Son 20 pain neck, upper mid back. posterior osteophyte c-4c-5 on mri. years later still paincan tiny osteophytes keep enlarging? unusual in young man?

Bone spurs enlarge : Yes, an osteophyte/bone spur can enlarge with time as one ages. These can be a cause of pain if they impinge nerves and/or cause stenosis of the nerve canals. We do see spurs start to form even in teenagers but yes, your son is on the younger side to have spurs. The good news is that they don't necessarily cause pain and nonsurgical treatment still can often provide pain relief of spine pain.