Bone Spur Symptoms and Treatment

What is a bone spur?

Bone spurs are just extra bone, or bony growth, in a location where no bones are typically present. These spurs can range in size from so small they are barely detectable to large enough to cause functional problems. However some bone spurs, especially in the heel, can actually be pointy like the name suggests. This can lead to injury.

What causes a bone spur to develop?

If a bone is under stress due to inflammation, overuse, rubbing against other bones (friction), injury or similar things, it reacts by building more bone. It is the natural reaction of bone as an attempt to protect itself from further injury. Bone spurs can therefore develop anywhere where the bone is stressed. It usually requires the stress to persist over a long period of time for a bone spur to develop.

This can be in a joint affected by osteoarthritis ("wear and tear arthritis"), where the bones of the joint rub together, because the cartilage that usually prevents direct bone to bone contact is worn and damaged. Other reasons for bone spurs are inflammation due to over-use as for example in tendinitis due to tennis elbow or Golfer’s elbow. Plantar fasciitis which is the inflammation of the plantar fascia called connective tissue on the sole of the foot often causes a bone spur to develop where the inflamed fascia is attached to the heel.

There are many medical conditions that lead to the formation of bone spurs, like for example the autoimmune disease ankylosing spondylitis, where the immune system that usually protects us form pathogens like bacteria and viruses accidentally attacks the cartilage in the discs of the spine and bone spurs develop in the spine. The most common areas for the development of bone spurs are the heels, the shoulders, the neck, the spine, the elbows, the knee and the feet.

What are the symptoms of a bone spur?

Most bone spurs do not cause any symptoms, so that most people who have bone spurs do not know that they have them. If a bone spur, however, rubs against another bone in a joint, it can cause pain, redness, heat and swelling in the joint, and it can also reduce the flexibility and the range of motion of the joint.

Sometimes bone spurs rub against tendons or ligaments. This can cause inflammation and pain in the ligament or tendon and can even cause a tear in it. A common location for bone spurs that rub against ligaments or tendons is in the shoulder and it can cause a rotator cuff tear or rotator cuff disorder. Bone spurs in the spine frequently cause a loss of motion. Additionally, they can pinch the nerves that come out of the spine, a condition that is called radiculopathy. Radiculopathy can be extremely painful and can also cause numbness, tingling, weakness and a feeling of the limb being asleep in the arms or legs, depending on which nerve is pinched. Bone spurs in the spine can also compress the spinal cord itself. This condition is called myelopathy and can be very painful. It can also cause weakness and problems with balance.

How are bone spurs diagnosed?

Most bone spurs don’t cause any symptoms or functional problems, so sometimes they are accidentally found on X-rays rather by coincidence than that they were actively looked for. However, in some cases bone spurs can cause joint pain, loss of motion and sometime seven further injuries to the joint. Nevertheless, joint pain and a reduced range of motion can have many reasons, with bone spurs being only one of them. X-rays of the painful area will show whether bone spurs are present, and whether they might be the reason for the symptoms.

How can a bone spur be treated?

Since bone spurs frequently don’t cause any symptoms, they often do not require any treatment, even if their presence is known from X-rays that were taken for other reasons. If bone spurs cause problems the treatment can be aimed directly at the bone spurs. In this case, bone spurs can be removed surgically. However before the surgical removal of a bone spur other forms of therapy are usually tried first. These other forms of therapy often are not intended to directly change the bone spur, but rather to reduce the symptoms or are directed against the causes of the spur. In cases where spurs in the foot are caused by shoes that are too tight, changing the footwear can bring relief.

Symptoms of heel spurs at the site where plantar fascia attaches to the heel often improve, if the pressure on the heel is reduced over a period of time. This can be achieved through methods such as weight loss, the use of a heel cuff or an orthotic insert, or by directing the patient to use of foot wear with better support.

Physical therapy to stretch and strengthen the affected muscles, tendons and ligaments around the bone spur can also often bring relief of painful bone spur symptoms. Deep tissue ultrasound therapy and massage therapy are other methods that aim at the improvement of bone spur symptoms without resorting to removing the bone spur.

Non-steroidal anti-inflammatory drugs that are widely available over the counter like ibuprofen or naproxen can help curb inflammation and achieve relief of pain. Physical therapy can also improve the strength of the muscles in the area of an affected joint and help increase the range of motion. If these attempts do not show the expected success, corticosteroids can be injected directly into the affected joint. These injections of corticosteroid into the joint decrease the inflammation, which reduces the pain and allows the injury to heal. If all of these options fail to relief the symptoms, surgery might be a last resort. Surgery might be used to remove the bone spurs themselves, if they are the reason for the joint problem, and if other treatment attempts have failed.

In more severe cases, in which large or pointy bone spurs have a severe impact on the patient's quality of life, a complete joint replacement surgery might be necessary. This removes the bone spur while simultaneously replacing the entire joint with artificial models, and is often suitable for people with severe osteoarthritis.