Topic Overview
What is a bone spur?
A bone spur (osteophyte) is a bony growth formed on
normal bone. Most people think of something sharp when they think of a "spur,"
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. Common places for bone spurs include
the spine, shoulders, hands, hips, knees, and feet.
What causes bone spurs?
A bone spur forms as the
body tries to repair itself by building extra bone. It typically 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). Also, the discs that provide
cushioning between the bones of the spine may break down with age. Over time,
this leads to pain and swelling and, in some cases, bone spurs forming along
the edges of the joint. Bone spurs due to aging are especially common in the
joints of the spine and feet.
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.
Another
common site for bone spurs is the shoulder. Your 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 your shoulder can wear against one
another. The muscles that allow you to lift and rotate your arm (called the
rotator cuff) start at your shoulder blade and are
attached to your upper arm with tendons. As these tendons move through the
narrow space between the top of your shoulder and your 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.
What are the symptoms?
Many people have bone spurs without ever knowing
it, because most bone spurs cause no symptoms. But if the bone spurs 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 spurs in
the foot can also cause corns and calluses when tissue builds up to provide
added padding over the bone spur.
How are bone spurs diagnosed?
A bone spur is usually visible on an
X-ray. But since most bone spurs do not cause problems, it would be
unusual to take an X-ray just to see whether you have a bone spur. If you had
an X-ray to evaluate one of the problems associated with bone spurs, such as
arthritis, bone spurs would be visible on that X-ray.
How are they treated?
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
reduce 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.