Bone spurs

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

Bone spurs, also called osteophytes, can form on any bone. They often
form where bones meet each other — in your joints. But, they can also be
found where ligaments and tendons connect with bone. Bone spurs can
also form on the bones of your spine.

Most bone spurs cause no symptoms and may go undetected for years. What
treatment, if any, that you receive for your bone spurs depends on where
they're located and how they affect your health.
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 in your joints
* Loss of motion in your joints

Location determines other symptoms
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, or even
your spinal cord, causing pain and numbness elsewhere in your body.
* On your neck, cervical bone spurs can protrude inward,
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 muscles
and 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.

When to see a doctor
Make an appointment with your doctor if you have pain or swelling in one
or more joints, or if you have difficulty moving a joint. If you have
an underlying health condition, early diagnosis and treatment can help
prevent or slow further joint damage.
Causes

Bone spurs usually occur as a result of a disease or condition —
commonly 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 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 the spur itself 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.

May be a normal part of aging
Bone spurs can also form on their own. They may be a part of aging.
They've been found in older people who don't have osteoarthritis or
other diseases.

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, instead of being just painful.

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.

Preparing for your appointment

If you have swelling, pain or limited motion in a joint, make an
appointment with your doctor. In some cases, however, you may be
referred to a doctor who specializes in the diagnosis and treatment of
joint disorders (rheumatologist).

Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

* List any symptoms you've been having, and for how long.
* Write down your key medical information, including other
conditions with which you've been diagnosed, all medications and
supplements you're taking, and any family history of bone or joint
disease.
* Note any recent injuries that may have damaged a joint.
* Write down questions to ask your doctor. Creating your list of
questions in advance can help you make the most of your time with your
doctor.

Below are some basic questions to ask a doctor who is examining you for
joint problems. If any additional questions occur to you during your
visit, don't hesitate to ask.

* What is the most likely cause of my signs and symptoms?
* Are there any other possible causes?
* What tests do I need to confirm a diagnosis?
* What treatment approach do you recommend, if any?
* How much do you expect my symptoms will improve with treatment?
* If you're recommending medications, are there any possible side effects?
* Is surgery an option in my case? Why or why not?
* What self-care measures can I take to help manage symptoms?
* How often will you see me to monitor my progress?
* Should I see a specialist?

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to
answer them may reserve time to go over any points you want to talk
about in-depth. Your doctor may ask:

* What are your symptoms?
* When did you first notice these symptoms?
* How severe is your pain?
* Are you having trouble moving the affected joint or joints?
* Are your symptoms affecting your ability to complete daily tasks?
* Have you recently had any injuries that may have caused joint damage?
* Have you tried any at-home treatments so far? If so, has anything helped?
* Have you been diagnosed with any other medical conditions?
* What medications are you currently taking, including vitamins and supplements?
* What is your typical exercise routine?
* Do any of your first-degree relatives — such as a parent or sibling — have a history of bone disorders?

What you can do in the meantime
In the time leading up to your appointment, try self-care measures at
home. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs),
such as aspirin, ibuprofen (Advil, Motrin, others) and naproxen sodium
(Aleve), may help relieve pain and swelling. You might also find relief
by applying an ice pack to the affected joint for 15 to 20 minutes
several times each day.

Until your doctor sees you, avoid using your joint in ways that cause or worsen pain.

Tests 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
* Computerized tomography (CT) scans
* Magnetic resonance imaging (MRI) scans

Treatments and drugs

There's no specific treatment for bone spurs.

If your bone spurs don't cause you any pain or if they don't limit any
range of motion in your joints, then you likely won't need treatment. If
you need treatment, it's typically directed at the underlying problem
to prevent further joint damage.

Medications
If your bone spurs are causing pain, your doctor may recommend
over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to ease
the pain.

Surgery
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.