Uncinate spurring refers to degenerative changes in the cervical spine (the neck). This condition involves the growth of extra bone tissue, known as an osteophyte or bone spur, which is a common sign of spinal wear and tear. These bony growths develop on unique joints within the neck vertebrae. While the presence of a bone spur is often asymptomatic, their specific location can lead to painful symptoms if they begin to encroach on nearby nerves or the spinal cord.
Where the Spurs Form
The term “uncinate” points directly to the uncinate processes, which are small, hook-like bony projections found only on the upper surface of the vertebral bodies in the neck (C3 to C7). These processes articulate with the vertebra above them to form specialized joints called the uncovertebral joints, also known as the joints of Luschka. These joints guide the motion of the cervical spine, limiting excessive side-bending.
Uncinate spurring occurs when osteophytes develop on these hook-shaped structures. The location of the uncinate processes is significant because they form the anterior boundary of the intervertebral foramen, the small opening through which spinal nerves exit the spinal canal. Spurs forming in this area can directly affect the space available for these neural structures.
Why Bone Spurs Develop
Uncinate spurring is primarily a manifestation of the natural aging process and chronic mechanical stress placed on the cervical spine. This process is a component of cervical spondylosis, the most common cause of bone spur formation in the neck. Degeneration begins when intervertebral discs lose height and hydration with age, reducing their ability to cushion the vertebrae.
The resulting loss of disc height causes instability in the spinal segment. The body attempts to stabilize the area by growing new bone tissue along the edges of the vertebrae and at the uncovertebral joints. This compensatory bone growth restricts motion and is the body’s attempt to fuse the segment.
How Uncinate Spurring Causes Pain
The bone spur itself is typically not painful, but it causes symptoms when it grows large enough to compress or irritate nearby neurological structures. Because of its location on the side of the vertebral body, uncinate spurring often grows directly into the intervertebral foramen. When this occurs, it can “pinch” the exiting spinal nerve root, a condition known as cervical radiculopathy.
Cervical radiculopathy causes symptoms that radiate away from the neck, such as sharp, shooting pain, numbness, tingling, or weakness traveling down the shoulder, arm, and into the hand. These symptoms are specific to the compressed nerve root. Less commonly, if the spur grows toward the center of the spinal canal, it can narrow the canal and put pressure on the spinal cord itself, a more serious condition called cervical myelopathy. Myelopathy symptoms involve clumsiness, difficulty with fine motor tasks, balance issues, and weakness in the arms and legs.
Confirming the Diagnosis and Managing Pain
The medical investigation of uncinate spurring starts with a physical examination to test reflexes, strength, and sensation in the arms and hands, determining if nerve compression is present. Imaging tests confirm the presence and location of the bone spurs. Standard X-rays are usually the first step, showing the bony outgrowths and overall alignment of the cervical spine.
A Computed Tomography (CT) scan provides detailed images of the bone. A Magnetic Resonance Imaging (MRI) scan visualizes soft tissues, such as the spinal cord, nerve roots, and intervertebral discs. The MRI is useful for assessing the degree of nerve or spinal cord compression caused by the spurring.
For the majority of patients, initial management focuses on conservative, non-surgical approaches. This includes rest, activity modification, and over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation. Physical therapy is a primary component of treatment, focusing on strengthening neck muscles, improving posture, and increasing flexibility.
If pain persists, a doctor may recommend targeted treatments like steroid injections, which deliver anti-inflammatory medication directly to the nerve root area. Surgery is typically reserved for cases where conservative treatments fail to relieve severe pain, or when there is evidence of progressive neurological deficit, such as significant muscle weakness or severe myelopathy. The goal of surgery is to decompress the affected nerve root or spinal cord by removing the bone spur.