Bone Spurs
Introduction
Bone
spurs, also called osteophytes, are bony projections
that grow along the edges of bones. The bone spurs
themselves aren't painful, but they can rub against
nearby nerves and bones and cause
pain.
Bone
spurs can form on any bone. Most commonly they form
where bones meet each other — in joints — but they can
also be found where ligaments and tendons connect with
bone. Bone spurs form in the joints that make up your
knees, hips, elbow, shoulders, fingers and feet. Bone
spurs can also form on the bones of your
spine.

It
isn't clear what causes bone spurs, but doctors believe
they occur in reaction to changes in your joints due to
diseases and aging. Bone spurs usually occur as a result
of a disease or condition — most commonly
osteoarthritis. But they can also form on their
own.
Most
bone spurs cause no signs or symptoms and may go
undetected for years. Other bone spurs form in places
where they might rub against other bones or push against
nerves, causing pain and disability. What treatment, if
any, that you receive for your bone spurs depends on
where they're located and how they affect your
health.
Signs and
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.
But
some bone spurs can cause pain and loss of motion in
your joints. Where your bone spurs are located
determines where you'll feel pain and whether you'll
experience any other signs or symptoms. For
instance:
- In your knee, bone
spurs may make it painful to extend and bend your leg.
Bone spurs can get in the way of bones and tendons
that keep your knee operating smoothly.
- On your spine, bone
spurs can push against your nerves, causing pain and
numbness elsewhere in your body.
- On your neck,
cervical bone spurs can protrude inwards, occasionally
making it difficult to swallow or painful to breathe.
Bone spurs can also push against veins, restricting
blood flow to your brain.
- In your shoulder,
bone spurs can restrict the range of motion of your
arm. Bone spurs can rub on your rotator cuff, a group
of tendons that help control your shoulder movements.
This can cause swelling (tendinitis) and tears in your
rotator cuff.
- On your fingers,
bone spurs may appear as hard lumps under your skin,
making your fingers appear disfigured. Bone spurs on
your fingers may cause intermittent pain.
Causes
Bone
spurs are most commonly associated 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 may also be a normal part of aging. Many older
people who don't have osteoarthritis or other diseases
may still have bone spurs, though they aren't aware of
them. 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, rather than a painful
condition.
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 it 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.
Screening
and diagnosis
If
you experience joint pain, your doctor will conduct a
physical exam to better understand the pain you're
feeling. He or she may feel around your joint to
determine exactly where your pain is coming from.
Sometimes your doctor can feel a bone spur, though
sometimes bone spurs form in spots that can't be easily
felt.
To
confirm a diagnosis, your doctor may order imaging tests
to get a look at your joints and bones. Some common ways
of looking for bone spurs include X-ray exams and
computerized tomography (CT) or magnetic resonance
imaging (MRI) scans.
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.
Treatment
There's no specific treatment for bone
spurs. Treatment is typically directed at the underlying
problem to prevent further joint damage. If your bone
spurs are causing pain, your doctor may recommend
nonsteroidal anti-inflammatory drugs (NSAIDs) to ease
the pain.
Bone
spurs that limit your range of motion or cause other
problems that limit your ability to go about your day
may require surgery. What surgical options you have will
depend on where your bone spurs are located and your
particular situation. For instance, bone spurs are often
removed as part of a more comprehensive surgery for
arthritis. If you have arthritis in your elbow, for
example, your surgeon may remove bone spurs when he or
she is making other repairs to your
elbow.
Surgery to remove bone spurs can be done
in an open procedure, meaning the surgeon cuts open the
skin around your joint to gain access to your joint. Or
bone spur removal may be done arthroscopically, meaning
the surgeon makes several small incisions to insert
special surgical tools. During arthroscopic surgery,
your surgeon uses a tiny camera to see inside your
joint.
If
your bone spurs don't cause you any pain or if they
don't limit any range of motion in your joints, then
your bone spurs likely won't need
treatment.