What are the common signs of a bone spur on the wrist. How can physical therapy benefit individuals with wrist bone spurs. What are the risk factors for developing bone spurs on the wrist.

Understanding Bone Spurs on the Wrist

Bone spurs, medically known as osteophytes, are abnormal bone growths that can develop on the surface of bones. While they can occur on various parts of the body, bone spurs on the wrist can be particularly troublesome due to the wrist’s frequent use and mobility. These bony projections often form as a result of joint damage or degenerative conditions like osteoarthritis.

Are bone spurs always symptomatic? Not necessarily. Many individuals with wrist bone spurs may not experience any noticeable signs or symptoms. However, when symptoms do occur, they can range from mild discomfort to significant pain and reduced mobility.

Alternative Names for Wrist Bone Spurs

• Benign Bone Spur of Wrist
• Osteophytes of Wrist

Identifying the Signs and Symptoms of Wrist Bone Spurs

While bone spurs on the wrist may not always cause symptoms, it’s crucial to be aware of potential indicators. Here are three key signs that may suggest the presence of a wrist bone spur:

1. Visible bony mass: A noticeable lump or protrusion under the skin on the wrist.
2. Pain and discomfort: Persistent or intermittent pain in the wrist area, especially during movement.
3. Reduced range of motion: Difficulty in fully flexing or extending the wrist.

Can wrist bone spurs cause neurological symptoms? In some cases, yes. If the bone spur presses on surrounding nerves, individuals may experience numbness, tingling sensations, or weakness in the affected area.

Risk Factors Contributing to Wrist Bone Spur Development

Understanding the risk factors associated with wrist bone spurs can help individuals take preventive measures or seek early intervention. Some common risk factors include:

• Advanced age
• Repetitive stress on the wrist (e.g., from high-impact sports or repetitive work tasks)
• Obesity or excess body weight
• Poor dietary habits
• Presence of degenerative joint diseases like osteoarthritis
• Genetic predisposition or family history of bone spurs

Does having these risk factors guarantee the development of wrist bone spurs? No, it doesn’t. Risk factors merely increase the likelihood of developing the condition, but they don’t ensure its occurrence. Conversely, individuals without these risk factors may still develop bone spurs.

Diagnostic Approaches for Wrist Bone Spurs

Accurate diagnosis of wrist bone spurs is crucial for effective treatment. Healthcare providers employ various diagnostic tools and techniques to confirm the presence of bone spurs and assess their impact on surrounding tissues. These may include:

• Physical examination and medical history review
• X-rays of the wrist
• Computerized tomography (CT) scans
• Magnetic resonance imaging (MRI)
• Electromyography (EMG)
• Nerve conduction velocity (NCV) studies

How do these diagnostic methods complement each other? Each test provides unique information about the bone spur and its effects on the wrist. While X-rays can show the bony growth, MRI scans offer detailed images of soft tissues, helping to identify any nerve compression or inflammation.

Treatment Options for Wrist Bone Spurs

The treatment approach for wrist bone spurs depends on the severity of symptoms and the impact on daily activities. Conservative methods are often the first line of treatment and may include:

• Over-the-counter pain medications (e.g., ibuprofen, acetaminophen)
• Physical therapy exercises
• Lifestyle modifications to reduce stress on the wrist
• Use of wrist splints or braces

When is surgical intervention considered for wrist bone spurs? Surgery may be recommended if conservative treatments fail to provide relief, or if the bone spur significantly reduces wrist mobility or causes persistent nerve compression.

The Role of Physical Therapy in Managing Wrist Bone Spurs

Physical therapy plays a crucial role in the non-surgical management of wrist bone spurs. Here are three key benefits of incorporating physical therapy into the treatment plan:

1. Improved wrist flexibility and range of motion
2. Strengthening of surrounding muscles to support the affected joint
3. Pain reduction through targeted exercises and manual therapy techniques

How does physical therapy contribute to long-term management of wrist bone spurs? By focusing on improving joint function and reducing stress on the affected area, physical therapy can help prevent further progression of the condition and minimize the need for more invasive treatments.

Prognosis and Long-Term Outlook for Wrist Bone Spurs

The prognosis for individuals with wrist bone spurs is generally favorable, especially when conservative treatment methods are employed early. Many patients experience significant improvement in symptoms and function through non-surgical approaches. However, it’s important to note that bone spurs can recur in some cases.

Can wrist bone spurs be completely cured? While complete elimination of bone spurs may not always be possible without surgery, effective management can significantly reduce symptoms and improve quality of life. Regular follow-ups with healthcare providers and adherence to recommended treatments are crucial for optimal outcomes.

Preventive Measures and Lifestyle Modifications

While it may not be possible to prevent all cases of wrist bone spurs, certain lifestyle modifications can help reduce the risk or minimize symptom progression:

• Maintaining a healthy weight to reduce stress on joints
• Incorporating regular, low-impact exercises to improve joint flexibility and strength
• Using proper ergonomics and techniques during repetitive wrist activities
• Adopting a balanced, nutrient-rich diet to support bone and joint health
• Taking regular breaks and performing stretching exercises during prolonged wrist-intensive tasks

How can individuals balance activity and rest to protect their wrists? It’s important to find a balance between maintaining wrist mobility through regular use and avoiding overexertion. Incorporating rest periods and using supportive devices when necessary can help prevent excessive stress on the wrist joint.

Understanding wrist bone spurs and their potential impact on daily life is crucial for early detection and effective management. By recognizing the signs and symptoms, being aware of risk factors, and exploring various treatment options, individuals can take proactive steps to maintain wrist health and function. Whether through conservative measures like physical therapy or more advanced interventions when necessary, proper care and attention to wrist bone spurs can lead to improved outcomes and quality of life.

Bone Spur of Wrist

Approved by

Krish Tangella MD, MBA, FCAP Pathology Feb. 20, 2018

Individuals with Bone Spurs of Wrist rarely experience any signs or symptoms. However, in some cases, individuals may experience pain in the wrist.

What are the other Names for this Condition? (Also known as/Synonyms)

• Benign Bone Spur of Wrist
• Osteophytes of Wrist

What is Bone Spur of Wrist? (Definition/Background Information)

• Bone spur is an abnormal bone growth that can develop on the surface of bones. Usually, bone spurs are not painful by themselves, but may cause pain when they rub against the nerves and press surrounding tissue
• Bone spurs may develop on the surface of any bone. It most commonly involves the bones of the feet, elbow, and spine. Joint damage caused by degenerative joint disease, such as osteoarthritis, is the primary cause of bone spur in the joints
• Individuals with Bone Spurs of Wrist rarely experience any signs or symptoms. However, in some cases, individuals may experience pain in the wrist
• A majority of Bone Spurs of the Wrist grow very slowly and are stable. However, in some cases, the growth is more rapid and unpredictable. In these cases, the healthcare provider may recommend surgery to remove the bone spurs
• Over-the-counter oral medications, such as ibuprofen and acetaminophen, are recommended if the condition is painful. Surgery may be required, if Bone Spurs of the Wrist reduce an individual’s range of motion in the affected wrist joint, presses on nerves, or if the pain is not controlled by medication
• The prognosis of Bone Spurs of Wrist is usually good and conservative methods are usually effective in treating many individuals. However, occasionally, a recurrence of the condition is noted

Who gets Bone Spur of Wrist? (Age and Sex Distribution)

• Bone Spurs of Wrist may occur in individuals of all ages, races, ethnic groups, and genders
• No geographical localization has been noted

What are the Risk Factors for Bone Spur of Wrist? (Predisposing Factors)

The common risk factors for Bone Spurs of the Wrist include:

• Advanced age
• Repetitive stress on the wrist caused by participation in high-impact sports
• Excessive body weight associated with obesity
• Unhealthy diet
• Degenerative joint disease such as osteoarthritis
• Heredity predisposition; a family history of bone spurs

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Bone Spur of Wrist? (Etiology)

• Bone Spurs of the Wrist are usually caused by a disease or condition that results from a degeneration of the cartilage
• Excess bone formation occurs as a result of the body’s response to abnormal pressure on the affected area of the bone

In other words, bone spurs are caused as part of a reactive process to a bone injury.

What are the Signs and Symptoms of Bone Spur of Wrist?

In many individuals, bones spurs are not painful by themselves and cause no significant signs or symptoms. However, in some, certain symptoms may develop depending on the severity of the condition.

The signs and symptoms of Bone Spurs of Wrist include:

• The appearance of a bony mass under the skin, on the wrist
• Uncontrollable pain in the wrist
• Numbness, feeling of weakness, tingling sensation of the wrist joint may be observed, if the surrounding nerves are pinched
• Decreased range of motion of the wrist

How is Bone Spur of Wrist Diagnosed?

Bone Spurs of Wrist may be diagnosed by the following observations and tests:

• A complete physical examination with thorough evaluation of medical history
• X-ray of the wrist: X-rays are noninvasive medical tests that use radiation to produce images of the bone
• Computerized tomography (CT) scan of the wrist: A CT scan takes a series of X-ray images from several different angles. These images are then merged to create cross-sectional images of bones and soft tissues with the body
• Magnetic resonance imaging (MRI) scan of the wrist: An MRI is a more detailed scan that uses radio waves and a magnetic field that generates thorough images of interior bones and soft tissues
• Electromyography (EMG): An EMG shows the electrical activity of the muscle during rest and muscle contraction. This test may be performed if the signs and symptoms indicate that there is muscle or nerve damage
• Nerve conduction velocity (NCV) studies: Nerve conduction velocity shows the speed at which electrical signals move through the affected nerve. Slow nerve signal speed may indicate nerve damage

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Bone Spur of Wrist?

The possible complications of Bone Spurs of Wrist include:

• Without treatment, in some individuals, bone spurs can cause severe uncontrollable pain, by impinging on surrounding structures such as the tendons and nerves
• Surgery to remove bone spurs may lead to the following complications:
  • Infection at the site of surgery
  • Poor wound closure
  • Anesthetic complications
• Permanent damage to the nerves in the wrist
• Occasionally, relief from surgery may only be temporary, since bone spurs may grow back (recurrent bone spurs)

How is Bone Spur of Wrist Treated?

The methods for treating Bone Spurs of Wrist depend on the severity of the signs and symptoms. Conservative methods for individuals with mild to moderate pain may include:

• Rest: Any activity that aggravates the condition further should be avoided. The healthcare provider may advise individuals to refrain from participating in certain activities, until the symptoms get better
• Non-steroidal anti-inflammatory oral medications, such as ibuprofen, naproxen, and acetaminophen may be used to treat bone spurs. These medications can help decrease pain and swelling
• Corticosteroid injections help provide temporary relief of symptoms, and in improving the range of motion. It is important to note that corticosteroid injections only give temporary relief. Prolonged episodes of such injections may injure the joints in the long-run
• Physical therapy exercises that include strengthening and improving flexibility in the wrist can help reduce discomfort. It can also help decrease pressure on the nerves

Surgical treatment for Bone Spurs of the Wrist: If conservative treatments are unsuccessful, surgery may be recommended. A common surgical procedure is:

• Bone spur removal: This procedure involves the surgical removal of any abnormal bony growth in the wrist

How can Bone Spur of Wrist be Prevented?

Bone Spurs of Wrist is a condition that cannot be prevented in most individuals. However, in some cases, following certain guidelines may help reduce the risk of developing bone spurs.

• Maintain a healthy body weight through a healthy diet and regular exercise
• Take frequent breaks while working on the computer to limit repetitive wrist action
• Limit activities that may involve repetitive stress on the wrist; wear appropriate safety equipment when participating in any (high-impact) sports. Significant stress on the wrist joints may lead to the development of bone spurs

What is the Prognosis of Bone Spur of Wrist? (Outcomes/Resolutions)

• In a majority of cases, the prognosis of Bone Spurs of Wrist is usually good and symptoms are resolved with suitable conservative treatment
• However, there is still a risk that the bone spur will continue to grow. in these cases, a healthcare provider will recommend surgery to treat the condition
• Occasionally, recurrent bone spurs may be observed and the relief obtained from surgery may only be temporary

Additional and Relevant Useful Information for Bone Spurs of Wrist:

Please visit the following link for more information on bone spur removal surgical procedure that may be performed if Bone Spurs develop on any surface of the bones.

http://www.dovemed.com/common-procedures/procedures-surgical/bone-spur-removal/

American Academy of Orthopaedic Surgeons (AAOS)
6300 North River Rd. Rosemont, IL 60018-4262
Phone: (847) 823-7186
Toll-Free: (800) 346-2267
Fax: (847) 823-8125
Email: [email protected]
Website: http://www.aaos.org

http://orthoinfo.aaos.org/topic.cfm?topic=a00149 (accessed on October 20, 2016)

http://www.mayoclinic.org/diseases-conditions/bone-spurs/basics/definition/con-20024478 (accessed on October 20, 2016)

https://www. cedars-sinai.edu/Patients/Health-Conditions/Bone-Spurs-Osteophytes.aspx (accessed on October 20, 2016)

Minami, A., Kato, H., Iwasaki, N., & Minami, M. (1999). Limited wrist fusions: comparison of results 22 and 89 months after surgery. The Journal of hand surgery, 24(1), 133-137.

Capo, J. T., Orillaza, N. S., & Lim, P. K. (2009). Carpal boss in an adolescent: case report. The Journal of hand surgery, 34(10), 1808-1810.

Hattori, Y., Doi, K., Hoshino, S., Sakamoto, S., & Yukata, K. (2010). Attritional rupture of the flexor tendons to the small finger caused by osteophyte of the ulnar head: case report. The Journal of hand surgery, 35(1), 24-26.

Serarslan, Y. (2009). Median nerve enterapment secondary to carpal osteophyte: A case report.

Walker, G., & McCambridge, T. M. Atypical Wrist Pain in a Female Gymnast.

Young, D., Papp, S., & Giachino, A. (2007). Physical examination of the wrist. Orthopedic Clinics of North America, 38(2), 149-165.

Heras-Palou, C. (2012). Extra-articular ulnar-sided wrist pain. In Arthroscopic Management of Ulnar Pain (pp. 335-347). Springer Berlin Heidelberg.

Palmer, K. T. (2003). Pain in the forearm, wrist and hand. Best Practice & Research Clinical Rheumatology, 17(1), 113-135.

Is your wrist pain carpal tunnel syndrome?

Around 1 in 5 people is affected by carpal tunnel syndrome, a common condition marked by numbness or decreased feeling in the fingers and wrist. I’ve seen patients whose carpal tunnel symptoms are so painful that they needed surgery. But surgery can often be avoided when people seek help for carpal tunnel symptoms sooner.

Early on, many people find that their carpal tunnel syndrome is annoying but manageable. The problem is the condition tends to get worse over time. Diagnosing and treating carpal tunnel early is critical for easing a person’s discomfort and preventing lasting nerve damage.

Carpal tunnel syndrome can be confused with other conditions affecting the hand or wrist, including arthritis, tendonitis, or other types of nerve compression.  If you’re experiencing discomfort, numbness or tingling in your wrist, hand or fingers and aren’t sure of the cause, I encourage you to answer these questions.

Where does your wrist hurt the most?

Carpal tunnel syndrome occurs when pressure is placed on your median nerve, a major nerve in your hand that gives feeling to all of your fingers except your pinky. The median nerve passes through the carpal tunnel, a path made of bone and ligament that runs through the base of your hand. If your wrist becomes swollen, the carpal tunnel can become narrower and compress the median nerve, causing pain or numbness. 

If you have problems with your carpal tunnel, you may experience things such as:

• Pain, numbness, tingling, or burning in your thumb and first three fingers. The pain can shoot up your forearm toward your shoulder.
• Intermittent shock-like sensations that start from your forearm and go out toward your fingers.
• Weakness or clumsiness in your fingers or hands that makes it harder to do things like button a shirt or write. You may also be more likely to drop things.
• In severe cases, numbness in your fingers may make it hard to tell if something is hot or cold to the touch. This can increase your risk for burns.

How serious is your pain and when do you have it?

Discomfort caused by carpal tunnel syndrome starts off mild. Sometimes the feeling is more noticeable in the dominant hand; other times it affects both hands. The sensations might come and go at first, and you may notice them more at night. The pain might wake you up, and you may find that shaking out your hand gives you some relief.

As the condition progresses, you might start to notice pain during the day. This tends to be worse when you’re engaging in an activity where your wrist is bent, like driving, holding a book, talking on the phone, typing, or writing. Eventually it may become difficult to perform movements that involve pinching or gripping, like making a fist.

Since carpal tunnel syndrome symptoms can come and go, you may mistakenly believe that whatever is causing your pain has cleared up. But without treatment, the problem won’t go away.

Do you have any risk factors for carpal tunnel syndrome?

Anyone can be affected by carpal tunnel syndrome, but it’s more common in certain people. You may be more prone to the condition if you:

• Have a family history of carpal tunnel syndrome
• Are older or were assigned female at birth
• Perform daily activities that involve repetitive hand or wrist motions  that put your hand or wrist in a strained position for long periods 
• Use vibrating hand tools. Capral tunnel syndrome is a common problem for people who work in manufacturing, sewing, cleaning, or meatpacking industries
• Have certain health problems, including diabetes or a thyroid issue
• Are pregnant. Hormone-related swelling may cause carpal tunnel syndrome during pregnancy
• Had an injury that caused your wrist to swell, like a strain or fracture
• Have obesity

Do you have arthritis?

Arthritis and carpal tunnel syndrome are two different conditions, but have similar symptoms. Arthritis can cause swelling in the wrist or the carpal tunnel tendons. Spurs are created around the wrist bone, which can potentially lead to the development of carpal tunnel syndrome. Arthritis can also make carpal tunnel syndrome worse.

Get the correct diagnoses and treatment

When I see someone who is showing possible carpal tunnel syndrome symptoms, I check the function and strength of their fingers and wrists, and I look for signs of inflammation. These things help me confirm the diagnosis.

If someone does have carpal tunnel syndrome, the treatments I select depend on the severity of their swelling. Some of my patients with mild symptoms see an improvement with lifestyle changes like wearing a splint or brace, or cutting back on activities that cause wrist pain.

They may also need to take over-the-counter medications such as ibuprofen (Advil) or naproxen (Aleve) to help relieve pain and reduce inflammation. Sometimes injections with a corticosteroid can help relieve painful symptoms or help calm a flare-up of symptoms.