Uncovertebral spurring is the growth of small bony projections (bone spurs) on the uncovertebral joints, a set of joints found only in the neck portion of the spine. These spurs develop as part of the body’s response to wear and tear on the cervical vertebrae, and they become increasingly common with age. Degeneration in these joints can begin as early as your 20s, though it typically causes no symptoms until middle age or later.
Where Uncovertebral Joints Are Located
The uncovertebral joints, sometimes called the joints of Luschka, sit along the sides of the cervical vertebrae from roughly C3 to C7. Each joint forms where a small hook-shaped projection on the lower vertebra meets the body of the vertebra above it. These joints are unique to the neck and serve two important roles: they help stabilize the cervical spine and they guide the neck’s range of motion when you turn, tilt, or flex your head.
Running right next to these joints are the nerve roots that exit the spine through small openings called foramina, as well as the vertebral arteries that supply blood to the brain. This tight neighborhood is what makes uncovertebral spurring clinically significant. Even a small bony overgrowth in this area can press against structures that matter.
How Bone Spurs Form
Uncovertebral spurs develop through a predictable biological chain reaction. As the discs between your cervical vertebrae lose height and moisture over time, the uncovertebral joints absorb more stress than they were designed to handle. The cartilage lining these joints begins to break down, and the body attempts a repair job by growing new cartilage at the edges of the joint. That new cartilage gradually hardens through calcification and eventually turns into bone, creating an osteophyte, or bone spur.
This process is essentially the body overbuilding in response to instability. The spur is meant to increase the surface area of the joint and redistribute mechanical load. The problem is that this extra bone doesn’t grow in a controlled way. It can extend into the foramen where nerve roots exit the spine, or into the spinal canal itself, creating narrowing that wouldn’t otherwise be there.
Which Levels Are Most Affected
Not all cervical segments degenerate at the same rate. A CT-based study of healthy adults found that the C5-C6 segment is the most commonly and severely affected level, followed by C4-C5 and C6-C7. The upper segments, C2-C3 and C3-C4, show relatively little change even as people age. This pattern makes sense biomechanically: the C5-C6 level sits at the point of greatest neck mobility and bears a significant share of the head’s weight during movement.
Degeneration at these joints begins in the 20s but progresses slowly at first. The most significant acceleration happens between ages 40 and 60, and then worsens again after 70. The C5-C6 segment in particular starts degenerating rapidly early and continues at a relatively steady pace throughout life, while other levels have periods of slower and faster progression.
Symptoms of Uncovertebral Spurring
Many people with uncovertebral spurs have no symptoms at all. Bone spurs frequently show up on imaging done for unrelated reasons. When spurs do cause problems, the symptoms depend on what the spur is pressing against.
The most common issue is foraminal stenosis, where the spur narrows the opening through which a nerve root exits the spine. This produces symptoms of a pinched nerve, which range in severity:
- Pain in the neck, shoulder, or arm, often following the path of the compressed nerve
- Tingling or pins-and-needles sensations in the fingers or hand
- Numbness in specific areas, such as the thumb, index, and middle fingers for compression near the lower neck
- Muscle weakness or difficulty gripping objects, which indicates more significant nerve involvement
The location of your symptoms often reveals which nerve root is affected. Spurring at C5-C6, for instance, commonly produces pain and tingling that radiates into the thumb side of the hand, while spurring at C6-C7 tends to affect the middle finger and ring finger. In rare but serious cases, large spurs that compress the spinal cord itself can cause difficulty with balance, coordination problems in the hands, or changes in bladder and bowel control.
Non-Surgical Treatment Options
Treatment almost always starts conservatively, and many people get adequate relief without surgery. The first approach typically combines rest, ice, and over-the-counter anti-inflammatory medications to calm the irritation around the compressed nerve. When those aren’t enough, stronger prescription anti-inflammatories or pain medications may help bridge the gap.
Physical therapy is one of the more effective tools for managing uncovertebral spurring long-term. A therapist can identify movement patterns or postural habits that are worsening your symptoms and teach you exercises to strengthen the muscles supporting your cervical spine. Stronger, more balanced neck muscles can reduce the mechanical stress on the affected joints. For some people, several sessions are enough to bring meaningful relief.
Corticosteroid injections near the affected nerve root are another option when inflammation is driving most of the pain. These injections reduce swelling around the nerve and can provide weeks to months of relief. Some people also benefit from acupuncture or chiropractic care, both of which can improve neck mobility and help manage pain as part of a broader treatment plan.
When Surgery Becomes Necessary
Surgery is reserved for people who have tried conservative treatments without success, or whose symptoms are progressing in ways that suggest the nerve is being damaged. Worsening muscle weakness, loss of coordination, or bladder problems are signs that the compression may need to be addressed urgently.
The most common surgical procedure for uncovertebral spurring is a foraminotomy, in which a surgeon widens the narrowed foramen by removing the bone spur and any other tissue compressing the nerve root. The surgeon makes an incision on the back or side of the neck, exposes the affected vertebra, and clears the blockage. In some cases, a portion of the vertebral bone (a laminectomy) may also need to be removed to fully decompress the nerve. Another common approach is anterior cervical discectomy and fusion, where the surgeon works from the front of the neck to remove the disc and spurs together, then fuses the two vertebrae for stability.
Recovery timelines vary by procedure, but most people notice improvement in their arm pain relatively quickly after surgery. Neck stiffness and soreness from the procedure itself can take several weeks to resolve, and physical therapy is typically part of the rehabilitation process.