January 19, 2019
heel pain from bone spur

Bone Spurs: Your Questions Answered

by Health After 50  

Bone spurs are bony growths that usually form on the margins of joints. Similar bony outgrowths also form where tendons, ligaments, or muscles attach to bone. They commonly develop in the spine (especially the neck and low back), shoulders, hips, knees, heels, hands, and toes.

Bone spurs themselves don’t cause pain or other symptoms—and most people don’t even know they have one unless they appear on an imaging test done for another reason. But if they grow large enough, they can press on nerves or surrounding tissue, causing pain, stiffness, and weakness, which can limit your movement.

What causes bone spurs?

Bone spurs are a normal part of aging to some extent; your body may produce them when bone responds to chronic physical stress. Bone spurs are most often a result of osteoarthritis. As cartilage in the joints wears away, bones begin to rub against each other and bone spurs develop. These bumps may protrude into surrounding tendons or break off and float within the joint space, causing swelling or interfering with range of motion.

Who gets bone spurs?

The development of bone spurs may be accelerated in people with osteoarthritis, plantar fasciitis (inflammation of tissue on the bottom of the foot), tendinitis, bone infections, prior injury, or biomechanical problems. People with occupations or activities that involve repetitive motion are more likely to develop bone spurs, as are people who are overweight or wear tight-fitting shoes. Joggers and dancers, for example, can form bone spurs in their feet from the recurring stress of the activities. Bone spurs also tend to run in families.

What are some complications of bone spurs?

Bone spurs that develop in the spine may lead to stenosis (a narrowing of the spinalcanal). In the cervical (neck) area, this can lead to pain, tingling, and numbness radiating to the neck, shoulders, and arms. Stenosis lower in the spine (such as the lumbar area) can cause symptoms in the buttocks, thighs, hips, legs, and feet. Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by multiple bone spurs and ligaments that have ossified (transformed into bone), usually in the spine, though it can affect other areas of the body. Most people with DISH have no symptoms, but if bone spurs in the neck region push into the throat—an uncommon occurrence—it can cause difficulty swallowing or even breathing.

Bone spurs in the shoulder joint can pinch the tendons of the rotator cuff, causing pain, stiffness, and weakness, all of which can lead to reduced range of motion. If you feel pain when straightening and bending your leg, you might have a bone spur in your knee. A bone spur in the hip can interfere with mobility and cause pain, sometimes in your knee.

Bone spurs in the fingers can be felt as hard lumps under the skin and cause disfiguration, such as knobbiness. You may also have difficulty straightening your fingers. Heel spurs often occur with plantar fasciitis and can prevent you from putting weight on your foot without feeling pain.

How are bone spurs treated?

You need treatment for a bone spur only if it’s causing symptoms. If you have joint pain, swelling, and stiffness, or any other musculoskeletal pain that lasts longer than six weeks, see your doctor. Such symptoms can be caused by many musculoskeletal conditions, not just bone spurs. Your doctor may order X-rays or other imaging tests, such as a computed tomography (CT) or magnetic resonance imaging (MRI) scan.

The best way to treat a bone spur is by addressing the underlying cause. In addition to arthritis and other medical conditions like DISH, excess weight, bad posture, old athletic injuries, or even shoes that don’t fit well may be to blame.

The treatment goal is to relieve pain and prevent additional damage in the least invasive way. Conservative therapy usually involves rest, icing, and stretching. Your doctor may suggest taking an over-the-counter pain reliever, such as acetaminophen (Tylenol and others) or a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen (Advil, Motrin, and others) or naproxen (Aleve and others), for a limited time to reduce pain and inflammation.

Weight loss, if you’re overweight, is always a good idea. Also, even though your symptoms may seem to worsen with movement, targeted physical therapy exercises can restore range of motion in the joints and promote good posture (which reduces pressure on nerves). Shoe inserts or orthotics may help relieve pain from heel spurs. Your doctor may give you cortisone shots for temporary relief of serious pain.

Surgical removal depends on the spur’s location and is an option for more severe or persistent symptoms, particularly if you already require surgery for arthritis. For example, bone spurs on the heel or shoulder can be surgically removed. Some people choose to have bone spurs removed for cosmetic reasons, especially when the hands are affected. Removal can be performed through traditional open surgery or minimally invasive (endoscopic) procedures.

Bone spurs removed during joint replacement surgery typically don’t grow back. But there’s no guarantee that other bone spurs won’t return.

Can bone spurs be prevented?

Not completely. However, you can lower your risk of developing bone spurs (and osteoarthritis) by trying to reduce stress on the joints by staying at a healthy weight, getting regular physical activity, and maintaining good posture.

This article first appeared in the December 2018 issue of UC Berkeley Health After 50.

Also see Bursitis Basics.