Bone Spurs

Bone spurs, also known as osteophytes, are bony projections that form along joints. Bone spurs form due to the increase in a damaged joint's surface area. This is most commonly from the onset of arthritis. Bone spurs usually limit joint movement and typically cause pain. Common places for bone spurs include the spine, shoulders, hands, hips, knees, and feet.

A bone spur forms as the body tries to repair itself by building extra bone. It generally 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). In addition, the discs that provide cushioning between the bones of the spine may break down with age. In this case the spurs are not the source of back pains, but instead are the common symptom of a deeper problem. However, bone spurs on the spine can impinge on nerves that leave the spine for other parts of the body. This impingement can cause pain in both upper and lower limbs and a numbness or tingling sensations in the hands and feet due to the nerves supplying sensation to their dermatomes

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. Bone spurs in the foot can also cause corns and calluses when tissue builds up to provide added padding over the bone spur.

Another common site for bone spurs is the shoulder. The 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 the shoulder can wear against one another. The muscles that lift and rotate the arm (called the rotator cuff) start at the shoulder blade and are attached to the upper arm with tendons. As these tendons move through the narrow space between the top of the shoulder and 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. In extreme cases bone spurs have grown along a person's entire skeletal structure: along the knees, hips, shoulders, ribs, arms and ankles. Such cases are only exhibited with multiple exostoses.

Bone spurs may also be the end result of certain disease processes. Osteomyelitis, a bone infection, may leave the adjacent bone with a spur formation. Charcot foot, the neuropathic breakdown of the feet seen primarily in diabetics, will also leave bone spurs which may then become symptomatic.

Some people have bone spurs without ever knowing it, because some bone spurs cause no symptoms. However, if they are pressing on other bones or tissues or are causing a muscle or tendon to rub, they can break that tissue down over time, causing swelling, pain, and tearing. Bone spur 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 non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Education in how to protect the joints is helpful if you have osteoarthritis. If a bone spur is in the foot, changing footwear or adding padding or a shoe insert such as a heel cup or orthotics 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, a corticosteroid injection at the painful area to decrease pain and inflammation of the soft tissues next to the bone spur may be helpful.

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.