Bone spurs are small, smooth growths of extra bone that develop along the edges of bones, usually where two bones meet at a joint. They’re extremely common, especially with age: about 80% of men and 60% of women over 50 have them, and by age 70, 95% of both men and women do. Most bone spurs cause no symptoms at all and are discovered accidentally on X-rays taken for other reasons.
How Bone Spurs Form
Your body builds bone spurs as a response to stress, friction, or damage in a joint. When cartilage wears down (as it does in osteoarthritis), the bones on either side of the joint start rubbing closer together. Your body tries to repair the situation by growing new bone along the edges, essentially attempting to increase the joint’s surface area and redistribute the load. These growths develop from precursor cells in the periosteum, the thin tissue layer that covers your bones.
Bone spurs are strongly associated with cartilage damage, but they can also form without it. Repetitive stress on tendons and ligaments, chronic inflammation, and even prolonged pressure from poor posture or ill-fitting shoes can trigger new bone growth. The process happens gradually over months or years, which is why bone spurs are so much more common in older adults.
Where They Develop and What They Feel Like
Bone spurs can form in almost any joint, but certain locations cause more trouble than others.
Knees: Spurs around the knee can make it painful to fully extend or bend your leg. You may notice stiffness after sitting for a while or a grating sensation during movement.
Hips: Hip bone spurs often create pain that feels like it’s coming from your knee or thigh rather than the hip itself. They can also reduce your range of motion, making it harder to walk or rotate your leg.
Spine: Spurs on the vertebrae deserve special attention. Your spinal column has small openings where nerves exit, and bone spurs can narrow those openings. When a spur compresses a nerve, it can cause pain, tingling, numbness, or weakness that radiates into your arms or legs, depending on where in the spine it occurs. In rare cases, spurs in the neck can grow large enough to interfere with swallowing.
Heels: Heel spurs develop on the underside of the heel bone, often alongside plantar fasciitis. They can cause a sharp, stabbing pain with your first steps in the morning.
Shoulders: Spurs in the shoulder can rub against the rotator cuff tendons, leading to inflammation, pain when raising your arm, and eventually tendon tears if left unaddressed.
Fingers: One ultrasound study of over 400 factory workers found at least one bone spur in 99.8% of participants, with an average age of 53. The vast majority of these were tiny, grade 1 growths that caused no symptoms. Researchers concluded that small finger bone spurs on imaging should be considered a normal finding.
Why Most Bone Spurs Never Cause Problems
The majority of bone spurs are completely painless. They sit quietly on the edges of joints and never grow large enough to press on anything sensitive. Many people live their entire lives with bone spurs and never know it. Problems only arise when a spur irritates nearby soft tissue, restricts joint movement, or presses on a nerve. Even spinal bone spurs, which carry the most risk, rarely cause serious complications.
This distinction matters because finding a bone spur on an X-ray doesn’t automatically explain your pain. If you’re having joint pain and imaging reveals a spur, your doctor will look at the spur’s size, location, and relationship to surrounding structures to determine whether it’s actually the source of the problem or just an incidental finding.
How Bone Spurs Are Found
Most bone spurs show up on standard X-rays, which can clearly outline the bony projection along a joint edge. When a spur is suspected of compressing a nerve, particularly in the spine, CT scans or MRI may be used to get a more detailed picture of how the spur interacts with surrounding nerves, the spinal cord, and soft tissues. These advanced imaging tools help determine whether the spur is actually responsible for symptoms like numbness or weakness.
Managing Symptoms Without Surgery
When a bone spur does cause pain, the first approach is almost always conservative. Over-the-counter anti-inflammatory medications can reduce swelling and discomfort around the affected joint. Ice and rest help during flare-ups. Physical therapy is a cornerstone of treatment: strengthening the muscles around a joint takes pressure off the bone surfaces and can significantly reduce pain, even though the spur itself remains in place.
For heel spurs, supportive shoes, orthotic inserts, and stretching exercises targeting the plantar fascia often resolve pain within several months. For spinal spurs causing nerve-related symptoms, physical therapy focused on posture correction and core stability can help open up the space around compressed nerves. Steroid injections into the affected area provide temporary but sometimes significant relief for joints and spinal nerve compression alike.
The key point is that treatment targets the symptoms, not the spur itself. A bone spur that isn’t causing problems doesn’t need treatment.
When Surgery Becomes an Option
Surgery is reserved for cases where conservative treatment has failed over a period of months, or where a spur is causing progressive nerve damage. The specific procedure depends on the location. For spinal bone spurs, surgeons may remove the spur and sometimes fuse adjacent vertebrae to stabilize the area. For joint spurs in the shoulder, knee, or hip, the growth can often be shaved down arthroscopically through small incisions.
Spinal surgery for bone spurs carries more risk than joint procedures. Patients typically undergo a thorough workup beforehand, including imaging to evaluate the spur’s size and its effect on surrounding nerves, to confirm that the spur is genuinely responsible for the symptoms before operating.
Reducing Your Risk
Because bone spurs are fundamentally a response to joint stress, the most effective prevention strategies center on protecting your joints over time. Maintaining a healthy weight reduces the load on your knees, hips, and spine. Regular low-impact exercise like swimming, cycling, or walking keeps the muscles around your joints strong without grinding down cartilage. Wearing supportive, well-fitting shoes matters more than most people realize, especially if you spend long hours on your feet.
Good posture reduces uneven stress on the spine, and ergonomic adjustments at your desk or workspace can prevent the kind of chronic strain that encourages spur formation in the neck and upper back. None of these measures guarantee you’ll avoid bone spurs entirely, given how universal they become with age. But they can slow the process and reduce the chance that any spurs you do develop will become symptomatic.