What Is a Bone Spur and What Are its Symptoms and Treatment?
A bone spur is a bony projection or outgrowth extending from the edge of a normal bone. It's also known as an osteophyte. A spur forms when a bone is injured in some way, such as by being constantly subjected to pressure, being rubbed repeatedly by another object or being subjected to some other form of continuous or repetitive stress. The spur may be harmless and may not cause any pain. Sometimes bone spurs press on other structures, such as nerves, ligaments, tendons and other bones, however, resulting in pain, inflammation and tissue damage.
Bone spurs often form at or near a joint, which is the site where one bone meets another. Some researchers believe that our bodies make bone spurs in order to increase the stability or strength of a damaged joint. Others think that the spurs are abnormal structures with no function.
Many people never realize that they have a bone spur until it appears in an X-ray for another problem, especially when the spur produces no symptoms. In other cases a spur may cause pain or numbness and may also interfere with the movement of a joint. Bone spurs are most common on the shoulder, heel and spine, but they also occur on the hips, knees, hands and elsewhere in the body.
An X-Ray of a Bone Spur in the Neck
Muscles, Tendons and Ligaments
Muscles, tendons and ligaments are all fibrous structures. They have different functions, however.
- A muscle contracts to move a bone.
- A tendon attaches a muscle to a bone.
- A ligament attaches one bone to another.
Bone Spurs in the Shoulder
The shoulder is made of three bones - the scapula (shoulder blade) at the back and the clavicle (collar bone) and humerus (upper arm bone) in the front. The rotator cuff is a structure made of muscles and tendons which covers the upper arm and attaches it to the shoulder blade. The cuff enables us to move our arm.
The rotator cuff is located under a roof-like structure called the acromion, which is an extension of the scapula. There is a narrow space between the acromion and the rotator cuff which is called the subacromial space.
Bone spurs on the underside of the acromion may narrow the subacromial space. This can cause irritation and inflammation of the tendons in the rotator cuff, resulting in a condition called rotator cuff tendinitis or shoulder impingement. The bone spur may also cause a tear in the cuff. The result of all this damage is pain and difficulty in moving the arm and shoulder.
Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injections can relieve the pain of an impinged shoulder and remove inflammation. Exercises can strengthen the muscles at the front and back of the shoulder, which may increase the volume of the subacromial space. These strength exercises must be done at the right stage of a treatment program, as advised by a medical professional, so that they don't make a shoulder problem worse. If bone spurs are inhibiting movement they may need to be removed surgically if non-surgical treatment is unsuccessful.
A Heel Spur
Bone Spur on the Heel and in the Foot and Plantar Fasciitis
In the heel, a bone spur may be produced due to excess pressure created by a person being overweight or by excessive, high impact exercise such as running. Heel spurs often have a hook-like appearance, as shown in the picture at the start of this article and in the video on the right. They often cause no problems, but like any bone spur if they press on a sensitive structure they may cause pain.
A heel spur is sometimes associated with a condition known as plantar fasciitis. The plantar fascia is a long ligament that runs along the sole of the foot and connects the heel to the toes. If this ligament becomes inflamed and tight, it may pull on the heel and cause a bone spur to form on the bottom of the heel. The pain of plantar fasciitis generally comes from the ligament damage and not from the heel spur.
The treatment for a painful heel spur and for plantar fasciitis are similar. Rest, ice, anti-inflammatory medications and foot and calf stretches are all useful. The stretches should be prescribed or demonstrated by a doctor or other medical professional. Sometimes people with plantar fasciitis are advised to wear night splints to keep the plantar fascia stretched overnight.
When a bone spur forms on the sole of a foot, the area over the spur may thicken, forming a callus or a corn. One technique which can ease the discomfort in the foot is for the person to lose weight if he or she is overweight. Adding padding to a shoe so that the padding covers the area with the bone spur can also help, and so can wearing supportive footwear or shoe inserts.
A Doctor Demonstrates a Plantar Fasciitis Stretching Exercise
Bone Spurs on the Spine, Hip and Knee
According to spine experts, many people over the age of sixty have bone spurs on their spine, or backbone. Aging increases the risk of bone spurs in general due to degenerative changes in the structures around and in joints.
Bone spurs on the spine appear as extensions on the front or side of the vertebrae and usually cause no problem. Spurs that press on a nerve can create a lot of pain, however. The pain may radiate to other areas of the body. The spur may also cause numbness and tingling in the arms and legs.
Bone spurs may occur on the hip and knee as well. Once again, they may cause no problems. Bone spurs on a hip may interfere with range of motion, however. They may also cause pain, which sometimes appears in the knees instead of the hip. A bone spur on the knee itself may cause pain when the knee is bent.
Osteoarthritis and Bone Spurs in the Fingers
Bone spurs in the fingers may give them a knobby or bumpy appearance. The spurs are a common symptom of osteoarthritis in joints. Normally, a layer of slippery cartilage covers the ends of the bones inside a joint capsule, allowing them to slide over each other freely. In osteoarthritis, this cartilage gradually disintegrates, causing the end of one bone to rub over another during movement. Spurs are often produced at the edges of the bones as a result of this stress.
Heberden's and Bouchard's nodes are bumps on the fingers that are associated with osteoarthritis and may also be associated with bone spurs. Heberden's nodes appear on the finger joint that is closest to the fingernail, while Bouchard's nodes are located on the middle joint of a finger. Osteophytes (bone spurs) do form in these areas, but there is a debate about whether Heberden's and Bouchard's nodes should be classified as osteophytes. Their formation and composition is still not understood completely. They may contain bone overgrowth, cartilage overgrowth and/or gelatinous cysts.
Diagnosis of a Bone Spur
A bone spur is detected by some type of radiology (medical imaging) technique, including X-rays, MRI scans, CT scans and ultrasound. These noninvasive examinations enable a doctor to see an image on the inside of the body.
Treatments for Bone Spurs
Anyone with symptoms suggesting the presence of a bone spur should seek their doctor's advice for a diagnosis and a treatment plan. Bone spurs that aren't causing any symptoms may never be discovered and may not need to be treated even if they are eventually found.
There are a number of options that can help relieve the pain of bone spurs that are causing problems. Conservative treatments can be very helpful and are usually tried first. These treatments include the application of ice, the use of anti-inflammatory medications and pain relievers, stretching and/or strengthening exercises (as advised by a medical professional), physical therapy - including ultrasound - and covering the area containing a spur with a cushioning pad (where applicable). Massage may sometimes be useful as well. Surgical techniques may be used to remove bone spurs if non-surgical methods are unsuccessful in eliminating pain and movement problems.
© 2012 Linda Crampton