Robert J. Snyder, MD
As a busy Orthopaedist, I see many patients in the office, whose main complaint goes something like this, “I have this really sharp pain, when I walk (or insert your activity of choice here). It hurts so bad, it must be caused by a bone spur”. Most of those pains are NOT caused by bone spurs, but rather another musculoskeletal problem. However, bone spurs, aka osteophytes (osteo=bone and phyte=growth) do occur in the body. In this article, I will discuss osteophytes, their causes and treatments.
Bone spurs usually form as a symptom/reaction to inflammation (such as tendinitis), injury, aging, degeneration or disease near or within a joint. The major cause for the development of bone spurs is arthritis. Cartilage is the cushiony material that acts as a slide and a shock absorber for the motion of all joints in the human body. When cartilage begins to wear away, the body will try to increase the surface area of the joint in order to relieve pressure on the eroded area and to increase its structural integrity. It does so by growing new bone in the form of osteophytes.
In some areas, most notably the spine, osteophytes from one vertebra may actually fuse with an osteophyte on the adjacent vertebra. These are called “kissing osteophytes” and are an attempt by the body to decrease motion between adjacent spinal vertebrae in an attempt by the body to decease pain.
Often, these bone spurs will accomplish their intended purpose of relieving pressure on the joint and the person that has them won’t even know they are there. Bone spurs are often seen in the spine, shoulders, feet, wrists, and fingers, but they can be anywhere that a joint is located. Sometimes, this new bone will exacerbate pain in the joint and do more harm than good, by impinging on nerves, other bone and/or other soft tissue and causing even more problem with joint movement. That is when a skilled Orthopaedist needs to intervene.
When a person comes to me complaining of pain, with or without movement, tingling, burning or weakness, or problems with a joint “catching” or “getting stuck”, I immediately send them for diagnostic x-rays. Radiographic images clearly show bone and bone spurs are easily visualized. If I determine a patient does indeed have a bone spur(s), I usually start with conservative treatment, with NSAIDs and a prescription for Physical Therapy. We may talk about ways you can modify activities that cause pain and at home treatments, such as a heating pad or ice that you can try. Often, these treatments will help alleviate pain and inflammation. Steroid injections can also help.
Bone spurs that are in the feet or hands often respond well to orthotics, bone spur pads or bracing, which takes pressure off the spur and allows inflammation in the area to decrease.
If a patient continues to have issues, an MRI or CT scan will be ordered to give us a more in-depth look at the soft tissues and other structures of the body. If we determine that the bone spur(s) is significantly impinging on a nerve or other tissue, surgery may be the only effective remedy. In surgery, your physician can not only address the bone spur, but the problem with the joint that is causing the bone spur(s).
Bone spur removal surgery is typically done on an outpatient basis, but will be dependent on the location of the bone spur in the body and if there are concurrent issues or damage caused by the bone spur that must be dealt with, such as a herniated disc in the spine or a torn rotator cuff in the shoulder. Your orthopaedic surgeon will advise you on the extent of the surgery that must take place for you to find symptom relief and correction of the joint issue.
Thankfully, most bone spurs can be treated non-surgically, but if surgery is required, most can be managed with minimally-invasive outpatient surgery procedures.