Bone spurs are outgrowths of bone, called osteophytes. They can occur on almost any bone in the body and are part of the body’s way of trying to heal itself. When bone is subjected to repeated stress, it reacts by forming new bone. If the new bone growth is excessive, it can appear as an outgrowth, jutting from the surface of the existing bone. Bone spurs in the toes are quite common, but they often cause no symptoms so many people don't even know they have them. Sometimes toe bone spurs produce pain or stiffness and interfere with walking or wearing shoes. Learning more about these spurs can help you find out whether you have one and what treatments are available.
Arthritis Is Often the Cause
Arthritis -- a disorder characterized by joint inflammation -- is a common cause of bone spurs. When arthritis is severe, it destroys the cartilage acting as a protective coating on the surface of bones within the joint. Without cartilage, a lot of stress is placed on the bones as they directly rub against each other every time the joint moves. This can produce a bone spur within the joint.
There are many joints in the toes, so there are many places where bone spurs can occur. There is 1 joint in the middle of each big toe, 2 joints in the middle of the other toes, and 1 joint at the base of each toe, where the toe connects to the rest of the foot. Arthritis of toe joints is often a degenerative disease, developing gradually as a person ages. It may or may not be accompanied by degenerative arthritis in other parts of the body.
Repetitive Pressure May Also be the Culprit
Repeated pressure on any area of the toes may lead to bone spurs. For example, a spur may appear at any point where one toe repeatedly rubs against another toe or against the inside of a shoe or other footwear. Toes that are abnormally bent or out of position are common causes of these types of spurs. These deformities may be the result of a previous toe fracture or an imbalance of ligaments and tendons in the toes. Wearing tight-fitting shoes over many years may also contribute to the development of bone spurs caused by repeated pressure.
Symptoms May or May Not Occur
Bone spurs themselves are painless, so they often produce no symptoms. However, they may cause pain if they press against surrounding bones, nerves or other tissues. The pain is typically worse when walking or running and when wearing shoes or other footwear. Bone spurs within joints may limit movement of the joint, producing stiffness. Severe arthritis of the joint at the base of the big toe -- called hallux rigidus -- usually produces a bone spur. As the name implies, stiffness is a major symptom of this condition. Sometimes a bone spur in a toe joint breaks off, becoming a loose piece of bone within the joint. This may cause the joint to suddenly lock.
X-rays Will Confirm the Diagnosis
When symptoms are absent, bone spurs are sometimes difficult to diagnose. A bump may be seen or felt at the site of the spur, especially when it is located outside a joint. Thickened areas of skin called calluses or corns may appear over a spur where it presses against another toe or footwear. Calluses are shallow and spread out, whereas corns tend to be deeper and localized to a smaller area. Some corns have a soft center that appears as an open sore. Calluses and corns suggest the possibility of an underlying bone spur, but they may occur in the absence of a spur as well. Because bone spurs are made of bone, they are easily seen on an x-ray. This is the best way to determine whether a bone spur is present, as well as its size.
Surgery Is Sometimes Necessary
Bone spurs generally do not require treatment if they are small and causing no symptoms. When symptoms appear, initial treatment usually consists of appropriate footwear, sometimes with pads or other inserts, to lessen pain and reduce pressure on the spur. Avoiding activities that worsen symptoms is also beneficial. Applying cold to the area and taking anti-inflammatory medications, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), can reduce pain and inflammation. Corticosteroid injections near the spur may also be helpful.
If pain is severe, surgery may be necessary. This often involves simply removing the spur, a procedure called cheilectomy. Fusing the joint, known as arthrodesis, is another option. Although it permanently prevents the joint from bending, arthrodesis may be considered when pain occurs with joint movement and the joint is severely damaged by arthritis. More complicated surgery -- such as arthroplasty -- is sometimes used for moderate or severe hallux rigidus.