What Are Bone Spurs?
A bone spur is an outgrowth of bone that can occur along the edges of a bone. It is also called an osteophyte. Bone spurs can form in any bone but are most commonly found in joints, where two or more bones come together. They also occur where muscles, ligaments, or tendons attach to the bone.
Some of the most common parts of the body affected by bone spurs are the neck (cervical spine), low back (lumbar spine), shoulder, hip, knee, and heel. Other areas may be affected as well, including the temporomandibular joint (TMJ), hands, wrists, and feet (the top of the foot [midfoot], arch of the foot, or toes).
What Causes a Bone Spur?
Bone spurs typically occur because of continued stress or rubbing of a bone for a prolonged period of time. This can be due to osteoarthritis or inflammation such as tendinitis. Normally there is a layer of cartilage along the edges of bones where they come together to form a joint. With osteoarthritis, this cartilage layer becomes worn away, and the bones can rub directly against each other. New bone forms in response to the stress or inflammation. It is the bone's method of trying to stabilize or protect itself.
There are other medical conditions that are commonly associated with bone spurs. These include a condition known as plantar fasciitis. This is an inflammation of the fascia or connective tissue on the bottom of the foot where it attaches to the heel bone or calcaneus. Diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis are both inflammatory disorders that affect the body's ligaments and cause bone spurs in the spine.
What Are Risk Factors for Bone Spurs?
Risk factors for bone spurs include trauma to a joint. An accident that injures a joint increases the likelihood of osteoarthritis and bone spurs occurring in that joint later in life. Also, overuse of a joint or tendon can predispose one to bone spurs.
Genetics is also a risk factor for the development of bone spurs. People with many family members with bone spurs are more likely to develop bone spurs themselves.
The conditions ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH) both place a person at high risk for developing bone spurs in the spine.
Diabetes is a risk factor for the development of bone spurs and osteoarthritis. The exact connection between these is unknown.
What Are Signs and Symptoms of a Bone Spur?
Bone spurs do not always cause symptoms. Many people have bone spurs but do not know it. However, if bone spurs rub against other bones or nearby soft tissues they can cause pain or a loss of normal motion in a joint. This is most common in the hips, knees, shoulders, hands, and feet.
If the bone spurs rub against tendons or ligaments, they can cause pain or a tear. This is a common complication in the shoulder and can lead to a rotator cuff tear.
If bone spurs occur in the spine, they can cause pain and loss of motion, but they can also pinch the nerves or spinal cord. When nerves in the spine are pinched, it is known as radiculopathy. It can cause pain, numbness, tingling, or weakness in the arms or legs. If the spinal cord is compressed, it is called myelopathy. This can cause problems with balance, weakness, and pain.
Cause of Bone Spurs
Osteoarthritis (OA) is not a single disease but rather the end result of a variety of disorders leading to the structural or functional failure of one or more of your joints. Osteoarthritis is the most common cause of chronic joint pain, affecting over 25 million Americans. Osteoarthritis involves the entire joint, including the nearby muscles, underlying bone, ligaments, joint lining (synovium), and the joint cover (capsule).
When Should Someone Seek Medical Care for a Bone Spur?
If you are having problems with increased pain in your joints or loss of motion, you may have bone spurs. Other conditions can also cause these symptoms. If these symptoms cause significant persistent pain, you should seek medical care to have it evaluated.
What Specialists Treat Bone Spurs?
Specialists who treat people with bone spurs include internists, family medicine doctors, generalists, rheumatologists, orthopedists, and physical medicine and rehabilitation specialists. Physical therapists and occupational therapists also treat patients with bone spurs.
How Do Health-Care Professionals Diagnose Bone Spurs?
A doctor will likely begin with a medical history and physical examination. The medical history is a series of questions about someone's condition and a review of any other medical problems. The physical examination will include testing the joints that are affected to determine how much motion an individual has, how much pain one experiences with motion, and a check of muscle strength.
Based on the results of the medical history and physical, a physician may recommend obtaining imaging studies to diagnose bone spurs. This often starts with plain radiographs (X-rays). These are typically able to show if bone spurs have formed and if the joint is affected. If there is a question of possible tear of a tendon such as a rotator cuff tear, an MRI may be ordered. An MRI or CT scan may also be ordered in the spine to assess for possible nerve or spinal cord compression.
What Are Treatment Options for a Bone Spur?
Treatment for bone spurs depends on the symptoms one is having. Pain is the most common symptom and is often initially treated with medications. Anti-inflammatory medications are typically used first. These help both to relieve pain and to reduce the inflammation caused by the bone spurs.
A doctor may also recommend physical therapy to help with bone spur symptoms. The physical therapy is not able to remove bone spurs, but it can help with some of the symptoms related to them. If one has a loss of motion in a joint caused by bone spurs, physical therapy can help strengthen the surrounding muscles and increase the motion in the joints. Physical therapy can include ice or cold packs, stretching exercises, ultrasound treatments, or massage.
In some cases, an injection of a steroid such as cortisone into the joint can help reduce pain from bone spurs. These injections can often be performed in a doctor's office, depending on the joint involved. If the hips or spine are involved, the injections usually are performed using an X-ray machine to help guide the placement of the injection.
Over-the-counter anti-inflammatory medications can be used to treat pain. A doctor or physical therapist can provide a patient with simple stretching exercises to perform at home. Other home remedies for bone spurs include applying ice to the affected joint.
What Medical Devices Treat Bone Spurs?
If the bone spurs affect the foot or heel, a doctor may recommend special pads or inserts for shoes called orthotics to help take the pressure off the bone spurs.
When Is Surgery Appropriate for Bone Spurs?
In some cases, if symptoms cannot be controlled with more conservative treatment, surgery could be an option. The goal of surgery is to remove the bone spurs to allow for a more normal joint or to remove the pressure on muscles, tendons, ligaments, or nerves. The surgery may simply remove the bone spurs, but in other cases, the removal could be part of a larger surgery such as a joint-replacement surgery.
Is Follow-up Necessary After Treatment of Bone Spurs?
If one continues to have worsening problems due to bone spurs, follow up with a doctor for further evaluation.
Is It Possible to Prevent a Bone Spur?
Bone spurs are usually the result of arthritis, so there is no specific way to prevent them. Maintaining an active lifestyle and being physically fit can often help reduce the symptoms related to bone spurs. Maintaining a healthy weight reduces the load on the joints. This may help prevent the formation of bone spurs, especially in the knees.
What Is the Prognosis of a Bone Spur?
The prognosis for the treatment of bone spurs is good. There have been many recent advancements in medications for the treatment of arthritis and other causes of bone spurs. Additionally, newer and less invasive surgical techniques allow for a faster recovery and return to normal activities.
For More Information on Bone Spurs
For more facts and information on bone spurs and osteoarthritis, contact the following organizations.
American College of Rheumatology
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health
Reviewed on 11/20/2017
Kalunian, K. "Diagnosis and classification of osteoarthritis." UpToDate.com. <http://www.uptodate.com/contents/diagnosis-and-classification-of-osteoarthritis>.