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Diseases and Conditions
Bone spurs
From MayoClinic.com
Special to CNN.com

Introduction

Bone spurs, also called osteophytes, are bony projections that grow along the edges of bones. The bone spurs themselves aren't painful, but they can rub against nearby nerves and bones and cause pain.

Bone spurs can form on any bone. Most commonly they form where bones meet each other — in joints — but they can also be found where ligaments and tendons connect with bone. Bone spurs form in the joints that make up your knees, hips, elbow, shoulders, fingers and feet. Bone spurs can also form on the bones of your spine.

It isn't clear what causes bone spurs, but doctors believe they occur in reaction to changes in your joints due to diseases and aging. Bone spurs usually occur as a result of a disease or condition — most commonly osteoarthritis. But they can also form on their own.

Most bone spurs cause no signs or symptoms and may go undetected for years. Other bone spurs form in places where they might rub against other bones or push against nerves, causing pain and disability. What treatment, if any, that you receive for your bone spurs depends on where they're located and how they affect your health.

Signs and symptoms

Most bone spurs cause no signs or symptoms. Often you don't even realize you have bone spurs until an X-ray for another condition reveals the growths.

But some bone spurs can cause pain and loss of motion in your joints. Where your bone spurs are located determines where you'll feel pain and whether you'll experience any other signs or symptoms. For instance:

  • In your knee, bone spurs may make it painful to extend and bend your leg. Bone spurs can get in the way of bones and tendons that keep your knee operating smoothly.
  • On your spine, bone spurs can push against your nerves, causing pain and numbness elsewhere in your body.
  • On your neck, cervical bone spurs can protrude inwards, occasionally making it difficult to swallow or painful to breathe. Bone spurs can also push against veins, restricting blood flow to your brain.
  • In your shoulder, bone spurs can restrict the range of motion of your arm. Bone spurs can rub on your rotator cuff, a group of tendons that help control your shoulder movements. This can cause swelling (tendinitis) and tears in your rotator cuff.
  • On your fingers, bone spurs may appear as hard lumps under your skin, making your fingers appear disfigured. Bone spurs on your fingers may cause intermittent pain.

Causes

Bone spurs are most commonly associated with osteoarthritis. As osteoarthritis breaks down the cartilage in your joint, your body attempts to repair the loss. Often this means creating new areas of bone along the edges of your existing bones.

Bone spurs may also be a normal part of aging. Many older people who don't have osteoarthritis or other diseases may still have bone spurs, though they aren't aware of them. Your body may create bone spurs to add stability to aging joints. Bone spurs may help redistribute your weight to protect areas of cartilage that are beginning to break down. For some people, bone spurs may actually provide a benefit, rather than a painful condition.

Bone spurs are the hallmark of other diseases and conditions, including:

  • Diffuse idiopathic skeletal hyperostosis (DISH). This condition causes bony growths to form on the ligaments of your spine.
  • Plantar fasciitis. A bone spur, sometimes called a heel spur, can form where the connective tissue (fascia) connects to your heel bone (calcaneus). The spur results from chronic irritation or inflammation of the connective tissue, but it doesn't cause the pain associated with plantar fasciitis.
  • Spondylosis. In this condition, osteoarthritis and bone spurs cause degeneration of the bones in your neck (cervical spondylosis) or your lower back (lumbar spondylosis).
  • Spinal stenosis. Bone spurs can contribute to a narrowing of the bones that make up your spine (spinal stenosis), putting pressure on your spinal cord.

Screening and diagnosis

If you experience joint pain, your doctor will conduct a physical exam to better understand the pain you're feeling. He or she may feel around your joint to determine exactly where your pain is coming from. Sometimes your doctor can feel a bone spur, though sometimes bone spurs form in spots that can't be easily felt.

To confirm a diagnosis, your doctor may order imaging tests to get a look at your joints and bones. Some common ways of looking for bone spurs include X-ray exams and computerized tomography (CT) or magnetic resonance imaging (MRI) scans.

Complications

Bone spurs can break off from the larger bone, becoming what doctors call loose bodies. Often bone spurs that have become loose bodies will float in your joint or become embedded in the lining of the joint (synovium).

Loose bodies can drift into the areas in between the bones that make up your joint, getting in the way and causing intermittent locking — a sensation that something is preventing you from moving your joint. This joint locking can come and go as the loose bodies move into and out of the way of your joint.

Treatment

There's no specific treatment for bone spurs. Treatment is typically directed at the underlying problem to prevent further joint damage. If your bone spurs are causing pain, your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to ease the pain.

Bone spurs that limit your range of motion or cause other problems that limit your ability to go about your day may require surgery. What surgical options you have will depend on where your bone spurs are located and your particular situation. For instance, bone spurs are often removed as part of a more comprehensive surgery for arthritis. If you have arthritis in your elbow, for example, your surgeon may remove bone spurs when he or she is making other repairs to your elbow.

Surgery to remove bone spurs can be done in an open procedure, meaning the surgeon cuts open the skin around your joint to gain access to your joint. Or bone spur removal may be done arthroscopically, meaning the surgeon makes several small incisions to insert special surgical tools. During arthroscopic surgery, your surgeon uses a tiny camera to see inside your joint.

If your bone spurs don't cause you any pain or if they don't limit any range of motion in your joints, then your bone spurs likely won't need treatment.

January 03, 2006

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