Causes, Symptoms, Diagnosis, Treatment, & Prevention

Written by WebMD Editorial Contributors

• What Are Bone Spurs?
• Causes of Bone Spurs
• Symptoms of Bone Spurs
• Bone Spur Diagnosis
• Bone Spur Treatments and Home Care
• Bone Spur Prevention
• More

Bone spurs (also called osteophytes) are smooth, hard bumps of extra bone that form on the ends of bones. They often pop up in the joints — the places where two bones meet.

Bone spurs can form on many parts of your body, including your:

• Hands
• Shoulders
• Neck
• Spine
• Hips
• Knees
• Feet (heels)

Most bone spurs don’t cause problems. But if they rub against other bones or press on nerves, you might experience pain and stiffness.

The most common cause of bone spurs is joint damage from osteoarthritis or degenerative joint disease. The cushioning between your joints and the bones of your spine can wear down with age. Rheumatoid arthritis, lupus, and gout can also damage your joints.

Bone spurs also often form after an injury to a joint or tendon. When your body thinks your bone is damaged, it tries to fix it by adding bone to the injured area.

Other causes of bone spurs include:

• Overuse – for example, if you run or dance a lot over a long period of time
• Genes
• Diet
• Obesity
• Bone problems that you were born with
• Narrowing of the spine (spinal stenosis)

You might not realize you have a bone spur until you get an X-ray to look for another condition. They only cause problems when they press on nerves, tendons, or other structures in your body. Then, you might feel any of the following:

• Pain in the affected joint
• Pain or stiffness when you try to bend or move the affected joint
• Weakness, numbness, or tingling in your arms or legs if the bone spur presses on nerves in your spine
• Muscle spasms, cramps, or weakness
• Bumps under your skin, seen mainly in the hands and fingers
• Trouble controlling your bladder or bowels if the bone spur presses on certain nerves in your spine (a symptom that’s seen very rarely)

Your symptoms might get worse when you exercise or try to move the affected joint.

A bone spur can break off and get stuck in the lining of the joint. This is called a “loose body.” It can lock up the joint and make it hard to move.

Often, bone spurs are first evaluated by your regular doctor who will likely refer you to a specialist. You’ll probably need to see a rheumatologist or orthopedic doctor. Rheumatologists specialize in joint problems. Orthopedic doctors focus on the musculoskeletal system. Your doctor will feel the joint to check for a bump. They may also order an X-ray to help them to see the bone spur better.

Other tests your doctor can use to diagnose bone spurs include:

• CT scan. It’s a powerful X-ray that makes detailed pictures inside your body.
• MRI. This uses powerful magnets and radio waves to make pictures of organs and structures inside your body.
• Electroconductive tests. These tests measure how fast your nerves send electrical signals. They can show the damage bone spurs have caused to nerves in your spinal canal.

To relieve pain and bring down swelling, you can try one of these over-the-counter pain relievers:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)
• Naproxen sodium (Aleve)

These can cause side effects, especially if you take them in large doses or for a long time. If you’ve taken them for more than a month, ask your doctor if you can try a different treatment.

Other therapies for bone spurs include:

• Rest
• Steroid shots to bring down swelling and reduce pain in the joints
• Physical therapy to improve joint strength and increase movement

If these treatments don’t work or the bone spur affects your movement, you might need surgery to remove the extra bone.

Bone spurs usually can’t be prevented if they’re the result of the natural wear and tear of arthritis. But you can take these steps to avoid bone spurs caused by other things:

• Wear shoes with a wide toe box, good arch support, and enough cushion to pad each step. Get your shoes fitted by a professional so they don’t rub against your feet when you walk. Wear thick socks to prevent your shoes from rubbing.
• Eat a well-rounded diet with plenty of calcium and vitamin D to protect your bones.
• Do regular weight-bearing exercises like walking or stair climbing to keep your bones strong.
• Try to keep the extra pounds off.

See your doctor if you have any signs of joint trouble, like pain, swelling, or stiffness. If you catch and treat arthritis early, you may be able to prevent the damage that leads to bone spurs.

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Causes, Symptoms, Diagnosis, Treatment, & Prevention

Written by WebMD Editorial Contributors

• What Are Bone Spurs?
• Causes of Bone Spurs
• Symptoms of Bone Spurs
• Bone Spur Diagnosis
• Bone Spur Treatments and Home Care
• Bone Spur Prevention
• More

Bone spurs (also called osteophytes) are smooth, hard bumps of extra bone that form on the ends of bones. They often pop up in the joints — the places where two bones meet.

Bone spurs can form on many parts of your body, including your:

• Hands
• Shoulders
• Neck
• Spine
• Hips
• Knees
• Feet (heels)

Most bone spurs don’t cause problems. But if they rub against other bones or press on nerves, you might experience pain and stiffness.

The most common cause of bone spurs is joint damage from osteoarthritis or degenerative joint disease. The cushioning between your joints and the bones of your spine can wear down with age. Rheumatoid arthritis, lupus, and gout can also damage your joints.

Bone spurs also often form after an injury to a joint or tendon. When your body thinks your bone is damaged, it tries to fix it by adding bone to the injured area.

Other causes of bone spurs include:

• Overuse – for example, if you run or dance a lot over a long period of time
• Genes
• Diet
• Obesity
• Bone problems that you were born with
• Narrowing of the spine (spinal stenosis)

You might not realize you have a bone spur until you get an X-ray to look for another condition. They only cause problems when they press on nerves, tendons, or other structures in your body. Then, you might feel any of the following:

• Pain in the affected joint
• Pain or stiffness when you try to bend or move the affected joint
• Weakness, numbness, or tingling in your arms or legs if the bone spur presses on nerves in your spine
• Muscle spasms, cramps, or weakness
• Bumps under your skin, seen mainly in the hands and fingers
• Trouble controlling your bladder or bowels if the bone spur presses on certain nerves in your spine (a symptom that’s seen very rarely)

Your symptoms might get worse when you exercise or try to move the affected joint.

A bone spur can break off and get stuck in the lining of the joint. This is called a “loose body.” It can lock up the joint and make it hard to move.

Often, bone spurs are first evaluated by your regular doctor who will likely refer you to a specialist. You’ll probably need to see a rheumatologist or orthopedic doctor. Rheumatologists specialize in joint problems. Orthopedic doctors focus on the musculoskeletal system. Your doctor will feel the joint to check for a bump. They may also order an X-ray to help them to see the bone spur better.

Other tests your doctor can use to diagnose bone spurs include:

• CT scan. It’s a powerful X-ray that makes detailed pictures inside your body.
• MRI. This uses powerful magnets and radio waves to make pictures of organs and structures inside your body.
• Electroconductive tests. These tests measure how fast your nerves send electrical signals. They can show the damage bone spurs have caused to nerves in your spinal canal.

To relieve pain and bring down swelling, you can try one of these over-the-counter pain relievers:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)
• Naproxen sodium (Aleve)

These can cause side effects, especially if you take them in large doses or for a long time. If you’ve taken them for more than a month, ask your doctor if you can try a different treatment.

Other therapies for bone spurs include:

• Rest
• Steroid shots to bring down swelling and reduce pain in the joints
• Physical therapy to improve joint strength and increase movement

If these treatments don’t work or the bone spur affects your movement, you might need surgery to remove the extra bone.

Bone spurs usually can’t be prevented if they’re the result of the natural wear and tear of arthritis. But you can take these steps to avoid bone spurs caused by other things:

• Wear shoes with a wide toe box, good arch support, and enough cushion to pad each step. Get your shoes fitted by a professional so they don’t rub against your feet when you walk. Wear thick socks to prevent your shoes from rubbing.
• Eat a well-rounded diet with plenty of calcium and vitamin D to protect your bones.
• Do regular weight-bearing exercises like walking or stair climbing to keep your bones strong.
• Try to keep the extra pounds off.

See your doctor if you have any signs of joint trouble, like pain, swelling, or stiffness. If you catch and treat arthritis early, you may be able to prevent the damage that leads to bone spurs.

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Treatment Heel “spur” – Orthopedics Ruslana Sergienko

A heel spur is the result of plantar fasciitis, the main symptom of which is pain in the heel that occurs or worsens with exercise. In most cases, the pain syndrome is caused by inflammatory and degenerative changes in the plantar (plantar) fascia.

Plantar fascia is a tough tendon plate, woven from a huge amount of microfibers, which is attached to the calcaneus and metatarsal heads, creating a kind of protective cover for the plantar surface of the foot.

As can be seen from the figure, the plantar fascia is stretched like a bowstring between the bones, the so-called arch of the foot. Imagine that with every step this kind of bowstring is pulled, holding this arch, preventing the bones of the foot from “parting”.

Constant load of body weight, overload during hard work, changes in posture due to diseases of the back lead to the appearance of microdamages in the places of attachment of the plantar fascia to the bones. As can be seen from the figure, the place of attachment of the “string” to the metatarsal bones is divided into five points, while on the heel there is only one point of attachment. The load is 5 times more on the heel, so the disease starts from the heel.

There is a microdamage (tear or rupture) of one of the many thin fibers of the plantar fascia. The body reacts in a standard way – inflammation develops. Inflammation leads to the formation of edema, abnormal germination of microvessels and small nerve branches into the damaged fascia, and pain occurs. The pain is especially severe after a night’s sleep and rest, the so-called “starting pain”.

The fibers of the plantar fascia that have remained intact begin to work instead of the broken ones, experiencing an increased load, and are also damaged.

Inflammation and pain progress, forcing to reduce the load. Human activity is reduced, new fibers are not damaged. The inflammatory process subsides, scars form at the site of the damaged fibers, and then bone growths that are visible on the x-ray and have a characteristic “spur” appearance.

That is why this disease is called “heel spur”, although the “spur” itself is already the result of long-term plantar fasciitis.

Who is more likely to suffer from heel spurs?

Heel spurs mainly affect people over 40 years of age, and women are more predisposed to this disease. The likelihood of developing heel spurs is increased by excess weight, problems with the spine, arthritis, flat feet, diseases of the large joints of the legs, injuries of the calcaneus, gout, circulatory disorders in the legs. Also, the heel spur is found in athletes with prolonged loads in the heel area.

What are the symptoms of a heel spur?

The leading symptom of heel spurs (plantar fasciitis) is pain in the heel region that occurs or worsens with exercise. Pain is more pronounced in the morning. In most cases, the diagnosis of plantar fasciitis is sufficient to analyze the patient’s complaints, physical examination and X-ray, which reveal the presence of a heel spur. The absence of radiological signs of a heel spur in combination with heel pain requires a differential diagnosis with systemic inflammatory diseases (rheumatoid arthritis, Reiter’s syndrome, etc. ), which can also debut with heel pain. In this case, the diagnosis of plantar fasciitis can be established using an ultrasound examination.

What is the treatment for heel spurs?

First, get rid of overloads.

This does not mean completely abandoning any movement. This means that a painless range of motion should be performed. For example, you have noticed that it is worth standing for 2 hours, the pain increases. Try to stand for 2 hours with breaks, for example 15 minutes. Or you walk 4 kilometers and experience pain. Try to walk 2 kilometers or the same 4 kilometers, but at a slow pace. Sports doctors have proven that continuing exercise in a “sparing mode” has a greater effect on the result of treatment than refusing to exercise at all.

Stretching and strengthening.

The stretching and strengthening program plays an important role in the treatment of the disease, as it can effectively relax cramped calf muscles or strengthen weak foot muscles. Why stretching or “stretching” is effective? It loosens the tension and reduces the risk of breaking the “bowstring”. A less taut plantar fascia is not damaged as much. Do these exercises at home.
The easiest way to stretch is using a support wall: Or steps: Another effective stretching method is to use footrests that can be used in the workplace, such as under a desk or in the kitchen, thus increasing the time for such “on-the-job” activities. . The use of “rocking chairs”, widely used to prevent salt deposits, is a type of “dynamic stretching” of the plantar fascia. For the same purpose, you can use a tennis ball or an iron can: Before getting out of bed, it is useful to perform a massage in the sole area to reduce pain:
or stretching with a towel: Strengthening the small muscles of the foot.
By performing 2 simple exercises, you can achieve a significant increase in strength in the small muscles of the foot, which will lead to unloading of the plantar fascia.

1. Pull up towel. The patient sits on a chair, the towel lies on the smooth floor in front of him. The patient puts his toes on the towel and, without taking his heel off the floor, bending his toes, pulls the towel towards him.
2. Finger up. The patient sits on a chair, the foot is placed on the floor, the toes are raised up. First, the thumb is placed on the floor, and the rest remain raised. Then the thumb is raised and remains in this position, and the rest are lowered and placed on the floor.

About 35% of patients achieve regression of symptoms only with the help of stretching and muscle strengthening.

Shoes.

It is not uncommon for plantar fasciitis to develop after wearing uncomfortable, especially tight shoes or shoes with excessively hard soles. People who suffer from plantar fasciitis may find that wearing sneaker-type shoes with soft, springy soles and an insole that hugs the arch of the foot significantly reduces pain. This is not surprising. The springy outsole absorbs impact when walking, while the arch-fitting insole supports it and transfers the load directly to the bones, bypassing the plantar fascia.

It should also be noted that over time, the properties of the polymeric materials from which shoes are made change, so such shoes need to be changed in a timely manner.

Insoles.

As far as insoles are concerned, it can be said that only custom-made devices, made on the basis of modern equipment based on the footprint, can help in the treatment of fasciitis. The insoles do not act on the fasciitis itself, but by correcting violations of the arch of the foot, for example, with flat feet. Incorrectly selected insoles can worsen the patient’s condition.

Night immobilizing dressings.

The purpose of immobilization bandages is to keep the ankle joint in a neutral position. It is noted that the vast majority of people sleep with outstretched socks. In this position, the places of attachment of the plantar fascia to the bones come together, which causes it to shorten over time. This is what causes morning pain in the foot. The person spent the whole night with outstretched socks, and in the morning he gets on his feet, sharply stretching the inflamed plantar fascia. The immobilizing bandage keeps the bones from coming together, and the plantar fascia does not contract overnight, which reduces morning pain.

An overnight immobilizing dressing can be made from plaster or polymeric bandages, or you can buy ready-made ones from those sold in a pharmacy.
An example of a nightly immobilizing bandage: Of course, sleeping in a cast is not very comfortable, but studies have shown that this method is effective in 80% of patients. Night immobilizing dressings are especially effective in patients with a long period of the disease (about 12 months or more).

Anti-inflammatory treatment of heel spurs.

Anti-inflammatory treatment of heel spurs includes ice, NSAIDs, electrophoresis and hormonal injections.

Ice is used in the form of ice massages, ice baths or ice packs.
Ice massage: the patient takes an ice cube, places it over the area of ​​pain and performs circular movements with slight pressure for 5 to 10 minutes.

Ice bath: fill a shallow container with ice water, place only the heel in it and hold for 10 to 15 minutes. Do not lower other parts of the foot into the water to avoid hypothermia.

Ice pack: Place crushed ice in a plastic bag, wrap in a towel and apply to the heel for 15 to 20 minutes. Instead of crushed ice, you can use a bag of frozen food.

Ice is applied after completion of exercise or after a working day.

Non-steroidal anti-inflammatory drugs (eg diclofenac or nimesulide).

Non-steroidal anti-inflammatory drugs have been studied for plantar fasciitis with conflicting results. Therefore, they are recommended only in case of increased pain, given the side effects of these drugs, which include gastrointestinal bleeding, gastritis, damage to kidney tissue.

Electrophoresis.

Electrophoresis is a physiotherapy procedure that uses the properties of low voltage electrical impulses to deliver corticosteroid (hormonal) drugs deep into tissues. Studies of the effectiveness of this treatment method showed that within 2-3 weeks after the end of the procedure, the therapeutic effect decreases.

Corticosteroid injections.

Corticosteroid injections are effective in up to 70% of patients, but are known to rupture the plantar fascia in up to 10% of patients. It is known that the introduction of corticosteroids into any tissue leads to its death at the injection site. Therefore, this method of treatment should be used with extreme caution.

Shock wave therapy is a highly effective non-surgical method of treating heel spurs, approved by the equivalent of the US Department of Health as the main one for this particular disease, based on the action of acoustic shock waves. The method of shock wave therapy has been used for a long time to crush stones in the urinary tract. This is the so-called intracorporeal (conducted inside the body) shock wave therapy. Unlike devices for crushing kidney stones (lithotripters), in devices for extracorporeal (used on the surface of the body) shock wave therapy, the acoustic wave is much less powerful. Its action is based on the stimulation of regenerative processes in areas of chronic tendon inflammation and nonunion fractures.

Shock wave therapy does not break up heel spurs as is commonly believed. It sharply enhances regeneration at the site of damage to the plantar fascia, stops long-term inflammation, thereby, on the contrary, preventing the development of heel spurs. The shock wave in orthopedics does not destroy, but restores.

The effectiveness of shock wave therapy is comparable to surgical treatment, since more than 93% of patients report a pronounced and persistent clinical effect. However, unlike surgical treatment, shock wave therapy is a painless method of treatment that does not require anesthesia and the patient’s stay in the hospital.
Shock wave therapy is a safe method of treating heel spurs, it has a complex effect and eliminates the cause of the heel spur.
Effects of shock wave therapy:

• reduction of pain and inflammation
• improvement of blood circulation and nutrition of damaged tissues
• destruction of calcifications, bone “growths”
• accelerate the healing of damaged tissues
• increased mobility in the injured area of ​​the body
• increasing the resistance of tendons, ligaments and muscles to physical stress and injury

Advantages of shock wave therapy:

• high clinical efficiency – up to 93% of patients have a clinical effect
• rapid onset of clinical effect – reduction of pain, swelling, improvement of mobility
• stable clinical effect of the course lasts up to 1 year
• patient safety – no complications or side effects
• convenience of treatment for the patient – the session lasts 5-10 minutes, the frequency of the procedure is 1 time per week, 5-7 sessions are enough for a complete recovery
• reduction in the need for drugs or complete elimination of them
• is an optimal replacement for surgery and injections.

It is recommended to support the effect of shock wave with stretching and muscle strengthening exercises, anti-inflammatory treatment in the form of ice and electrophoresis, as well as modification of the load regimen.

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Heel spur, causes, symptoms, treatment

Heel spur is a bony growth in the area of ​​the plantar surface of the calcaneus. Its appearance is associated with constant irritation of the place of attachment to the heel bone of the plantar aponeurosis. This irritation usually occurs with increased physical exertion on the foot.

The main cause of bone outgrowth in the calcaneal region is the constant irritation of the place of attachment to the bone of the tendons or ligaments, in particular, the plantar aponeurosis. As a result of constant irritation in this area, inflammation occurs. That is what is causing the pain. Gradually, the place of attachment of the inflamed ligament or aponeurosis undergoes “calcification” – that is, as if “impregnated” with calcium salts. In this period, when radiography of the foot, you can see the shadow of the bone growth – osteophyte .

Major risk factors for heel spurs :

• Age over 40 years.
• Comorbidities in the joints of the foot, such as osteoarthritis or rheumatoid arthritis.
• Violation of blood microcirculation in the foot.
• Other degenerative diseases.

Symptoms of a heel spur

Symptoms of a heel spur do not appear immediately after the formation of a bone growth. Due to the proximity of the tendons, a heel spur can cause constant pain in the foot. Heel spur pain is described as similar to toothache.

It should be noted that the pain of a heel spur is not due to the pressure of body weight on the spur itself, but due to inflammation of the soft tissues around the spur. The pressure of these inflamed tissues, for example, when stepping on the heel, leads to sharp pains. Usually, pain most often occurs at the very beginning of walking. This is explained as follows. At rest, the nerves and capillaries in the area of ​​the inflamed tissue, as it were, adapt to the rest of the foot. However, with a sharp start of movement, the vessels and nerves do not have time to adapt to new conditions. As a result, pain occurs.

Diagnosis

Performed by routine inspection and feel of the sole and heel. At the same time, the most painful point is located. The spur itself is usually not palpable, however, due to chronic inflammation of the soft tissues, their compaction can develop, which can be felt.

X-ray of the foot allows to clarify the diagnosis. In this case, the bone growth is visible on the x-ray.

Heel spur treatment

Treatment of a heel spur often is carried out conservatively and is aimed at three main points:

• Elimination of inflammation of the soft tissues around the spur;
• Prevention of inflammation;
• Elimination of the heel spur itself.

Patients come to the Orthopedics and Sports Injury Clinic of the Zaporozhye Regional Hospital with different problems, but with the same goal – to move freely again without pain and enjoy life. Natalya Borisovna from the Tokmak region was deprived of this happiness by a heel spur.

A woman says that she has suffered from heel spurs for years. I tried to defeat inflammation with the help of physiotherapy, all kinds of medicines and folk remedies, but they did not solve the problem, but only dulled the pain in the joint. Own house in the village, household, work – it became more and more difficult to live in the same rhythm. One day, Natalia Borisovna was suggested to go to the Orthopedics and Sports Injury Clinic , one of the best in Ukraine.

After consultation, the diagnosis of heel spur » was confirmed – the bone growth was clearly visible on the x-ray. At the appointment, the specialists of the clinic explained to the woman that the methods she had hoped for were effective only at the very beginning of the disease. And since Natalya Borisovna’s heel spur has been preventing her from living a normal life for years, the operation was the only right decision. Moreover, it was by no means impossible to delay the intervention.

“The patient needed to have her spur removed as soon as possible. She was at high risk of tearing her Achilles tendon where it attaches to her calcaneus. If we had not carried out the treatment, the growths would have become more and more. Therefore, in order to prevent a complex and risky operation to restore the Achilles tendon, we decided not to waste time and remove the spur,” comments Ivan Zabelin, head of the Orthopedics and Sports Injury Clinic.

Rengen-Directs before the Operation of the X-ray of the foot after surgery

During the intervention of the orthopedist of the clinic using low-traumatic techniques, they removed the resulting growth, so now nothing will prevent Natalia Borisovna to move normally. The patient is now feeling much better and is already planning treatment for a heel spur on her second leg.