Do Bone Spurs Always Need Surgery?

You may have noticed a bump on the top of your foot or the back of your heel bone and wondered what it is – and if it’s anything to worry about. 

It’s likely a bone spur, which is often found in the foot but can also develop in the hip, back, spine, shoulder or knee. 

Bone spurs are small projections of bone that develop along the edge where two or more bones meet, or where a tendon or ligament attach to a bone. 

When your bones are under repetitive stress, new bone can form in response. Your body responds to joint deterioration and cartilage loss by trying to stabilize the joint by creating more bone. These newly formed bone protrusions are generally smooth and stay attached to the bone, but occasionally can break off and can get stuck in a joint, causing a locking sensation. 

Bone spurs also can form where a tendon attaches to a bone, primarily because of tendon degeneration, like where the Achilles tendon attaches to the back of the heel bone. 

Why Do Bone Spurs Form? 

Contributing factors that cause bone spurs to form include: 

● Aging. The normal aging process stresses tendons and ligaments. Similarly, wear and tear to cartilage can cause osteoarthritis, the primary condition linked to bone spur development.

● Prolonged joint stress and impact. This is frequently seen in runners and athletes who jump in their sport, putting repetitive stress on joints and strains on tendons.

● Heredity. Inherited physical conditions can predispose you to bone spur development.

● Injury. Most frequently, this is caused by a sports-related injury or injury from motor vehicle accidents or falls.

● Skeletal problems. This can be the result of poor posture, inadequate shoe support or a shift in gait. 

Bone Spurs Are Painful – Or Not

One misconception associated with bone spurs is that they always cause pain. In fact, many times a bone spur will go undiscovered until seen on an X-ray for a different issue. Even if a bump is visible, the spur is often asymptomatic. 

In some instances, bone spurs can cause pain. If there’s a bone spur at the top of the foot, the pressure from shoes — especially if the top of the shoe is not flexible or soft — can be painful. Bone spurs at the back of the heel can also be painful. 

Treating Bone Spurs 

Treatment focuses on relieving discomfort and tackling the underlying cause of the bone spurs. Recommendations might include: 

● Relieving stress on the affected joint by reducing activity or impact.

● Over-the-counter pain relievers such as ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs).

● Corticosteroid injections to reduce inflammation of tissue next to the spur (not recommended for tendon-related spurs).

● Exercise or physical therapy to strengthen and stretch surrounding muscles and improve range of motion. 

In most instances, removing the spur is not required to alleviate the discomfort, but when necessary, a surgical solution called an osteophytectomy (bone to bone connection) or exostectomy (tendon to bone connection) may be performed. This is when a small incision is made and the bone spur is shaved down or cut off. This procedure is frequently done in conjunction with other medical procedures aimed toward correcting the originating cause. 

Preventing Bone Spurs 

Because bone spurs are usually the byproduct of bigger issues, trying to reduce the risk of osteoarthritis and injury from exercise is a good place to start. Consider: 

● Wearing shoes with a good arch support and enough cushion to pad each step. Thicker socks can prevent shoes from rubbing and irritation. Avoid tight-fitting shoes.

● Eating a healthy diet rich in bone-protecting calcium and vitamin D, and inflammation-fighting omega-3 fatty acids.

● Doing lower-impact exercise, such as yoga, swimming and biking.

● Keeping your weight within healthy BMI levels. The stress on your joints just from walking amounts to one-and-a-half times your total body weight, and it increases to four or five times your body weight when you run or jump. Losing weight reduces the stress on your joints, which cuts your risk of developing bone spurs. 

If your bone spur causes discomfort or begins to affect your quality of your life, see an orthopedic food and ankle specialist to determine the best steps to get relief.