An osteophyte, commonly known as a bone spur, is an extra growth of bone tissue that typically forms along the edges of bones, often where bones meet in a joint or where tendons and ligaments attach. These growths are the body’s attempt to repair damage, usually in response to wear and tear associated with osteoarthritis or chronic irritation. Although bone spurs are common, many people are unaware they have them because they frequently cause no symptoms. Treatment is necessary only when the bony projection irritates surrounding soft tissues, restricts joint movement, or compresses a nearby nerve.
When Is Removal Necessary
A bone spur requires intervention only when it becomes symptomatic, causing chronic pain or functional impairment that affects daily life. Physicians recommend treatment when the spur is responsible for ongoing pain that does not resolve with conservative management. A common indication is nerve impingement, where a spur in the spine presses on a nerve root, leading to symptoms like numbness, tingling, or muscle weakness.
Spurs can also limit the range of motion in a joint, such as the knee or hip, making movements painful. For instance, a heel spur might cause chronic plantar fasciitis, or shoulder spurs can irritate rotator cuff tendons, leading to shoulder impingement. When the bony growth causes tissue damage or blocks joint function, and non-surgical approaches have been exhausted, surgical removal is considered.
Non-Surgical Management Options
Conservative, non-surgical approaches are the first line of defense to manage symptoms before considering surgery. These treatments focus on reducing the inflammation and pain caused by the spur, rather than attempting to dissolve the bony growth itself.
Common Non-Surgical Treatments
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are used to mitigate localized swelling and discomfort.
- Physical therapy, utilizing targeted exercises to strengthen the muscles surrounding the affected joint and improve joint mobility.
- Corticosteroid injections administered directly into the inflamed joint or soft tissue, providing a powerful anti-inflammatory effect for temporary relief.
- Orthotic devices or braces are used to redistribute pressure and support the affected area, particularly for spurs located in the feet or ankles.
Surgical Procedures for Bone Spur Removal
When conservative treatments fail to provide lasting relief or restore function, surgical intervention is considered to physically remove the problematic bony growth. The procedure is known as an osteophytectomy, and the specific approach depends on the spur’s location, size, and surrounding damage. Surgeons typically choose between two main procedural types: arthroscopic or open surgery.
Arthroscopic surgery, often referred to as a minimally invasive approach, is preferred when possible because it involves only a few small incisions. Through these small cuts, a surgeon inserts an arthroscope—a narrow tube equipped with a camera and light source—to visualize the joint on a monitor. Miniature surgical tools are then inserted through other incisions to precisely shave away or cut the bone spur (ostectomy) and smooth the bone surface. This method results in less disruption to surrounding soft tissues, potentially leading to a shorter recovery time and reduced scarring.
Open surgery requires a larger, single incision directly over the affected area, allowing the surgeon direct visual access to the bone spur. This technique is reserved for larger, deep-seated spurs, those in complex anatomical locations, or cases requiring extensive repair of surrounding tendons or ligaments. For spinal spurs causing severe nerve compression, specific procedures like a foraminotomy or laminectomy may be performed to remove the bone and widen the space around the nerves. The goal of surgical removal is to eliminate the source of irritation and restore mechanical function to the joint or nerve pathway.
Recovery and Post-Procedure Expectations
Recovery following bone spur removal surgery is highly variable, depending on the technique used and the spur’s location. Patients often return home the same day, especially after minimally invasive arthroscopic procedures. Initial recovery involves managing post-operative pain with prescribed medications and meticulous wound care to prevent infection.
A structured rehabilitation program, often involving physical therapy, is a fundamental component of recovery. Therapy typically begins a few weeks after the operation and focuses on restoring the joint’s strength, flexibility, and range of motion. Light daily activities may resume within a couple of weeks, but patients must avoid heavy lifting or strenuous exercise for several weeks or months, depending on the surgeon’s guidance. Full recovery can take anywhere from a few weeks for minor arthroscopic cases to several months, particularly if the procedure involved complex spinal work or significant soft tissue repair.