Cause and Treatment of Bone Spurs

Overgrowth of bone is related to joint degeneration

bone spur
A bone spur often occurs when arthritis forms in a joint. MedicalArtInc / Getty Images

Bone spurs, or osteophytes, are bony projections that form along joints and are often seen in conditions such as arthritis. Bone spurs can cause pain and are largely responsible for limitations in joint motion.

Why Bone Spurs Form

Bone spurs can form as the body responds to an abnormality around a joint. The most common cause is osteoarthritis, a degenerative disease in which the normal cartilage surrounding a joint is gradually worn away.

As the protective cartilage is depleted and bone becomes increasingly exposed, the body will respond with inflammation and changes to the structures around the joints. Ligaments will thicken, and deposits of calcium will gradually form around new bone growth. This new bone growth what we refer to a spur.

The formation of spurs can be thought of as the body’s effort to increase the surface area of an exposed joint — a protective measure to better distribute any impact or force that may be applied to that joint. Unfortunately, it tends to have the opposite effect, restricting joint mobility while constricting nerves and other tissues servicing that joint.

Bone spurs are also common in a non-inflammatory disease called diffuse idiopathy skeletal hyperostosis (DISH). While the cause of DISH is unknown, as many of 80 percent of people diagnosed with the disease will experience pain and stiffness as a result pf the formation of spurs along the spine.

Osteophytes should not be confused with enthesophytes, bony projections that form at the attachment of a tendon or ligament.

Symptoms of Bone Spurs

In many cases, a bone spur will not cause any pain or problems. Even in cases where there is pain, it may not be caused by the spur itself but the underlying condition (arthritis, disease, degeneration).

Bone spurs that form along the spine can result in an impingement where a nerve is compressed by the bone overgrowth. In such case, there can be pain felt in multiple parts of the body depending on which nerve line is affected. It can cause pain in the legs or arms as well as numbness and a prickly, pins-and-needles sensation in the feet or hands.

The formation of osteophytes on the joints of the fingers (called Heberden's nodes and Bouchard's nodes) not only cause the typical swelling we associate with arthritis but seriously limit the dexterity of hands and fingers. Pain most often occurs during the earlier stages of arthritis (generally around middle age) and tend to subside in later age.

Treatment of Bone Spurs

While bone spurs themselves are not problematic, they are indicative of an underlying problem that may need treatment. Changes in bone growth are often documented to help monitor and manage the severity of degenerative diseases like arthritis. If there is pain, a non-steroidal anti-inflammatory drug (NSAID) like ibuprofen may be prescribed.

There are rare circumstances when a bone spur may be removed, mainly if a growth seriously impacts a person’s ability to function. However, the majority of these spurs will return unless the underlying problem is somehow resolved.

In cases of osteoarthritis, this may not be possible.

Sometimes bone spurs around the fingers or toes (such as happens with hallux rigidus of the big toe) can be removed to improve motion and reduce pain.

Source:

Wong, S.; Chiu, K.; and Yan, C. "Review Article: Osteophytes." J Orthop Surg. 2016; 24(3):403-410.

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