Osteophytes

osteophytesOsteophytes (bone spurs) are the bumpy outgrowth of the bone that develop along the margins of the joints.

Description
It is suggested that about 50% of people at the age over 60 have bone spurs somewhere on the joints surface. Osteophytes or bone spurs are the bony outgrowth formed as the result of the degeneration in the skeleton. Osteophytes should be distinguished from enthesophytes which are the projections formed at the attachment of a tendon or a ligament.

Causes
Bone spurs are usually associated with osteoarthritis as a result of the damage and inflammation and degenerating changes of the bone structure due to aging, mechanic instability or injuries and some diseases.
Degeneration of the cartilage in the spine causes extra movement. To compensate this hypermobility bones start growing, forming osteophytes on the surfaces of the joints.
Poor diet, overweight and poor posturing may accelerate the growth of bone spurs.

Risk factors
Osteophytes are more common in elderly people and after arthritis, injuries, osteomyelitis and Charcot foot (degeneration of the foot in people affected by the diabetes). Bone spurs of the spine have a tendency to affect people who have disorders like ankylosing spondylitis, spinal stenosis or osteoarthritis.

Symptoms
Sometimes bone spurs cause no symptoms and years may pass before they are detected. Symptoms occur when the outgrowths rub against other bones irritate the nerves causing radiating pain. Commonly osteophytes are found in the neck, shoulder, knee, lower back, fingers or big toe and foot or heel.
However, osteophytes may be painful and lead to the motion reduction in the affected joints.

[Read also:Osteoarthritis]

The symptoms depend on the area where osteophytes grow:
Spine – spinal osteophytes cause pain and stiffness in the back. The outgrowth narrows the vertebral foramen and leads to the compression of the spinal cord and the spinal nerves. This causes weakness, tingling sensation and numbness of the extremities;
Neck – if the nerves are involved numbness, weakness and tingling sensation in the arms occur, affected person feels pins and needles along with the pain and the stiffness of the neck. Bone spurs in the neck may disturb the blood supply to the brain leading to headaches;
Shoulder – probably tendonitis and rotator cuff tear may occur as the result of permanent irritation;
Hip and knee – arthritis leads to the reduction of the movements’ range;
Knee – the osteophytes of the knee may lead to painful bending or extending a leg;
Fingers and toes – osteophytes appear under the skin as hard lumps and deform the hands (Heberden’s nodes on the distal interphalangeal nodes and Bouchard’s nodes on the proximal interphalangeal joints).

The pain usually worsens during activity and alleviates when a person has a rest.
In severe cases osteophytes may may affect the entire skeleton, causing multiple exostoses.

Diagnosis
To evaluate the diagnosis doctor examines the person and may feel around the joint a bone spur.
X-ray examination and CT/MRI are performed to view the skeleton and joints.

Treatment
The treatment depends on the localization of the osteophytes and whether they are asymptomatic or not.
Non-steroidal anti-inflammatory drugs (acetaminophen, ibuprofen) and muscle relaxant pain medications may be administered to relieve the pain.
Physical therapy may be helpful to restore the strenghth of the muscles and improve the posture.
To reduce the swelling of the joints and alleviate the spinal pain cortisone epidural injections can be used. If the pain is intense and the nerves or spinal cord are involved surgical removal of the bone spur is recommended.

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