Have you noticed swelling and pain when putting weight on your feet, especially around the heel or joints? If so, you might be dealing with bone spurs. So, what exactly are they? We spoke with Dr Tan Ken Jin, Orthopaedic Foot and Ankle Surgeon at Orthosports, Mount Elizabeth Novena Hospital, to share with us the symptoms, diagnosis and treatment options for bone spurs.
What Are Bone Spurs?
Bone spurs, also known as osteophytes, are smooth bony projections formed from calcium deposits along the edges of bones or near joints.
These bony projections develop as a natural response to inflammation or stress in the body. They often form as part of the body’s repair process.
While these bony growths are typically associated with ageing and joint wear-and-tear, bone spurs can lead to discomfort, reduced mobility, or even complications if left untreated.
Bone spurs can occur in any part of the skeleton with common areas including:
- Knees
- Hips
- Spine
- Shoulders
- Hands
- Feet, particularly the heel
Bone spurs frequently develop at joint areas too such as:
- Ankle joint
- Big toe joint
- Bottom of the heel
- Behind the heel
Causes of Bone Spurs
Bone spurs are primarily caused by ongoing joint damage or inflammation in which the body repairs by replacing bone tissue.
The common causes include:
- Medical conditions such as osteoarthritis, osteoporosis, rheumatoid arthritis, lupus, or degenerative disk disease.
- Natural ageing and joint degeneration.
- Repetitive motion or stress on specific joints.
- Injuries or trauma to the joint or surrounding tissues.
What Are the Common Symptoms?
Bone spurs may not present with symptoms if they do not press against nerves or other tissues.
Nonetheless, as they persist to grow, bone spurs may cause symptoms that include:
- Pain near the affected joint, especially during movement.
- Swelling around the joint.
- Stiffness in the affected area.
- Numbness or tingling in areas where the spurs compress nearby nerves, such as in the spine.
- Weakness in the arms or legs in severe cases due to nerve compression
The symptoms may vary based on the location of the bone spurs.
- Heel spurs can cause pain when you step on the affected foot
- Spurs on big toe can lead to pain while walking or bending the toe
Diagnosing Bone Spurs
Diagnosis involves evaluating the symptoms, conducting physical examination and using clinical imaging to confirm and determine the type of bone spurs.
- Physical Examination: The affected joint is examined for signs of swelling, tenderness, or restricted movement.
- Imaging Tests
- X-rays: As the most common imaging technique that uses radiation to create images, X-rays can help detect any bony protrusion.
- MRI scans: Using magnetic fields and radio waves to produce images, MRI scans can help assess any soft tissue involvement or irritation and inflammation caused by bone spurs.
What are the Treatment Options?
Treatment for bone spurs is broadly categorised into non-surgical or surgical interventions.
Non-Surgical Treatments
Non-surgical approaches are mainly rehabilitative and aimed at reducing the inflammation and pain caused by the spurs.
- Use of anti-inflammatory medications or painkillers such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), to help relieve pain and inflammation.
- Reducing activity to minimise joint stress
- Physiotherapist-guided strengthening exercises can improve mobility and reduce strain on the affected joints
- Therapies like ultrasound or shockwave treatments
Surgical Treatments
Surgery is considered when non-surgical methods are ineffective or when the bone spurs cause severe nerve compression or joint damage.
Surgical treatments can be further divided into open surgery and minimally invasive surgery.
Open surgery
Open surgery is effective to remove bone spurs when non-surgical methods failed. Nonetheless, it is invasive and needs longer recovery period.
Open surgery involves an open incision to remove the bone spurs. Surgical saws are commonly used to cut away the bony growths.
Minimally Invasive Surgery (Arthroscopic surgery)
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Arthroscopic surgery is a less invasive option to remove bone spurs using specialised tools. Since there is no or very minimal incision needed, it promotes quicker recovery and easier rehabilitation.
A nanoneedle is used to access the small spaces between ankle or toes to visualise the removal of spurs. Then, a wedge-like burr is inserted into the joint gaps through a small incision guided by X-ray imaging to locate the spurs. The wedge-like burr will then spin at high speed to shave off the bone spurs.
The duration of the procedure depends on the complexity. Simple cases usually need 30 minutes while more complex surgeries such as reconstruction of the tendon and ligament, may need up to 1.5 hours.
In terms of post-procedure recovery, it can depends on the complexity of surgery and location of the spurs. For instance, patients with heel spurs can often walk immediately after the surgery. Meanwhile, one with a complex case of ankle spur may require a few weeks of recovery and the use of ankle brace. This is because these type of spurs often involves ligament repair or cartilage reconstruction.
Living with Bone Spurs
Bone spurs are a common condition, often linked to ageing or other underlying health issues. While most cases can be managed without surgery, minimally invasive procedures are an effective alternative for persistent symptoms. If you suspect you have bone spurs, it is best to consult an orthopaedic surgeon to discuss your treatment options and develop a tailored treatment plan.
This article is supported by an educational grant.
