What Is a Bone Spur? Why You Might Have One and What to Do about It

If you experience sudden, sharp pain in the heel of your foot while walking, or in your knees as you go from sitting to standing, you might have a bone spur. These small, bony projections or “spikes” form at the edges of bones, usually at the joint, and can also show up in the hands, toes and shoulders.

Sometimes you can even see a bone spur if it’s close to the skin, appearing as a lump or bump. Bone spurs are relatively common as you age, particularly if you have osteoarthritis.

“Oftentimes, even in someone who has a bone spur, the pain they are feeling is due to osteoarthritis or chronic irritation of tendons that attach muscles to bones, which is the underlying problem,” says Tiana S. Woolridge, MD, MPH, a sports medicine physician at HSS. Though a large bone spur can be painful and limit the functioning of the joint, removing it isn’t usually the first treatment option.

Causes of Bone Spurs

Several factors can contribute to or are associated with the risk of developing bone spurs. They include:

• Osteoarthritis.
• Age. Bone spurs tend to show up in older adults, particularly if they’re in the early stages of osteoarthritis development.
• A history of playing a competitive sport. Someone who plays a sport with a lot of repetitive motion is more likely to develop arthritis early or wear away cartilage within the joints and hence be more likely to develop bone spurs.
• Cartilage damage. When the joint space narrows due to cartilage damage, there tends to be a higher likelihood of bone spurs developing in that area. This could be due to wear and tear or a previous injury to the area.
• Weight. Obesity is a risk factor for the development of osteoarthritis, particularly in the knees and hands.

How to Treat Bone Spurs

Oftentimes bone spurs, which are also called osteophytes, don’t cause pain or limit range of motion. You could have one or more and not know it until you see one on an X-ray. Spurs don’t have to be treated if they aren’t contributing to discomfort.

“When I tell a patient that I see a bone spur on the X-ray they often ask, ‘Can we shave that off?’” says Dr. Woolridge. If the spur is causing a lot of irritation of the soft tissues or nerves around the spur, a doctor can remove them with surgery, she adds. However, bone spurs can come back, which is one major reason why surgery isn’t typically the first option.

What she suggests instead is a thorough evaluation, starting with an X-ray, to see if there is a correlation between the location of the pain and the bone spur. “I’ll see these bone spurs on x-ray which look like spikes or peaks at the end of the bone,” says Dr. Woolridge, but sometimes that’s not the area where the patient feels the pain.

Treatment for bone spurs is often focused on the underlying problem that caused the spur to develop, such as osteoarthritis, tendon irritation, or plantar fasciitis. Non-surgical options Dr. Woolridge recommends include:

• a short course of anti-inflammatory medications (e.g., NSAIDs) for pain relief, like ibuprofen
• ice
• compression and bracing devices to stabilize the joints
• activity modification
• cortisone shots (also called corticosteroid injections) if the patient can’t sleep due to intense pain or if they are experiencing swelling in the joint
• hyaluronic acid injections into the joint to relieve pain and stiffness
• physical therapy to strengthen the muscles around the joints and improve joint mobility
• diclofenac (Voltaren), a topical anti-inflammatory pain gel
• supplements that help with arthritis inflammation, pain, and joint function, including turmeric, collagen or Boswellia serrata extract or Boswellic acid
• platelet-rich plasma injections (PRP) to kick-start the body’s inflammatory response for healing

“I try to have patients start as conservatively as possible for bone spur treatment,” says Dr. Woolridge. “If those aren’t working, I might refer them to a surgeon.”

When Surgery for Bone Spurs Is Recommended

If the bone spur is causing a lot of irritation or limiting the function or range of motion of a joint, or if pain does not improve with conservative treatments such as the ones mentioned above, surgery may be required.