Bone spur

Alternative Names

Bone spurs, Osteophytes, Loose Bodies

What is Bone spur

A bone spur (osteophyte) is a growth of bone formed on your normal bone. Sometimes people think that a "spur" is something sharp but a bone spur is just extra bone. It’s usually smooth, but it can cause wear and tear or pain if it presses or rubs on other bones or soft tissues such as ligaments, tendons, or nerves in the body. Usually the places where bone spurs occurs are the spine, shoulders, hands, hips, knees, and feet.

Signs and symptoms

Sometimes bone spurs don’t have any signs of symptoms. If they do cause symptoms, the symptoms will depend on their location. Bone spurs can cause with pain, numbness, and tenderness if they are irritating adjacent tissues, such as skin, fat pads, nerves or tendons.

Heel spurs cause local foot pain, tenderness, and sometimes swelling. This can lead to difficulty walking due to pain at the bottom of the foot with weight-bearing. Sometimes there is accompanying inflammation of the entire bottom of the foot (plantar fasciitis) when the heel spur occurs in the bottom of the heel bone. Occasionally, bone spurs in this location are a result of inflammatory arthritis, such as from reactive arthritis, ankylosing spondylitis, or diffuse idiopathic skeletal hyperostosis (DISH or Forrestier's disease).

Spurs in the spine can pinch adjacent nerves to cause numbness, tingling, and pain as well as weakness in the area of the body supplied by the affected nerve.

If bone spurs do not cause symptoms and they are incidentally detected by X-ray tests that are performed for other reasons. These spurs may have formed because of past injury to nearby tissues, such as tendons, that caused local inflammation of the bone, leading to the development of the bone spur.

Possible complications

Bone spurs can break off from the larger bone, becoming 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.

What causes

Bone spurs usually occur as a result of a disease or condition — commonly with osteoarthritis. As osteoarthritis breaks down the cartilage in your joint, your body attempts to repair the loss. Often this means creating new areas of bone along the edges of your existing bones.

Bone spurs are the hallmark of other diseases and conditions, including:

• Diffuse idiopathic skeletal hyperostosis (DISH). This condition causes bony growths to form on the ligaments of your spine.
• Plantar fasciitis. A bone spur, sometimes called a heel spur, can form where the connective tissue (fascia) connects to your heel bone (calcaneus). The spur results from chronic irritation or inflammation of the connective tissue, but the spur itself doesn't cause the pain associated with plantar fasciitis.
• Spondylosis. In this condition, osteoarthritis and bone spurs cause degeneration of the bones in your neck (cervical spondylosis) or your lower back (lumbar spondylosis).
• Spinal stenosis. Bone spurs can contribute to a narrowing of the bones that make up your spine (spinal stenosis), putting pressure on your spinal cord.

Bone spurs can also form on their own. They may be a part of aging. They've been found in older people who don't have osteoarthritis or other diseases.

Your body may create bone spurs to add stability to aging joints. Bone spurs may help redistribute your weight to protect areas of cartilage that are beginning to break down. For some people, bone spurs may actually provide a benefit, instead of being just painful.

Prevention

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.

Treatment

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 decrease 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.