A bone spur is a smooth, bony projection that grows along the edge of a bone, usually where two bones meet at a joint. Despite the name, bone spurs aren’t sharp or pointy. They’re your body’s attempt to repair itself by adding extra bone in areas under stress. Many bone spurs cause no symptoms at all and go unnoticed for years, but when they press on nerves, tendons, or other structures, they can cause significant pain and limited movement.
Bone spurs become increasingly common with age. Between 20% and 25% of people aged 20 to 45 already have them somewhere in their spine. By age 60, that number jumps to 73% to 90%.
Why Bone Spurs Form
The most common driver is osteoarthritis. As cartilage gradually wears down inside a joint, the space between bones narrows. The body responds by building new bone along the joint margins, essentially trying to stabilize the joint and compensate for the lost cushioning. These bony growths form opposite to the direction of cartilage loss, which is why they tend to appear at the edges of damaged joints.
Osteoarthritis isn’t the only cause. Bone spurs also develop at sites where tendons or ligaments attach to bone, especially when those connections are under repeated stress. Years of running, for example, can produce heel spurs where the plantar fascia pulls against the heel bone. Joint injuries, poor posture, and the general wear and tear of aging all contribute. Carrying extra body weight accelerates the process in weight-bearing joints like the knees and hips.
Where Bone Spurs Commonly Develop
Bone spurs tend to form on bones that absorb a lot of force or repetitive motion. The most common locations include the feet (especially the heels), hands and knuckles, shoulders, hips, knees, and spine. Each location produces its own set of symptoms, and some are far more disruptive than others.
Spine and Neck
Spinal bone spurs are the most likely to cause serious complications, though they often don’t. The vertebrae in your spine have small openings where nerves exit the spinal column. A bone spur growing near one of these openings can compress a nerve, causing radiating pain, tingling, numbness, or a “pins and needles” sensation in the arms or legs. In some cases, spurs grow inward and press directly on the spinal cord itself, which can cause weakness or coordination problems. Rarely, bone spurs in the neck grow large enough to interfere with swallowing.
Knees and Hips
In the knee, bone spurs can make it painful to fully extend or bend the leg. They sometimes feel like a catching or locking sensation during movement. Hip bone spurs reduce range of motion and can refer pain to the thigh or knee, which sometimes leads people to think the problem is somewhere other than the hip.
Heels
Heel spurs are visible on X-rays and form where the plantar fascia (the thick band of tissue along the bottom of the foot) attaches to the heel bone. Here’s the important distinction: heel spurs and plantar fasciitis are not the same thing. Most people with heel spurs on their X-rays have no heel pain at all. Heel spurs do not cause plantar fasciitis pain. Plantar fasciitis can be treated successfully without removing the spur, and surgery to remove a heel spur is rarely necessary.
Symptoms to Recognize
Most bone spurs produce no symptoms whatsoever. You could have several and never know it. When they do cause problems, the symptoms depend entirely on location. Pain and stiffness in a joint are the most common complaints. You might notice reduced range of motion, swelling around a joint, or a visible bump under the skin (particularly on the hands or feet).
The symptoms that warrant more attention are neurological: tingling, numbness, or weakness in an arm or leg. These suggest a bone spur is compressing a nerve, most often in the spine. This type of nerve compression, called radiculopathy, can worsen over time if left unaddressed.
How Bone Spurs Are Diagnosed
Bone spurs often show up incidentally on imaging done for another reason. When a doctor suspects one based on your symptoms, a standard X-ray is usually the first step. X-rays clearly show the bony projections along joint margins and also reveal narrowing of the joint space where cartilage has worn away.
CT scans provide even more detailed images of bone and are excellent for visualizing the exact size and position of a spur. MRI is used when soft tissue involvement matters, particularly to evaluate whether a spinal bone spur is compressing a nerve or the spinal cord. An MRI can also show cartilage loss, which helps confirm osteoarthritis as the underlying cause.
Managing Pain Without Surgery
Since many bone spurs cause no symptoms, treatment is only needed when they’re causing pain or functional problems. The first approach is almost always conservative, and it works for most people.
Over-the-counter pain relievers like acetaminophen, ibuprofen, or naproxen can reduce inflammation and ease discomfort. Physical therapy strengthens the muscles around the affected joint, improves flexibility, and takes pressure off the area where the spur is growing. For many people, this combination is enough to manage symptoms long-term.
Weight loss makes a meaningful difference for bone spurs in the hips and knees. Even a modest reduction in body weight decreases the load on those joints. Low-impact exercise like walking, biking, and swimming strengthens supporting muscles without adding further joint stress. Ice applied to a swollen joint can reduce inflammation in the short term, and rest during flare-ups helps prevent aggravation.
When Surgery Becomes Necessary
Surgery is reserved for bone spurs that don’t respond to conservative treatment or that cause nerve compression with progressive symptoms. The goal is typically to remove the spur and relieve pressure on the affected nerve or tissue. In the spine, this might involve widening the space where a nerve exits the spinal column. In joints like the shoulder, surgeons can often remove spurs arthroscopically through small incisions.
Recovery time varies by location and procedure. Arthroscopic removal from a shoulder or knee generally means a few weeks of limited activity followed by physical therapy. Spinal surgery requires a longer recovery, often several months before full activity resumes. Surgery is effective at relieving nerve compression symptoms, but it doesn’t stop new bone spurs from forming if the underlying cause, like osteoarthritis, continues to progress.
Bone Spurs and Osteoarthritis
Bone spurs and osteoarthritis are so closely linked that the presence of spurs on an X-ray is one of the key markers radiologists use to diagnose and stage the disease. As osteoarthritis progresses, the pattern is predictable: cartilage thins, joint space narrows, bone spurs form along the margins, and eventually small cysts and areas of hardened bone appear beneath the joint surface.
This means bone spurs are often a sign of an ongoing process rather than a standalone problem. Treating the arthritis itself, through weight management, exercise, physical therapy, and sometimes joint injections, addresses the root cause and can slow the formation of new spurs. Focusing only on the spur without addressing the joint degeneration behind it is unlikely to provide lasting relief.