What Are Osteophytes?

Understanding Osteophytes 

Osteophytes, commonly referred to as bone spurs, are bony projections that form along joint margins. While this may sound alarming, osteophytes are common and frequently part of the body’s natural response to joint loading. Recognising and managing the existence of osteophytes and their associated symptoms can help patients maintain function and manage pain. 

What Are Bone Spurs?

Osteophytes are small outgrowths of bone that typically develop near joints. Often forming in areas such as the spine, hips, knees, ankles, hands, and shoulders… These growths are the body’s attempt to stabilise a joint, distributing load and dealing with repeated forces applied to the area. However, while bone spurs may provide some “structural reinforcement” they can also contribute to joint stiffness and pain.

From a physiotherapy standpoint, it is essential to identify whether osteophytes are contributing to a patient’s pain and movement limitations. Often, they are found incidentally during imaging for other concerns, and many individuals remain asymptomatic despite the presence of bone spurs. In symptomatic cases, physiotherapy treatment can play an important role in managing mobility issues, reducing discomfort, and supporting long-term joint health.

Main Causes of Osteophytes

The most common cause of osteophyte formation is osteoarthritis. As joint cartilage deteriorates, the body responds by producing new bone in an attempt to protect the joint. This new bone growth leads to the formation of bone spurs. Other causes include:

• Joint instability, this can be the result of ligamentous laxity or injury. In an attempt to stabilise an unstable joint the body may “lay-down” more bone in the formation of spurs. 
• Chronic inflammation, such as in rheumatoid arthritis
• Spinal disc degeneration, particularly in the cervical and lumbar spine can lead to the development of marginal bone spurs around the disc – vertebrae interface. As well as a reduction in spacing between vertebral levels placing increased load on the facet joints. Over time contributing to the development on spurs (as seen in the above blog image).
• Genetic predisposition, age-related wear, and previous trauma can also influence osteophyte development.

Research has shown that increased mechanical stress on joints leads to changes in bone architecture, including osteophyte formation (Neogi, 2013).

What Does a Bone Spur Feel Like?

The sensation of a bone spur varies depending on its location and whether it impinges on surrounding tissues. Common symptoms described can include:

• Aching pain around the affected joint, especially during movement
• Stiffness and reduced range of motion. This may feel like a relatively hard / uncomfortable block to movement rather than a just a sensation of tightness. As the spur abuts against other tissue impacting the freedom of movement. 
• Tingling, numbness, or weakness is sometimes a reported symptom. This would be the case should the spur compresses a nerve. Most commonly associated with bone spurs in the spine.
• A noticeable bump under the skin in some cases, and often palpable in superficial joints like big toe and fingers. In the hip and spine osteophytes are typically neither visible or palpable due to the depth of the joints and overlying soft tissues. 

Osteophytes In Different Areas Of the Body 

• In the spine osteophytes can lead to radicular symptoms, such as sciatica in the lower back or referred arm pain with bone spurs in the neck.
• In the shoulder or hip, they may cause pinching sensations in certain movements. Or contribute to bursitis and tendon impingement causing pain and potentially weakness.
• In the ankle bone spurs at the front of the ankle can cause a limitation to dorsiflexion. This can impact the knee moving forward of the toes limiting running and jumping actions as well as something as simple as going up and down stairs.

What Happens if Bone Spurs Go Untreated?

If osteophytes are left untreated and they are symptomatic, the condition may gradually worsen. Untreated bone spurs can lead to:

• Chronic joint pain, stiffness and range of movement losses
• Nerve compression, potentially leading to numbness or weakness, especially in the spine
• Tendon degradation and potential tearing should the bone spur compress against softer tissues like tendons. Such as the rotator cuff in the shoulder. 
• Increased risk of compensatory injuries and even falls due to altered movement patterns. 

Bone Spurs Aren’t Always Symptomatic

It’s important to note that many osteophytes do not require treatment and do not cause symptoms. Physiotherapy focuses on achieving successful non-surgical management of symptomatic spurs where possible. At Sydney Physio Clinic, we work closely with patients to develop tailored plans that maintain function and reduce discomfort through exercise, manual therapy, and education and activity modification where necessary.

Physiotherapy Management of Osteophytes

Treatment goals focus on reducing pain and maintaining strength and function. With improving joint mobility where appropriate. Management strategies may include:

• Targeted exercise programs to improve strength and flexibility
• Joint mobilisation and soft tissue techniques to reduce stiffness and enhance tissue range of motion
• Postural correction and ergonomic advice as appropriate, namely relevant in the spine and shoulder 
• Education on load management and activity modification
• Use of supportive taping, supportive devices or braces as appropriate

In spinal cases, traction and neural mobilisation techniques may assist in relieving nerve compression symptoms. Physiotherapists can also guide patients through progressive loading programs to promote joint health and avoid flare-ups.

When Is Surgical Intervention Needed?

Most cases of bone spur related discomfort can be managed conservatively. However, should symptoms persist despite appropriate physiotherapy treatment surgical options may be explored.

Preventing Osteophyte Progression

Although age and genetics cannot be modified, there are proactive strategies that reduce the risk or progression of osteophyte formation.

• Maintaining a healthy body weight to reduce joint stress
• Staying active with regular, lower-impact exercise such as walking, swimming, or cycling (depending on which joint is symptomatic) 
• Managing joint injuries early with proper assessment and rehabilitation
• Addressing postural and movement imbalances where relevant with physiotherapy or exercise physiology treatment. 

Education and early intervention is important. Physiotherapists at Sydney Physio Clinic routinely work with patients experiencing early joint changes to support long-term joint health and slow down any negative change.

The Presence Of A Bone Spur Is Not All Doom & Gloom 

Osteophytes are a natural response to joint stress or degeneration, but when symptomatic, they can affect quality of life. Ideally physiotherapy offers an effective, non-invasive way to manage symptoms and maintain function. Whether it’s spinal nerve compression or joint stiffness in the hip, knee, ankle or big toe… Early intervention can reduce discomfort and promote longevity of function. At Sydney Physio Clinic, we provide comprehensive, individualised care helping you move with confidence again.