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What is Bone Spurs?
Bone spurs are bony projections that develop along the edges of bones. Also called osteophytes, bone spurs often form where bones meet each other in your joints. Bone spurs can also form on the bones of your spine.
The main cause of bone spurs is the wear-and-tear damage associated with osteoarthritis. Most bone spurs cause no symptoms and may go undetected for years. Bone spurs may not require treatment. Decisions about treatment depend on where spurs are located and how they affect your health.
What causes Bone Spurs?
A bone spur forms as the body tries to repair itself by building extra bone. It typically forms in response to pressure, rubbing, or stress that continues over a long period of time.
Some bone spurs form as part of the aging process. As we age, the slippery tissue called cartilage that covers the ends of the bones within joints breaks down and eventually wears away (osteoarthritis). Also, the discs that provide cushioning between the bones of the spine may break down with age. Over time, this leads to pain and swelling and, in some cases, bone spurs forming along the edges of the joint. Bone spurs due to aging are especially common in the joints of the spine and feet.
Bone spurs also form in the feet in response to tight ligaments, to activities such as dancing and running that put stress on the feet, and to pressure from being overweight or from poorly fitting shoes. For example, the long ligament on the bottom of the foot (plantar fascia) can become stressed or tight and pull on the heel, causing the ligament to become inflamed (plantar fasciitis). As the bone tries to mend itself, a bone spur can form on the bottom of the heel (known as a “heel spur”). Pressure at the back of the heel from frequently wearing shoes that are too tight can cause a bone spur on the back of the heel. This is sometimes called a “pump bump,” because it is often seen in women who wear high heels.
Another common site for bone spurs is the shoulder. Your shoulder joint is able to move in a number of directions due to its complex structure. Over time, the bones, muscles, tendons, and ligaments that make up your shoulder can wear against one another. The muscles that allow you to lift and rotate your arm (called the rotator cuff) start at your shoulder blade and are attached to your upper arm with tendons. As these tendons move through the narrow space between the top of your shoulder and your upper arm, they can rub on the bones. Bone spurs can form in this narrow area that, in turn, pinch the rotator cuff tendons, resulting in irritation, inflammation, stiffness, weakness, pain, and sometimes tearing of the tendon. This condition, rotator cuff disorder, commonly occurs with age and/or repetitive use of the shoulder. It is also common in athletes, especially baseball players, and in people such as painters who frequently work with their arms above their heads.
Bone Spurs Symptoms
Most bone spurs cause no signs or symptoms. Often you don’t even realize you have bone spurs until an X-ray for another condition reveals the growths. In some cases, though, bone spurs can cause pain and loss of motion in your joints.
Specific symptoms depend on where the bone spurs are located. Examples include:
- Knee. Bone spurs in your knee may make it painful to extend and bend your leg. The bony growths can get in the way of bones and tendons that keep your knee operating smoothly.
- Spine. Bone spurs on your vertebrae can narrow the space that contains your spinal cord. These bone spurs can pinch the spinal cord or its nerve roots and may sometimes cause weakness or numbness in your arms or legs.
- Hip. Bone spurs can make it painful to move your hip, although the pain is sometimes referred down to your knee. Depending upon the placement, bone spurs also can reduce the range of motion in your hip joint.
- Shoulder. Bone spurs can rub on your rotator cuff, a group of muscles and tendons that help control your shoulder movements. This can cause swelling (tendinitis) and tears in your rotator cuff.
- Fingers. Appearing as hard lumps under your skin, bone spurs can make the joints in your fingers look knobby.
Where do Bone Spurs occur?
Bone spurs develop in areas of inflammation or injury in nearby cartilage or tendons. Common locations for bone spurs are in the back, or sole, of the heel bone of the foot, around joints that have degenerated cartilage, and in the spine adjacent to degenerated discs. Congenital types (osteochondromas) commonly occur around the growth areas of the shoulder and knee.
Bone Spurs Diagnosis
After taking the patient’s medical history and performing a physical examination, physicians can rule out conditions that may have similar symptoms but different causes.
Tests that a doctor may order include:
- Electroconductive tests. These show the degree and seriousness of the spinal nerve injury.
- Computed tomography (CT) scans
- Magnetic resonance imaging (MRI)
- X-rays to highlight any bone changes
Bone Spurs Complications
Bone spurs can break off from the larger bone, becoming what doctors call loose bodies. Often bone spurs that have become loose bodies will float in your joint or become embedded in the lining of the joint (synovium).
Loose bodies can drift into the areas in between the bones that make up your joint, getting in the way and causing intermittent locking a sensation that something is preventing you from moving your joint. This joint locking can come and go as the loose bodies move into and out of the way of your joint.
How are they treated?
Bone spurs do not require treatment unless they are causing pain or damaging other tissues. When needed, treatment may be directed at the causes, the symptoms, or the bone spurs themselves.
Treatment directed at the cause of bone spurs may include weight loss to take some pressure off the joints (especially when osteoarthritis or plantar fasciitis is the cause) and stretching the affected area, such as the heel cord and bottom of the foot. Seeing a physical therapist for ultrasound or deep tissue massage may be helpful for plantar fasciitis or shoulder pain.
Treatment directed at symptoms could include rest, ice, stretching, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Education in how to protect your joints is helpful if you have osteoarthritis. If a bone spur is in your foot, changing footwear or adding padding or a shoe insert such as a heel cup or orthotic may help. If the bone spur is causing corns or calluses, padding the area or wearing different shoes can help. A podiatrist (foot doctor) may be consulted if corns and calluses become a bigger problem. If the bone spur continues to cause symptoms, your doctor may suggest a corticosteroid injection at the painful area to reduce pain and inflammation of the soft tissues next to the bone spur.
Sometimes the bone spurs themselves are treated. Bone spurs can be surgically removed or treated as part of a surgery to repair or replace a joint when osteoarthritis has caused considerable damage and deformity. Examples might include repair of a bunion or heel spur in the foot or removal of small spurs underneath the point of the shoulder.
Can bone spurs be prevented?
There are no means of preventing bone spurs.