13PubMed Central. Subaxial Vertebral Artery Rotational Occlusion Syndrome: An Overview of Clinical Aspects, Diagnostic Work-Up, and Surgical Management In such cases, turning the head can briefly cut blood flow, causing dizziness, blurred vision or fainting, and the diagnosis is confirmed with a CT scan of the blood vessels.14Journal of Spinal Disorders & Techniques. Subaxial Rotational Vertebral Artery Syndrome
In daily life, these symptoms typically come on with a specific head position, such as looking over a shoulder when reversing a car or looking up at a shelf. They tend to pass within moments once the head returns to a neutral position. Dizziness from this cause is far less common than dizziness from inner-ear problems, low blood pressure or medicines. Doctors usually rule out the other causes first, and having spurs on a scan does not mean the artery is at risk.
The same age-related neck wear that produces spurs can narrow the spinal canal and press on the spinal cord itself.15PubMed Central. Degenerative Cervical Myelopathy: Pathophysiology and Current Treatment Strategies Signs include clumsy hands, trouble with buttons or writing, unsteady walking, or symptoms in both arms or legs.
Dizziness, vision changes or fainting when turning the head need prompt evaluation. Weakness that is getting worse, such as dropping objects, should not wait. Clumsy hands, trouble walking, balance problems or changes in bladder or bowel control need urgent care.
How Doctors Confirm the Cause
A herniated disc and a bone spur can pinch the same nerve and cause the same arm symptoms. The difference matters because a soft disc bulge can shrink over time, while a bony spur does not go away on its own. MRI shows soft tissue well, but dense bone and hard disc material both appear dark and can blend together at the edge of a nerve opening. On standard MRI, telling a spur from a disc herniation is unreliable, with about a third of spurs missed.16PubMed. Differentiation of Osteophytes and Disc Herniations in Spinal Radiculopathy Using Susceptibility-Weighted Magnetic Resonance Imaging So doctors often add an X-ray or CT, which show bone clearly, and a special MRI method identified almost all spurs correctly.17PubMed. Differentiation of Osteophytes and Disc Herniations in Spinal Radiculopathy Using Susceptibility-Weighted Magnetic Resonance Imaging
CT shows bone detail clearly, so it can outline a spur and measure how much it narrows the nerve opening. It is often used when surgery is being considered and the surgeon needs to see the bony shape. Because CT uses radiation, it is chosen when the extra detail will change decisions.
The exam comes first. The doctor tests strength in the arms, hands and fingers and checks reflexes and sensation along the arm. They may tilt and press on your head to see if arm symptoms appear. The results show which nerve is affected, so the scan can be checked against it.
When you review your scan, ask which level, if any, matches your symptoms. Ask whether the narrowing is from bone, disc or both, and whether the findings change your treatment or are simply age-related.
Treatment Without Surgery
Nonsurgical care is the main treatment for symptoms from neck wear, and most people respond well to it.18PubMed. Degenerative disorders of the lumbar and cervical spine Common options include physical therapy, pain medicines and injections near the irritated nerve.19Stem Cells LA. Effective Uncovertebral Hypertrophy Treatment: Symptoms and Solutions Many people improve noticeably over about 3 to 6 months of consistent care.20Stem Cells LA. Effective Uncovertebral Hypertrophy Treatment: Symptoms and Solutions
Physical therapy builds strength in the deep neck and upper back muscles that support posture. Gentle stretches and nerve-gliding moves can ease arm symptoms, and therapists teach posture changes for desk and phone use. Results build over weeks, so sticking with the home exercises matters.
Everyday habits help too. Raise screens to eye level to reduce forward head bending, and take breaks to move the neck during long sitting. Avoid positions that bring on arm symptoms, such as looking up for long periods. Short courses of anti-inflammatory medicine can ease pain if they are safe for you.
For a nerve injection, a steroid is placed near the irritated nerve using X-ray guidance. It aims to calm inflammation rather than remove the spur. Relief can last weeks to months and can help you do therapy.
Care often starts with activity changes, medicine and therapy together, and injections are usually added if pain stays severe. Early flares do not mean treatment has failed.
When Surgery Is Considered and How Well It Works
Surgeons can shave away the part of the side joint that crowds the nerve opening using a fine high-speed burr.21PubMed Central. Partial uncinatectomy combined with anterior cervical discectomy and fusion for the treatment of one-level cervical radiculopathy: analysis of clinical efficacy and sagittal alignment This is often done alongside removing the disc and fusing the two vertebrae from the front of the neck.22PubMed Central. Safety and Efficacy of Anterior Cervical Discectomy and Fusion with Uncinate Process Resection: A Systematic Review and Meta-Analysis With severe narrowing, removing the side ridge can fully free the nerve and clearly relieve symptoms.23PubMed Central. Safety and Efficacy of Anterior Cervical Discectomy and Fusion with Uncinate Process Resection: A Systematic Review and Meta-Analysis
The choice of approach depends on the level, where the spur sits, and whether the disc is also a problem. Operations from the back of the neck can remove just the spur and leave the disc and motion intact. Front-of-neck operations usually remove the disc and fuse the vertebrae, which also lets the surgeon reach the side ridge.
It may be time to discuss surgery if arm pain is still severe after about three months of good nonsurgical care, or if weakness is getting worse rather than better. Signs of spinal cord pressure, such as clumsiness or walking trouble, also count.
After operations that widen the nerve opening by removing the spur, about 9 in 10 people had complete or major relief of arm pain.24PubMed. Transpedicular approaches to cervical uncovertebral osteophytes causing radiculopathy Relief is not always complete; in one small group, 3 of 5 people had full relief and 2 had partial relief.25PubMed Central. Anterior Cervical Foraminotomy for Radiculopathy After Cervical Artificial Disc Replacement: Technique Description and Case Report
Many people go home within a day or two after front-of-neck surgery. Sore throat and mild swallowing difficulty are common for a short time. Arm pain often eases quickly, while numbness and weakness recover more slowly. Fusion means some loss of motion at that one level.
Spurs can also regrow. After spurs at the front of the neck were removed for swallowing trouble, about 1 in 4 regrew at around 2 mm a year.26PubMed Central. Anterior Cervical Osteophyte Resection for Treatment of Dysphagia In people with a condition that causes widespread spine bone growth, spurs regrew in everyone, though most stayed symptom-free for years.27PubMed Central. Postsurgical recurrence of osteophytes causing dysphagia in patients with diffuse idiopathic skeletal hyperostosis