What Are Osteophytes?

Osteophytes, more commonly called bone spurs, are smooth, bony lumps that grow on the edges of bones, usually near joints or where tendons and ligaments attach. They are very common, especially as we get older, and most people who have them never know: they often only show up on an X-ray taken for another reason.

Why osteophytes form

Osteophytes are the body's response to damage or stress in a joint. When cartilage, the smooth tissue that covers the ends of bones, roughens and thins, the body tries to repair the joint and lays down new bone at its edges. This "bony scar" is an osteophyte.

The most common cause is osteoarthritis. Other factors include:

• ageing and general wear on the joints
• previous joint injuries
• repeated stress on a joint, for example from sport or physical work
• being overweight, which increases the load on weight-bearing joints
• some types of inflammatory arthritis, such as ankylosing spondylitis

Where osteophytes grow

Bone spurs can form on almost any bone, but they are most common in:

• the spine, especially the neck and lower back
• the knees and hips
• the hands, where they form firm knobbly lumps on the finger joints (Heberden's and Bouchard's nodes)
• the feet, especially the heel and big toe
• the shoulders

Symptoms

Many osteophytes cause no symptoms at all. When they do, it's usually because they rub against other tissues, limit a joint's movement or press on a nerve. Symptoms depend on where the spur is:

• Pain and stiffness in the affected joint, often worse when moving it
• Reduced range of movement
• A visible or palpable lump, for example on a finger joint or the top of the foot
• Pins and needles, numbness or weakness in the arms or legs, if a spur in the spine presses on a nerve root or the spinal cord

Bone spurs in the spine can narrow the spaces nerves pass through, causing spinal stenosis or a pinched nerve (radiculopathy). Rarely, large spurs at the front of the neck can press on the gullet and make swallowing difficult.

See a GP if you have joint pain or stiffness that doesn't settle, or numbness, nerve pain or weakness anywhere in your body. New problems controlling your bladder or bowels, or rapidly worsening weakness, need urgent medical attention.

Diagnosis

Bone spurs show up clearly on an X-ray. If a spur may be pressing on a nerve, a CT or MRI scan can show the nerves and spinal cord in more detail, and nerve tests such as electromyography (EMG) and nerve conduction studies can show which nerves are affected.

Treatment

Osteophytes only need treating if they cause problems. Because they are so closely linked to arthritis, the treatments are largely the same as for arthritis:

• Painkillers, such as paracetamol, or anti-inflammatories such as ibuprofen
• Ice to reduce swelling and soreness around the spur
• Physiotherapy to strengthen muscles, improve movement and reduce pressure on the joint
• Losing weight if you're overweight, to reduce stress on weight-bearing joints
• Supportive footwear or insoles, for spurs in the feet
• Steroid injections to relieve pain and inflammation in some cases
• Surgery, as a last resort: removing the spur, making more space for a trapped nerve, or replacing a badly damaged hip or knee

Can bone spurs be dissolved naturally?

No. A bone spur is ordinary bone, and no diet, supplement or remedy can dissolve it. Claims to the contrary usually refer to easing the inflammation around a spur, which ice and anti-inflammatory medicines can help with. A bone spur only goes away if it is removed surgically, and most people never need that.

Living with osteophytes

Staying active is important. Choose low-impact exercise such as walking, swimming or cycling rather than high-impact activities, warm up before exercise, and wear well-fitting shoes. Keeping to a healthy weight reduces the load on your joints.

For bone spurs in the spine, see osteophytic spurring and endplate osteophytes.