Bone Spur

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A bone spur is a lump of calcium that often grows along the edges of bones, such as the vertebrae of the spine. The clinical name for them is osteophytes, or exostoses; both of which mean a bone projection. The most common location where we find bone spurs is where bones meet each other – the leading cause for bone spurs is joint damage such as osteoarthritis, degenerated spinal disc, damage to tendons, or other joint damage. A patient may think of the bone spur as his / her body’s way of trying to compensate for any of the conditions described by growing a little extra bone. The small lumps of calcium normally develop around the edges of the vertebrae or along the facing surfaces of the joints, sometimes resembling small beaks.

In most cases, bone spurs will not cause issues because they grow in areas where we do not notice them. On some occasions, however, they can grow in just the right spot where it will impinge onto a fiber of a nerve, and possibly compounding a protrusion from a herniated disc. In these cases, you may also be diagnosed with spinal stenosis. When a bone spur begins to rub against other bones or press on nerves, that is when you can experience pain, stiffness, and tingling; if left untreated over the long term, numbness and muscle weakness may occur.

The main problem is that bone spurs do not resolve on their own – therefore in some severe cases, eventually, surgical treatment may be required.

Causes & Symptoms

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Bone spurs form 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. 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 can also develop in the feet in response to tight ligaments, due to activities such as dancing and running that put stress on the feet and to pressure from wearing poor-fitting shoes. For instance, the long ligament on the bottom of the foot (also known as 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). Additionally, 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 pump’ 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, however, 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 (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.

Overall, bone spur symptoms can range from mild to severe. Mild symptoms may include joint achiness or stiffness. When severe, bone spurs can cause debilitating pain, frozen joints, or neurological deficits. The size and location of the bone spur can impact the severity of the symptoms. Some other common areas of bone spur formation are:

 

  • Shoulder – Bone spurs in your shoulder typically develop at the AC (acromioclavicular) joint. When this occurs, a hook forms at the end of the acromion; therefore, impinging the tissues that pass underneath it. This may cause pain, loss of range of motion, and damage to the impinged tissues, which may result in tears to the rotator cuff.

 

  • Knee & Hip – Bone spurs in your knees and hips can cause pain, loss in the range of motion, and difficulty walking, rising from a chair, and walking up the stairs.

 

  • Foot – Bone spurs in the foot are typically called heel spurs as they are commonly found on the calcaneus, or heel bone, where the plantar fascia attaches. They are formed from natural wear and tear from walking and running. Obesity is also a risk factor in developing heel spurs due to the added weight and stress placed on the bone surfaces of the feet.

 

  • Spine – Bone spurs develop on the bony segments of the spine known as the vertebrae. They can cause narrowing of the canals where your spinal cord and nerves travel. This narrowing, called spinal stenosis, can cause neck and back pain, as well as neurological symptoms in the arms and legs. Neurological symptoms include pain, numbness, tingling, weakness, and loss of coordination in the arms and legs. Changes in your gait may also occur.

Who Gets a Bone Spur?

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Patients who are at higher risk from bone spurs are athletes. Overuse of joints or repetitive movement raises the risk due to physically intense movements over a long period of time. Genes often have the most significant role in the development of spurs; if an individual’s parents had bone spurs in the past, he / she may have a chance of developing the condition as well. Other risk factors that can lead to bone spurs include a poor diet / nutrition, obesity, gout, aging, injuries, and poor posture.

How Does it Affect You? How Serious is it?

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The formation of bone spurs, called osteophytosis, is much more common after the age of 60. However, younger adults can also develop bone spurs too. Bone spurs typically develop around the areas of the joints, cartilage, tendon, or ligament (when inflamed). When the body detects an injury or inflammation, it triggers a cellular response to repair the damage by producing excess bone in the area, however, in the most severe cases, osteoarthritis can be a leading cause of bone spurs development.

Osteoarthritis is the most common form of arthritis – also called wear and tear arthritis or degenerative arthritis. It occurs when the protective layer of cartilage covering joints begins to break down and wear away.

Recommended Treatment & Rehabilitation

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A diagnosis of bone spurs is typically grouped with a diagnosis of degenerative disc changes at the spine or at a specific joint. A thorough history and examination are performed by a medical doctor that typically includes:

 

Range of motion test – Assessing how far you can move your spine or joint in each direction and if it elicits pain.

 

Neurological assessment – A group of tests that evaluates your neurological system and may aid in pinpointing the area of the spine or joints where your symptoms are originating.

 

Palpation – Touching, pushing, and squeezing of the muscles and other structures to determine the source of pain.

 

Depending on what your doctor discovers on your exam he / she may make a diagnosis of bone spurs. If necessary, your doctor may even order further testing to refine the diagnosis. Some of these additional tests include:

 

X-ray

 

An image of the bones in your spine or joints – an X-ray can locate arthritic changes in the vertebrae, including the location and severity of bone spurs. Load-bearing X-rays can also be used to assess abnormal bone alignment, which may contribute to your bone spur formation.

 

MRI (Magnetic Resonance Imaging)

 

An image of the soft tissues of the spine, which cannot be seen on X-ray. Most commonly an MRI will be ordered for the physician to assess whether a bone spur seen on an X-ray is causing compression or irritation of a nearby nerve. MRI can also locate tumors, damaged discs, and loose ligaments in the spine.

 

EMG (Electromyography)

 

An EMG measures the activity of the muscles at rest and during contraction, determining the communication of the nerve to the muscle.

 

The two major goals of treatment for symptomatic bone spurs are to decrease or eliminate the symptoms and to address the underlying cause of the bone spur formation. Generally, non-surgical treatments are typically recommended first and are extremely effective. Conservative treatments include medication, physiotherapy, and corticosteroid injections. One or all may be used to treat your bone spurs symptoms, including the following:

 

Medication

 

Over-the-counter medications such as Advil or Tylenol may be used to treat your pain if symptoms are mild to moderate. Muscle relaxers such as Skelaxin are used to treat spasms often associated with bone spurs. Nerve membrane stabilizers, such as Neurontin, help reduce the irritability of nerves that are pinched by bone spurs. Opioids are only used whenever pain symptoms are severe. They are often prescribed for short-term use and are only used as a last resort if nothing else is helping with the pain.

 

Physiotherapy

 

Physical therapists can perform manual therapy and provide you with a program of stretching and exercises to help alleviate your symptoms more quickly than with just rest and medication alone. Physiotherapy can be prescribed in conjunction with other treatments such as pain medication and / or injections to help with your symptoms.

 

Steroid injections

 

A physician performs an image-guided injection into the specific area of the joint or spine thought to be the location of your bone spur and pain. Common places steroid injections are performed are at the AC joint of the shoulder, the suspected location of a heel spur on the calcaneus, the joint space between the tibia and femur at the knee, and / or the nerve root exiting the spinal cord. While corticosteroids do not remove or fix the bone spur, they do help decrease the pain and inflammation surrounding the tissues.

 

Surgery

 

If symptoms do not improve with conservative treatment or the patient is experiencing progressing pain and neurological impairment due to bone spurs, surgical intervention is required.

 

Stretching

 

Stretching your toes, feet, and ankles can help alleviate pressure and strain whether you experience a toe bone spur or a heel bone spur. Here are some stretches you can do at home or at work to alleviate pain and discomfort:

 

Foot flex

 

Sit with your legs stretched in front of you. Then, reach for your toes and pull them back toward you. Finally, hold the position for 30 seconds, then repeat the procedure 2-3 times.

 

Wall squat

 

Squat with your back against the wall. Secondly, slowly lift your heels while your toes stay on the floor. Lastly, after a few more seconds, lower your heels. It is necessary to repeat 10 more times.

 

Wall calf stretch

 

Face the wall a few feet back with your left foot in front of your right foot. Lean towards the wall, allowing your left knee to bend slightly. Afterwards, let your left foot support your weight. Keep your right knee straight and lift your right heel off the ground. Finally, hold your position for 20 seconds. Switch the positions of your left and right foot and repeat several times for each side.

Alternative & Homeopathic Treatment

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Currently, there are no ways to prevent the development of bone spurs. However, you can manage self-care treatments at home to help keep your bones and joints healthy and decrease your risk of injuries. Here are a few at-home treatments anyone can use and perform:

 

  • Ice packs – Applying a cold compress on your feet can relieve swelling and pain. Place an ice pack or frozen water bottle on your foot for at least 10 minutes at a time.

 

  • Vitamins and supplements – Vitamins and minerals are an important defense against bone spurs. If you have bone spurs, it is important to make sure you are not deficient in calcium. Since magnesium and vitamin D are essential for the absorption of calcium, you will also want to be sure your levels of these are not low. These vitamins should be obtained through your diet.

 

  • Massage therapy – Massages are useful for relieving and managing pain. To alleviate the pain associated with heel bone spurs, a massage therapist might apply a massage to the calf muscles. This stimulators blood circulation which causes the calf muscle to relax, putting less strain under the foot.