Bone spurs, also known as osteophytes, are common bony growths that frequently develop on the edges of bones, often near joints experiencing wear and tear. These growths are usually a response to localized damage, such as that caused by degenerative joint conditions. Many people wonder if these physical bony structures can resolve themselves without intervention.
What Exactly Are Bone Spurs
Bone spurs are smooth, hard outgrowths of bone tissue that form around the end of a bone, typically within or near a joint capsule. These growths are the body’s attempt to stabilize a joint that has become damaged, most frequently due to the breakdown of cartilage seen in osteoarthritis. This process involves depositing new bone tissue.
Bone spurs are commonly found in joints that sustain repeated stress, such as the spine, hips, knees, shoulders, and the heel. They can cause problems if they grow large enough to compress nearby nerves or rub against tendons and ligaments. This irritation can lead to localized pain, stiffness, and a reduced range of motion in the affected area. The presence of a bone spur alone does not guarantee symptoms; many people have them and never know until they are discovered on an X-ray for an unrelated issue.
The Natural Course of Bone Spurs
The physical bony growth itself is permanent and will not dissolve or be reabsorbed by the body. This is because the spur is true bone, and the body does not spontaneously break down and remove healthy bone material. The only way to physically remove an osteophyte is through a surgical procedure.
The common misconception that a bone spur has “healed” stems from the fact that the associated symptoms often resolve. The pain, inflammation, and discomfort are not caused by the spur itself, but by the irritation and inflammation of the surrounding soft tissues, like tendons, ligaments, and nerves. Over time, these soft tissues may adapt to the presence of the spur, or the localized inflammation may simply subside. When the pain resolves, the spur becomes asymptomatic.
Managing Symptoms Without Surgery
When a bone spur becomes symptomatic, initial treatment focuses on reducing inflammation and managing pain without removing the bony structure. Rest is often the first recommendation, allowing the inflamed soft tissues surrounding the spur to calm down.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are commonly used to decrease localized swelling and discomfort. Physical therapy plays a significant role by utilizing exercises to strengthen the muscles supporting the joint, which can help stabilize the area and relieve pressure on the irritated tissues. A physical therapist may also provide specific stretching routines to improve flexibility and range of motion. For bone spurs in the foot, such as heel spurs, wearing specific footwear or custom orthotics can help redistribute pressure and reduce strain on the affected ligaments. If pain is severe and localized, a physician may administer a corticosteroid injection, which delivers a potent anti-inflammatory medication directly to the site of irritation.
When Is Surgical Removal Necessary
Surgical removal of a bone spur, known as an osteophyte resection, is typically considered a last resort after months of conservative management have failed to provide adequate relief. The primary criteria for intervention are not the mere presence of the spur but when it causes a significant functional limitation, persistent severe pain, or neurological impairment. Functional limitations include a severely reduced range of motion in a joint, while neurological symptoms involve the bone spur pressing on a nerve.
In the spine, for instance, a bone spur causing pressure on a nerve root can lead to radiating pain, numbness, or muscle weakness, a condition often associated with spinal stenosis. For these specific, severe cases, surgery removes the bony overgrowth to relieve pressure on the nerve or restore normal joint mechanics. Procedures can range from minimally invasive techniques like arthroscopy to open surgery, such as a laminectomy in the spine to create more space around the nerves.