Bone spurs, medically known as osteophytes, are extra growths of bone tissue that form along the edges of bones, most frequently within joints. They are a common finding, particularly as people age, and often develop in the small joints of the hands. This new bone growth can sometimes be seen or felt.
Where Bone Spurs Form and How They Appear
A bone spur in the hand presents as a firm, immovable lump located directly over a joint line. The most frequent locations are the joints of the fingers, where these growths have specific names based on their position. These formations are slow-growing, developing over time, and can range in size from a small pea to slightly larger.
One common site is the joint closest to the fingertip, the distal interphalangeal (DIP) joint. Bone spurs appearing here are called Heberden’s nodes, creating a knobby, sometimes crooked appearance at the end of the finger. These bony enlargements can also affect the middle joint of the finger, the proximal interphalangeal (PIP) joint, where they are referred to as Bouchard’s nodes.
The spur appears as a hard, smooth lump, and the overlying skin usually looks normal. This rigidity distinguishes a bone spur from softer growths, such as a fluid-filled ganglion cyst or a fatty lipoma. While the spur itself is bone, its presence can cause the joint to swell, leading to a noticeable thickening of the finger.
Another frequent site is the carpometacarpal (CMC) joint, located at the base of the thumb. Spurs in this area can cause a squared-off or widened appearance at the thumb base. These formations can limit the joint’s range of motion, making it difficult to fully bend or straighten the finger. When the bone spur rubs against adjacent tissues or irritates a nearby nerve, it can lead to pain, stiffness, or a burning sensation.
The Primary Reason Bone Spurs Develop
The formation of a bone spur is the body’s attempt to repair damage within a joint. The underlying process is almost always linked to osteoarthritis, a degenerative condition resulting from the long-term wear and tear on joints. Healthy joints are protected by firm, flexible cartilage that allows the bones to glide smoothly. Over time, this protective cartilage begins to break down and wear away.
As the cartilage erodes, the space between the bones narrows, and friction increases, causing irritation and inflammation. The body interprets this joint instability as an injury that needs stabilization. In response, specialized cells deposit new bone tissue along the edges of the joint surface. This overgrowth forms the osteophyte, or bone spur.
The resulting bone spur functions as a natural attempt at joint fusion, increasing the surface area to distribute the load more effectively. This biological response is a repair mechanism, though it often leads to stiffness and reduced mobility. While osteoarthritis is the most common factor, bone spurs can also develop following a specific injury or trauma that disrupts joint mechanics. The development of these growths is a mechanical and biological process.
How Bone Spurs Are Diagnosed and Managed
Diagnosis begins with a physical examination when a patient notices a hard lump or experiences pain and stiffness in a hand joint. A healthcare provider will feel the affected joint to assess the lump’s texture, location, and rigidity, looking for the characteristic hard prominence of an osteophyte. The doctor will also evaluate the joint’s range of motion and check for tenderness or swelling.
For a definitive diagnosis, imaging tests are required, with the X-ray being the standard tool. An X-ray provides clear images of bone structure, confirming the lump is a bony growth and not a soft tissue mass or cyst. The images can also show the extent of cartilage loss and joint damage, which helps confirm underlying osteoarthritis. Many osteophytes do not cause noticeable symptoms and are sometimes discovered incidentally on an X-ray taken for an unrelated reason.
The initial management of symptomatic bone spurs focuses on non-surgical methods aimed at relieving pain and improving function. Common first steps include modifying activities to reduce stress on the affected joint and using nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to manage inflammation and pain. Applying cold packs to the joint during flare-ups can help reduce swelling and discomfort.
Physical or occupational therapy may be recommended to teach exercises that maintain joint flexibility and hand strength. Splinting or bracing the affected joint, especially the thumb CMC joint, can provide temporary rest and stabilization. If pain becomes severe, if the joint rapidly loses function, or if the lump grows quickly, a medical evaluation is warranted to explore other treatment options. These options may include corticosteroid injections or, in rare cases, surgical removal of the spur.