Osteophytes may remain asymptomatic for several years and symptoms, when present, depend on the location of the spur. Spurs are of clinical importance as they cause pain, and sometimes, loss of function of joints. Compression of nerves limits the mobility of joints and obstruct many tissues and organs. For example, vertebral osteophytes lead to pain in the lumbar region and abdominal pain [6]. Osteophytes of the spine is also associated with dysphagia and breathing problems [7]. Report of spine osteophytes causing vocal cord paralysis is also available [8]. Cervical osteophytes with vertical artery compression may also result in dysphonia [9].

Osteophytes located in other parts of the body may cause considerable pain and affect functions. Acromioclavicular joint osteophyte is associated with rupture of supraspinatus tendon [10]. Medial tibial condyle spur may cause knee pain, particularly in patients with osteoarthritis. Osteophytes of the neck may result in pins and needles sensation, numbness, and weakness in the arms. Rotator cuff tear results from osteophytes in the shoulder region that limit the space available for tendons and ligaments. Lumps may be seen on the fingers with the presence of osteophytes.

• Inflammation

  Spurs usually are caused by inflammation that stimulates formation of new bone. Examples of causes of local inflammation at the edge of joints that cause spurs are inflammation of the tendons and ligaments that attach to the bone. [medicinenet.com]

  They help to reduce pain and inflammation in the affected region. Local injections or oral anti-inflammatory medications are commonly used depending on the location of spur. [symptoma.com]

  If inflammation occurs at the attachment point, a bone spur may develop. [spine-health.com]

  The cause of a bone spur is nearby chronic inflammation. An osteophyte materializes during the process of replacing tissue damaged by inflammatory disease. Spur on a bone is natures way of lending support and stability to an area. [healthblurbs.com]

  Pathophysiologically, dysphagia may occur secondary to 1) mechanical compression with partial obstruction, or 2) periesophageal inflammation caused by pharyngoesophageal motion over the osteophytes. [ncbi.nlm.nih.gov]

• Pathologist

  Srinivasan US 1 * and Radhi Lawrence 2 1 Chief Neurosurgeon, Madras Institute of Orthopaedics and Traumatology Hospitals, India 2 Chief Pathologist, Madras Institute of Orthopaedics and Traumatology Hospitals, India Corresponding Author : Srinivasan US [omicsonline.org]

• Vomiting

  Side Effects of Osteofit C Plus Capsule 10s: Dry mouth, muscle pain, increased thirst, loss of appetite, vomiting, metallic taste, upset stomach, constipation, difficult urination. [sastimedicine.com]

  Common side effects of calcitriol : Dry mouth, muscle pain, increased thirst, loss of appetite, vomiting, metallic taste, upset stomach, constipation, difficult urination. [medplusmart.com]

  During this investigation, the patient gagged and vomited, and reiterated that he had been having similar difficulty with eating and drinking more recently. His medical history was unremarkable. He was a nonsmoker and did not take any medications. [bcmj.org]

• Abdominal Pain

  A 46-year-old woman was admitted with acute abdominal pain radiating to the back. Computed tomography examinations showed a needle-thin perforation of the aorta, opposite the origin of the superior mesenteric artery, with a pseudoaneurysm. [ncbi.nlm.nih.gov]

  For example, vertebral osteophytes lead to pain in the lumbar region and abdominal pain. Osteophytes of the spine is also associated with dysphagia and breathing problems. Report of spine osteophytes causing vocal cord paralysis is also available. [symptoma.com]

• Diarrhea

  Very loose stools (diarrhea). Any rash. Side effect or health problem is not better or you are feeling worse. [medplusmart.com]

• Nausea

  Common side effects of mecobalamin : Headache, nausea, vomiting, diarrhea, loss of appetite, skin rash, hot flushes What do I do if I miss a dose Take a missed dose as soon as you think about it. [medplusmart.com]

• Flushing

  Do not flush medications down the toilet or pour them into drainage unless instructed to do so. Medication discarded in this manner may contaminate the environment. [tabletwise.com]

  Common side effects of mecobalamin : Headache, nausea, vomiting, diarrhea, loss of appetite, skin rash, hot flushes What do I do if I miss a dose Take a missed dose as soon as you think about it. [medplusmart.com]

• Osteophyte

  Degenerative changes in the cervical spine can produce osteophytes and other hypertrophic abnormalities. Asymptomatic osteophytes of the anterior margins of the cervical vertebrae may occur in 20-30% of the population. [ncbi.nlm.nih.gov]

• Arthritis

  Arthritis Foundation. http://www.arthritis.org/about-arthritis/types/back-pain/articles/oa-and-back-pain.php. Accessed Jan. 15, 2018. Imboden JB, et al. Osteoarthritis. In: Current Diagnosis & Treatment: Rheumatology. 3rd ed. [mayoclinic.com]

  This article presents the results of an arthroscopic technique for treatment of elbow arthritis in a series of patients. [ncbi.nlm.nih.gov]

  Osteophytes can also form in the spine as a result of ankylosing spondylitis, a type of arthritis that specifically affects the spine. [nhs.uk]

• Back Pain

  RESULTS: The prevalence of low back pain was significantly greater in the group of osteophyte formation with disc height narrowing than the other 2 groups. [ncbi.nlm.nih.gov]

  Back Pain > Facet Joint Syndrome > Osteophytes [cure-back-pain.org]

  Degeneration, bone spur development and related disorders result in neck and back pain, radiating arm and leg pain and weakness in the extremities. [spine-health.com]

  Is your back pain caused by OA? Arthritis Foundation. http://www.arthritis.org/about-arthritis/types/back-pain/articles/oa-and-back-pain.php. Accessed Jan. 15, 2018. Imboden JB, et al. Osteoarthritis. [mayoclinic.com]

• Heberden Node

  The aim of this study was to evaluate the results of osteophyte excision without cyst excision for the treatment of a mucous cyst combined with Heberden's node. [ncbi.nlm.nih.gov]

  Aside from the manifestations of osteoarthritis, osteophytes can: fracture causing pain impinge neuromuscular structures present as Heberden nodes and Bouchard nodules in osteoarthritis of the hand Currently, it is unknown if osteophytes are a functional [radiopaedia.org]

  Osteophytes on the fingers or toes are known as Heberden's nodes (if on the distal interphalangeal joint) or Bouchard's nodes (if on the proximal interphalangeal joints). Normally, asymptomatic cases are not treated. [en.wikipedia.org]

  Examples include heel spurs, which are calcium growths that can form when a foot bone is exposed to continuous stress, or Heberden’s nodes, which are bone projections that grow on the fingers and/or toes in conjunction with osteoarthritis. [footfiles.com]

• Bouchard's Node

  Osteophytes on the fingers or toes are known as Heberden's nodes (if on the distal interphalangeal joint) or Bouchard's nodes (if on the proximal interphalangeal joints). Normally, asymptomatic cases are not treated. [en.wikipedia.org]

• Confusion

  However, because the appearance varies, findings on MR images can be confusing. We found "collar type osteophyte" of the femur i.e. an osteophyte rim around the femoral neck, to be a conspicuous finding of intra-articular OO. [ncbi.nlm.nih.gov]

  They are considered a hallmark of osteoarthritis and can be confused with syndesmophytes and enthesophytes. Small osteophytes are sometimes referred to as osteophytic lipping. [radiopaedia.org]

  They should not be confused with enthesophytes, which are bony projections that form at the attachment of a tendon or ligament. [en.wikipedia.org]

  This is not to be confused with Swimmer’s Ear, which is an infection of the ear canal. The normal diameter of an ear canal is about 5-8mm. With exostosis, the bone in the ear canal thickens and develops lumps, causing the ear canal to narrow. [everydayhearing.com]

  They may or may not cause pain, and patients often confuse heel spurs with a related condition known as plantar fasciitis – inflammation of the band of tissue that stretches from the ball of the foot to the heel, forming the arch. [drweil.com]

• Dizziness

  I've got sublaxation degenration which has caused chronic dizziness and a headache. I am presently being treated under the care of a chiropractor. anon188450 Post 24 I'm a 43 year old female. [wisegeek.org]

  If you experience drowsiness, dizziness, hypotension or a headache as side-effects when using Osteofit C Plus Capsule medicine then it may not be safe to drive a vehicle or operate heavy machinery. [tabletwise.com]

  Our clinics offer Physiotherapy, IMS (Intramuscular Stimulation) & Dry Needling, Kinesiology, Exercise Rehabilitation, Massage Therapy, Sports Rehabilitation, Post-Operative Rehabilitation, Vestibular, Dizziness & Balance Rehabilitation, Women's health [shelbournephysio.ca]

  Clinical Case A retired 73-year-old patient, with a history of dizziness, who consults the ENT. Cervical spine X-ray is requested for this patient. [scielo.br]

• Vertigo

  She has published contributions to laser development in ear surgery, advanced non surgical treatment of hearing loss, vertigo, imbalance and autoimmune ear disease. [ear-hearing-doctors.com]

Individuals with osteophytes present with non-specific pain and often the area of pain is not associated with the location of osteophyte. In most of the cases, diagnosis of osteophyte is incidental during the workup for some other non-correlated condition.

Physical examination may reveal discomfort and pain at the region of spur during palpation. Osteophytes that are located deep may not be revealed with external touch. Shoulder range motion testing is used to check for mobility and pain. Spur that impinge upon rotor cuff tendons often cause considerable pain.

X-rays are the ideal imaging studies for the identification of location and severity of bone spurs. But, very small spurs may not be visible in these images. Radiographic images are useful in assessing the degree of degenerative changes. In the early stages, radiographic images may show osteophytes with well-maintained space in the joint. Degenerative changes are severe in advanced forms of osteophyte formation. Narrowing of joint space, osteophytes, sclerosis and joint irregularities are some among them. Cases with impingement of nerves or muscles may be viewed with other imaging methods like MRI, CT, or EMG.

• Joint Space Narrowing

  OBJECTIVE: To clarify the individual associations of joint space narrowing (JSN) and osteophytosis at the knee with quality of life (QOL) in Japanese men and women using a large-scale population-based cohort from the Research on Osteoarthritis Against [ncbi.nlm.nih.gov]

  Radiographic knee OA was defined as the presence of joint space narrowing and osteophyte in any knee compartment. No radiograph showing patellectomy or joint replacement was included. [ard.bmj.com]

  To separate the effect of osteophytes from baseline narrowing, we stratified knees by the worse joint space narrowing grade in the knee (0–3) at baseline and, within each grade of narrowing, calculated a z score using the knee's overall osteophyte score [academic.oup.com]

Treatment of osteophyte is dependent on the severity of symptoms. The most common symptom associated with the condition is pain, which may or may not be related to the location of the spur. Non-steroidal anti-inflammatory medications are the first line of treatment for osteophytes. They help to reduce pain and inflammation in the affected region. Local injections or oral anti-inflammatory medications are commonly used depending on the location of spur.

Physical therapy are equally effective in relieving symptoms due to osteophytes. These exercises the muscles surrounding the spur and strengthen them, improving their mobility. Stretching exercises, use of ice packs, massage and ultrasound treatment, are all used under physical therapy. Cortisone injections are sometimes used to reduce pain in the joints. For spine and hip, these injections are delivered with the help of X-ray. Mechanical methods like orthotics, or shoe inserts, are useful in relieving symptoms of spurs in the leg. Surgical measures are suggested in case of impingement of nerves, or tendons. Surgery is an option only when conservative treatment measures do not provide any relief to the symptoms.

Asymptomatic osteophytes may not require any specific treatment and may not cause any major issues. Conservative treatment may be enough for many bone spurs which often have a good prognosis. However, osteophytes persist even when the symptoms resolve. Osteophytes may cause severe disability when they press against the neighboring nerves. Some of the spurs show enlargement over a period of time. Surgery may not give permanent relief as the spurs may grow back.

Remodeling of joints secondary to changes in joints, like osteoarthritis or pathological changes, are presumed to be most common causes of bone spur formation. Osteophytes may also be an adaptation to stabilize articular cartilage [2]. Presence of osteophytes is directly related to age as chances of osteoarthritis and cartilage wear off increases with time. Cartilage damage may act as a mechanical stimuli and stimulate osteophyte formation, but spur formation may also occur in healthy joints. Cartilage damage associated with narrowing of joints is highly correlated with formation of osteophytes [3]. In the knees, anterior cruciate ligament tear stimulates osteophyte formation, anterior and posterior to the point of tear. This aids in limiting the translocation of femur on tibia ensuring stability.

Local inflammation, as in tendinitis and osteoarthritis, is also related to formation of osteophytes. Thus plantar fasciitis and Achilles tendinitis also increase the chance of spur formation. Osteophytes may result from certain congenital conditions like osteochondroma, and are referred to as congenital spurs.

Osteophytes are commonly seen in persons over the age of 60 years, as the incidence of osteophyte formation increases with age. In majority of cases, the condition remains asymptomatic and may be diagnosed through X-rays indicated for other reasons. In individuals above 50 years, ankle spurs are more common among women when compared to men [4]. A moderate positive correlation is noted between these spurs for women over 30 years.

Excessive mechanical stress and the presence of structural fissures in the articular cartilage result in cartilage damage in the joints. Cartilage in this area becomes rough and worn out, which affects the movement of the joint. This may initiate the release of enzymes that expedite the disintegration of cartilage. This acts as the trigger for osteophyte formation. Osteophytes express transforming growth factor β, a factor that is involved in the initial formation and also in the later developmental stages of bone spurs [5]. Expression of growth factors and mediators play a key role in formation of osteophytes. Osteophytes contain fibroblasts, prechondrocytes, maturing chondrocytes, hypertrophic chondrocytes and osteoblasts. Type II collagen is the most prominent component in the cartilaginous zone of osteophytes.

Osteophytes play an important role in providing protection to the articular cartilage by redistributing forces in the affected region. Thus, they form an adaptive reaction to deal with the instability in the joints containing damaged cartilage.

Preventing the underlying cause of osteophytes like inflammation is the only known way to prevent spurs. Being physically fit and active helps to reduce the symptoms due to osteophytes.

Osteophytes are bony outgrowths covered by smooth fibrocartilage often associated with osteoarthritis. These projections usually grow from the periosteum at the junction between bone and cartilage [1]. Osteophytes are one of the common features noted in the radiography of osteoarthritis. Traction spurs, found at the insertion of tendons and ligaments, and inflammatory spurs are other types of osteophytes. They are considered as an adaptive response of the joint to stabilize and provide protection to articular cartilage. Studies report that osteophytes stabilize knees affected by osteoarthritis.

Osteophytes may remain asymptomatic in many, but are of clinical importance as they may represent or predict disintegration of joint. Herberden’s nodes, spine, elbow and feet are the most common sites of osteophyte formation. Osteophytes may be associated with pain when they compress nearby structures like nerves and spinal cord. Treatment is based on the severity of symptoms.

Osteophytes or bone spurs are small outgrowths of bones from the edges of bones. Although very common in joints, it can be formed in any bone. They may also form at the region of attachment of ligaments, tendons or muscles to bones. Neck, lower back, shoulder, knee, foot and heel are the most common regions of occurrence of spurs. Stress and rubbing of bone for a long duration are the most common causes of bone spurs. Osteoarthritis and inflammation cause stress to bones and joints. With age, the cartilage cover on the edges of bones wear off causing the bones to rub against each other. This triggers the formation of new bone in the region resulting in osteophytes. This is considered as body’s method to stabilize the affected joint. Previous trauma and increasing age are two major risk factors in the development of bone spurs. Incidence of bone spurs increases with age and osteophytes are very common among individuals over 40 years.

Pain is most common symptom of osteophytes. Pain may be related to or totally different from the location of spur. When bone spurs press against the surrounding nerve or muscle, they cause pain and affect the motion of the joint. This is commonly seen in the hips, knees, shoulders, hands and feet. When spurs rub against the tendons or ligaments, it may result in tear. Spinal osteophytes may cause pain and loss of functioning and mobility. Numbness, tingling or weakness in arms or legs are seen when nerves are pinched due to the presence of spurs. Pressing of muscles may result in loss of balance, weakness and pain.

A thorough physical examination is needed to review the condition and to check for any other medical problems. This will also help to assess the severity of the problem and the mobility of the affected joint. Imaging studies like X-ray is suggested to evaluate bone spurs. X-ray imaging helps to assess the location and extent of degeneration of joint. Tear of ligament and tendons are assessed using MRI or a CT scan. These methods help to observe compression of nerve and spinal cord due to the presence of spurs.

Treatment of osteophytes is based on the severity of symptoms. Non-steroidal anti-inflammatory medications are commonly used to reduce pain and to relieve the inflammation in the affected joint. Symptoms can also be controlled through physical therapy. This includes, cold packs, exercises, ultrasound treatments and massages. These methods help to improve the movement of the affected joint and to reduce pain. Cortisone injections are used to relieve pain in certain cases. Surgery is opted only if the condition is not responding to any of the conservative treatment methods. Surgery may not give permanent relief as spurs may grow back even after the treatment. Maintaining an active life is the best way to reduce the symptoms due to the presence of bone spurs.

Bone spurs that are asymptomatic may not require any specific treatment. Symptoms, when present, may be mild or disabling, depending on the location. In most of the cases, conservative treatment measures provide good relief. But in many cases, the spurs may persist even when the symptoms are resolved.

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3. Boegard T, Rudling O, Petersson IF, Jonsson K. Correlation between radiographically diagnosed osteophytes and magnetic resonance detected cartilage defects in the patellofemoral joint. Ann Rheum Dis. 1998; 57: 395–400. 
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5. Uchino M, Izumi T, Tominaga T, et al. Growth factor expression in the osteophytes of the human femoral head in osteoarthritis. Clin Orthop Relat Res. 2000;377:119–125.
6. Lamer TJ. Lumbar spine pain originating from vertebral osteophytes. Reg Anesth Pain Med. 1999; 24: 347–351. 
7. Aronowitz P, Cobarrubias F. Images in clinical medicine. Anterior cervical osteophytes causing airway compromise. N Engl J Med. 2003 25; 349: 2540.
8. Brandenberg G, Leibrock LG. Dysphagia and dysphonia secondary to anterior cervical osteophytes. Neurosurgery. 1986; 18: 90–93.
9. Giroux JC. Vertebral artery compression by cervical osteophytes. Adv Otorhinolaryngol. 1982; 28: 111–117.
10. Petersson CJ, Gentz CF. Ruptures of the supraspinatus tendon. The significance of distally pointing acromioclavicular osteophytes. Clin Orthop Relat Res. 1983;174:143–148.