When arthritis doesn’t get better, bone spurs could be the culprit…
That stabbing, aching pain in your joints may mean that you just have a touch of garden-variety osteoarthritis. Or so you tell yourself.
What most people don’t realize: When osteoarthritis wears down the cartilage covering the ends of your bones, it can lead to bony growths known as osteophytes, an often undetected source of severe joint pain.
Commonly known as bone spurs, these smooth or pointed growths on normal bone tissue also can form in response to stress on a joint—as may occur from repetitive motion activities, such as running or typing. Regardless of the trigger, bone spurs can rub against other bones, ligaments, tendons or nerves and are marked by painful inflammation.
Why this matters: It’s important to distinguish bone spurs from run-of-the-mill arthritis so that you can take the necessary steps to stay ahead of potentially debilitating joint inflammation. If not dealt with in the right way (and at the right time), bone spurs often require powerful additional treatment to control the pain, and this treatment can have bad side effects. You want to deal with bone spurs early.
What you need to know to determine whether you have bone spurs—and the therapies that help most…
MORE THAN ARTHRITIS
How do you tell whether your joint pain is partly or completely due to bone spurs?
Clues to watch for: Osteoarthritis pain tends to come and go gradually—like the general stiffness that affects a large area of your body, such as your lower back, in the morning but eases by afternoon.
A bone spur, on the other hand, may cause chronic localized pain that’s bad enough to make you not want to move your back, neck, hip, finger or some other joint that may be affected. You may have bone spurs in more than one place, but one spur could cause more pain, depending on its location and the amount of physical activity in that area.
The more sudden and severe the pain, the more likely that a bone spur is the culprit. Numbness, tenderness and weakness may also occur. If a parent or sibling has suffered from bone spurs, you’re at increased risk, too—research suggests there is a genetic component.
HOT SPOTS FOR BONE SPURS
Any joint can develop a bone spur, but here are the most common locations and how the pain and other symptoms may vary in each part of your body…
• Knees. Bone spurs in the knee—a common location for those that occur with osteoarthritis—often resemble a pointy bird’s beak on X-rays. The resulting discomfort is typically a blend of arthritis and bone spur pain—both sore and sharp.
• Feet and/or heels. Acute pain that occurs with every step—the kind that makes you want to avoid walking—can signal bone spurs in the feet and/or heels (often called “heel spurs”). Corns and calluses may also build up over heels or toes as the body tries to protect the area by providing added padding. Therefore, if you have pain along with corns and/or calluses, ask your doctor to check for a bone spur.
• Hips. Arthritis in the hips generally produces a deep aching and stiffness that occurs when you stand or walk. Bone spurs at the side of the hip—where the bony prominence can sometimes be felt—trigger pain when the hip is flexed, such as when riding a bike.
• Hands and/or shoulders. Jabbing pain (rather than a dull throb) is the telltale sign.
• Neck and/or spine. Bone spurs at these locations usually do not cause pain unless accompanied by arthritis, but they can pinch the spinal cord and irritate surrounding nerves.
If you have one or more bone spurs, the usual arthritis treatments—including nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin) and naproxen (Aleve)…stretching…and warm heat—often don’t make a dent in your joint pain.
Because bone spurs usually are not large enough to feel externally, an X-ray is the easiest way to diagnose them. In certain areas, such as the neck, more advanced imaging tests, such as MRI or CT scans, may be needed to diagnose them.
My advice: If your joint pain doesn’t respond to the therapies described earlier and you suspect that you may have bone spurs, you don’t need a definitive diagnosis provided by an X-ray. Ask your physician whether you may have bone spurs, and get his/her OK to promptly try the approaches below. If you don’t start treatment quickly, the serious pain that bone spurs typically cause may limit your use of the joint, progressively weakening muscles surrounding it and creating an even worse problem.
FINDING THE BEST TREATMENT
Among the best therapies for joint pain due to bone spurs…
• Alternate heating pads and ice packs in 20-minute intervals. Use ice first to ease acute pain, then moist heat to penetrate inflamed areas. Do this twice a day.
• Get acupuncture. Acupuncture has been shown to reduce pain and improve functional mobility. Your acupuncturist will tailor a treatment plan for your bone spur.
• Eat inflammation-fighting foods. Processed foods promote inflammation, while certain whole foods, such as salmon, nuts, beets, leafy greens, olive oil and berries, fight it. Include as many of these foods in your daily diet as possible.
• Use targeted supplements. These include fish oil, turmeric and ginger. There is strong research showing that these supplements help fight painful inflammation. My advice: You can take one or all of these supplements, depending on the intensity of your pain. Daily dosages are up to 3 g of fish oil…three 400-mg to 600-mg tablets or capsules of turmeric…and two 500-mg to 1,000-mg capsules of ginger, taken with food. It usually takes about two months for turmeric to work. Caution: Talk to your doctor before using any of these supplements if you take any type of medication (especially a blood thinner) or have a chronic medical condition.
• Try ultrasound therapy. Ultrasound uses sound waves that can penetrate more than two inches into the body to reach the painful area. Often used for shoulder or heel pain caused by bone spurs, it can be administered by a medical doctor or physical therapist. Caveat: The pain relief provided by ultrasound may be long-lasting but sometimes lasts only a few weeks.
WHEN TO CONSIDER SURGERY
One of the biggest misconceptions about bone spurs is that they need to be removed surgically. The truth is, when strategies such as those described in this article are used, the inflammation may lessen after a period of weeks or months even though the spur does not go away.
In determining the need for surgery, location of the bone spurs is the key factor. For example, bone spurs located in the neck can press on nerves or even the esophagus, which can interfere with swallowing.
Generally, however, the risks associated with surgery, such as infection, outweigh the benefits for most bone spurs. If you have tried the regimen described above for bone spurs for about a year but still have not gotten adequate pain relief, then ask your primary care doctor for a referral to an orthopedic surgeon.