BONE SPURS

Bone spurs are outgrowths of normal bony structures. They usually arise from some form of arthritis or a chronic pulling from a tendon. Other times they may be formed by continuous pressure (rubbing), or possibly arise from childhood. While some spurs may be asymptomatic, the problematic bone spurs typically cause pain (may vary from mild to sharp) depending on what the bone is putting pressure on. If the bone can be felt easily, then chances are it is compressing some nerves on or near the skin which causes the painful sensation. Other times, the pain is worst during activity or walking. Below are some of the more commonly seen locations of bone spurs.

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Heel Spurs:

These are perhaps some of the best known spurs. A heel spur refers to an outgrowth on the bottom of the heel. Typically they grow straight out and are associated with plantar fasciitis/heel pain. In most cases, the spur itself is actually an adaptive change secondary to a more chronic plantar fasciitis/heel pain. Often times, these aren't the direct cause of pain (in which case the plantar fasciitis may be more to blame). However, in some cases the spurs (which originate in a similar manner) physically grow downward which in turn causes a very uncomfortable sensation with every step you take.

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Posterior Calcaneal Spurs (behind the heel)/Haglund's Deformities:

This is a spur which is located at the back of the heel and typically go hand and hand with the insertion point of the Achilles tendon. Often times, these cause a discomfort while wearing a closed back shoe or during activity. There is usually an association with some injury with the Achilles tendon, or due to calf tightness. Whether it was through injury or repetitive pulling of the Achilles tendon, the bone on the back of the heel grows out over time to form an uncomfortable bump. There may also be some hard bony fragments left between the Achilles tendon insertion point and the calcaneus (bone of the heel).

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Arthritic Changes:

These can occur in virtually any joint of the foot. They tend to present most often in the top of the midfoot or forefoot. Arthritis is most often a progressive wear and tear of the joint. The cartilage, which allows for smooth gliding of the joint, is worn down and the bone grinds on itself in the joint. Bone spurs in these joints are a result of adaptation changes over times. These tend to be specific joints which are painful with motion and may be especially uncomfortable when the weather changes.

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Toes:

Spurs within the toes are typically caused by some form of repetitive pressure, either from adjacent toes or poor fitting shoes (rubbing). They may also be fundamentally the same as the long term result of arthritic change (most toes contain 3 smaller bones, big toe contains 2). The hardened sensation will often cause some form of a callous buildup. The pressure from the bone can be very uncomfortable.

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Typically treatment for spurs starts conservatively by targeting the underlying cause of the spur. Various methods include padding, orthotics/arch supports, or injections to name a few. If conservative treatment fails, then surgical treatment might be necessary.

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