Bone Spur

What it is and why it forms

A bone spur (the medical term is osteophyte) is a small, jagged extra piece of bone that grows at the edge of a joint. Your body doesn’t grow spurs out of spite; they’re a sign of chronic arthritis or joint instability. When cartilage wears away or ligaments become loose, the bone underneath tries to stabilize the joint by growing extra material at the edges—like a joint trying to grow its own splint.

Spurs are common in older adults and in joints that have been through wear and tear or injury. They show up on X-rays as small triangular projections of bone at the joint margins.

The confusion: X-rays show them, but many don’t hurt

Here’s the frustrating part: bone spurs and bone pain are not the same thing. An X-ray often shows spurs, and a patient thinks they’ve found the source of pain. But spurs themselves rarely hurt. They’re usually asymptomatic bystanders. The pain is typically coming from the underlying arthritis, the inflamed synovium (joint lining), or the damaged cartilage—not the spur.

This is a common source of confusion in the clinic. A patient with a sore knee gets an X-ray, sees “bone spurs” in the report, and assumes that’s the problem. In reality, we’re treating the arthritis and inflammation driving the pain, and the spur is just along for the ride.

When spurs actually do matter

While most bone spurs are painless, there are specific situations where they cause real problems:

• Nerve impingement in the spine — a spur growing into the spinal canal can pinch a nerve root, causing radiating pain, numbness, or weakness down the arm or leg.
• Heel spurs with plantar fasciitis — the spur at the bottom of the heel isn’t always the main problem, but when it combines with inflamed plantar fascia, it can aggravate pain and make stretching uncomfortable.
• Loose bodies in a joint — occasionally a spur breaks off and becomes a loose fragment in the joint, catching or locking during motion.
• Shoulder impingement — an acromial spur can narrow the space under the acromion, aggravating rotator cuff impingement.

Even in these cases, we treat the underlying problem first (reduce inflammation, decompress the nerve, stabilize the joint). Surgery to remove spurs is rarely the answer alone.

How we address them

Because most spurs don’t cause pain, treatment focuses on the underlying arthritis: NSAIDs, activity modification, physical therapy, cortisone injections, and bracing. If a spur is genuinely impinging a nerve or catching in a joint, imaging and clinical exam will guide whether surgery is appropriate, but that’s the exception, not the rule.

The bottom line

Don’t let the word “spur” frighten you. It’s a sign your joint has been through wear and tear, but bone spurs themselves are usually passengers, not drivers of pain. We treat what’s actually causing symptoms—inflammation, cartilage damage, nerve compression—and the spurs often become irrelevant as the pain improves.

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