What is a Bone Spur?
A bone spur, also known as an osteophyte, is a bony projection that can develop along the edge of a bone. Typically they are found where the bones meet at the joints, but they can also form in the spine. They are generally caused by the joint damage of osteoarthritis. Often they are undetected and asymptomatic and may not even require treatment. Treatments are considered based on the location of the bone spur and how it is impacting the patient’s health. If there are no symptoms, bone spurs may just appear on an X-ray that is being performed for some other reason. Any symptoms might include loss of motion in the joints and pain. Specifically, bone spurs can impact the knee, spine, hip, shoulder, and fingers, and other parts. Knee osteophytes make it difficult to extend the leg. A bone spur in the spine can narrow the space for the spinal cord, pinching the nerves and leading to numbness or weakness in the extremities. Bone spurs make hip movement painful, reducing range of motion. They can also rub on the rotator cuff of the shoulder, leading to tendinitis swelling and tears. A bone spur in the finger appears as a hard lump under the skin.1 A bone spur, or extra bone, is usually smooth, but the reason it causes pain or wear and tear is because it can rub on nerves, ligaments, and tendons.2
Bone Spur Causes and Problems
A bone spur is formed when “the body tries to repair itself by building extra bone” as a “response to pressure, rubbing, or stress that continues over a long period of time.” They are part of aging. As cartilage wears away and discs break down, over time there is swelling and pain. Aging-related bone spurs commonly impact the feet and spine. The feet spurs also form from running, dancing, poor-fitting shoes, and being overweight, all of which stress the feet. Plantar fasciitis, for example can lead to the creation of a heel spur at the bottom of the heel. A “pump bump” may develop if shoes are tight, leading to a bone spur on the back of the heel. The shoulder is another common site for the creation of bone spurs. These may “pinch the rotator cuff tendons, resulting in irritation, inflammation, stiffness, weakness, pain, and sometimes tearing of the tendon” leading to “rotator cuff disorder”. This is caused by age and repetitive use, such as in athletes (for example, ball players) and painters, who perform overhead work.3 There is a condition called disc osteophyte complex, which “occurs when more than one spinal vertebra or intervertebral disc is affected by osteophytes” as a result of the spine weakening with obesity, over-exertion, age, and degenerative disease. Symptoms are caused when the “bone spurs interfere with neural activity”.4 Cervical osteophytes form in the neck region, often due to cervical osteoarthritis. Sometimes this disorder is a result of trauma, poor posture, and other arthritis types. When bone spurs occur in the neck, symptoms might include stiffness, headaches, neck pain, radiating pain, tingling, or weakness down the arms, or (rarely) trouble swallowing or breathing.5
Bone Spur Treatment Options
It is necessary to see a doctor about a bone spur if there is swelling or pain in a joint, or if there is trouble moving joints. Early treatment can slow additional damage.6 Heel spurs could be treated non-surgically. If the pain in the foot is worse in the morning, after rest, for example, it is important to stretch and try changing shoes. Taping may help, and orthotic devices could be prescribed. Physiotherapy is another option. Some patients may opt for over-the-counter pain medications such as NSAIDs, while others may be prescribed a corticosteroid injection. In fact, “more than 90 percent of people get better with nonsurgical treatments”. Bone spur surgery might be necessary after about a year of treatments not working. Surgery for this condition would involve spur removal and perhaps “release of the plantar fascia”.7 A small incision is made around the heel, and “the procedure is performed by ‘feel’…(and the surgeon) would cut the ligament free from the heel bone”. In a newer procedure, a camera is used to visualize the plantar fascial ligament. Additionally, “some surgeons still prefer to remove the spur at the time of surgery”. After surgery, movement should be limited for a week. Some patients may need a cast for walking. It takes about 3 weeks for a patient to walk normally, and they should wear orthotics to prevent recurrence. Surgery complications include infection and the patient walking too much on the foot during recovery, leading to continued pain. The surgery may fail.8 Some patients with bone spurs on the spine may also need surgery. But, given the risks, it is important to consider more conservative treatments, such as chiropractic care and physical therapy before resorting to surgery.9
Learn more about bone spur treatments.