Painful bone spurs can be treated

Bone spurs -- bony projections that develop on the edge of normal bones -- may seem harmless. The spur itself doesn't hurt, and sometimes you don't even know it's there. But bone spurs also can cause significant pain and other symptoms.

Here's what you need to know:

1. BONE SPURS CAN APPEAR ANYWHERE IN THE BODY

These growths that project from bone, which go by the medical term "osteophytes," can be sharp or smooth. "They're caused by excess forces, such as pulling or wear-and-tear around joints or tendon attachments to bone," said Dr. Russell Caprioli, chief of podiatry at Long Island Jewish Medical Center in New Hyde Park. "The most common types in the foot are heel spurs and spurs around or above the big toe joint."

However, bone spurs can appear elsewhere in the body, too. Likely trouble spots include the knee, hip, spine, shoulder and fingers.

2. BONE SPURS CAN CAUSE SEVERE PAIN

The pain from bone spurs can be debilitating, but the level of pain depends largely on the location of the spur, said Dr. John Jackalone, a podiatrist and co-director of the St. Joseph Hospital's Center for Wound Healing and Hyperbaric Medicine in Bethpage.

"One of the most common spurs, the heel spur, can cause difficulty walking or standing due to its location at the bottom of the foot," he said. "Many patients present with severe pain and an inability to perform daily activities, such as exercise."

The pain, swelling, weakness or numbness that can accompany a bone spur is created when it rubs against another part of the body, pinches nerves or the spinal cord, or gets in the way of moving parts like bones and tendons.

In some cases, bone spurs are harmless. But Jackalone said that doesn't mean they should be ignored.

"Bone spurs that do not cause pain or discomfort may be observed over time," he said. "A physician may examine the spurs with a simple X-ray or an MRI to determine whether or not they require further investigation and identification."

3. HEEL SPURS TOP THE PAIN CHART

"Heel spur pain, known as heel spur syndrome, is very painful, particularly for the first step in the morning getting out of bed or after periods of sitting," Caprioli said. "This is a very common complaint in the summer months, when people are walking in very flat shoes or flip-flops." This type of footwear "increases the pull on the heel, creating tearing of tissue," he said. "The inflammation and pulling cause the body to deposit calcium in the area, causing further bone growth and creating the spur."

Bone spurs in the big toe actually "do a little better in the summer due to open shoe gear," Caprioli said. "However, once closed-shoe season comes around, the pressure and irritation can be very debilitating."

4. PAINFUL BONE SPURS CAN BE TREATED

Caprioli said that cortisone injections are helpful for both heel and joint pain from bone spurs. However, though the shots "decrease the inflammation and pain, they do nothing to remove or improve the spur," he noted.

For big-toe spurs, he said, joint replacement is an option in severe cases.

Jackalone said that other potential treatments include physical therapy that allows stretching and pain reduction, splinting, orthotics and braces.

Newer treatments that show promise, he said, include radio-

frequency therapy and a treatment that involves the injection of a patient's own plasma, both done to reduce inflammation.

Removing a spur -- which might seem desirable to someone feeling pain from it -- is an option only for the big toe, Caprioli explained. "We almost always remove them surgically because they are an obstacle to shoe gear and actually rub and cause inflammation and pain in the joint," he said. "We rarely remove heel spurs unless they are in the back of the heel, by the Achilles tendon, or are so large and irregular that they need to be removed."

And, without treatment to address whatever caused the condition in the first place, Caprioli said, "all spurs can grow back."

5. HIGH HEELS MIGHT JUST BE HELPFUL

You're not likely to hear many foot doctors recommend women wear heels. But heel spurs can change the equation.

"Flat shoes are bad, and heels are better," Caprioli said. "Most patients will revert to flat shoes immediately once they experience heel pain. This actually makes the problem worse."