Bone Spur: Causes, Symptoms and Imaging Findings
Bone spurs, also called osteophytes, are bony growths that develop along the edge of a joint, usually in response to long-term joint change and loading. They are common on imaging and may cause no symptoms at all, so seeing one on an X-ray does not automatically identify the source of pain.
Spurs matter where space is already tight. In the spine, one narrowing the opening a nerve root passes through can produce symptoms along that nerve into an arm or a leg. At the heel, the spur itself is rarely the problem; the loaded tissue attaching nearby usually is. The distinction worth making is whether symptoms follow a nerve path or stay local to the joint.
This guide to bone spurs, why they form and what the imaging findings mean, is published by Chiropractic Specialty Center, Bukit Damansara (KL) main center: WhatsApp+60 17 269 1873 Call+603 2093 1000
Key Takeaways
- Bone spurs are smooth bony outgrowths at joint margins. They are closely linked with osteoarthritis and become more common with age.
- Many spurs cause no symptoms. Imaging studies show spinal degenerative findings, including spurs, in a large share of people with no pain.
- Symptoms depend on location: local stiffness and pain at a joint, or nerve symptoms when a spur narrows the space around a nerve root or the spinal cord.
- No non-surgical treatment removes a spur. Conservative care aims at the pain, stiffness and weakness around it, and surgery is kept for cases with significant nerve compression or failed conservative care.
What Bone Spurs Are
An osteophyte is new bone and cartilage that forms at the edge of a joint. It is part of the joint’s response to long-term change in the cartilage and to load, and it is one of the features used to grade osteoarthritis on X-ray. Spurs are usually smooth rather than sharp, and they can form in the spine, hips, knees, shoulders, hands, feet and heels.
Whether a spur matters depends on where it is and what it is next to. A spur at the edge of a knee or finger joint may simply be a marker of arthritis. A spur that narrows the canal or an exit opening in the neck or lower back can affect a nerve, and a spur under the acromion in the shoulder may be part of an impingement picture.
Bone Spur Assessment at Two KL Centers
If a scan has shown a bone spur and you are unsure whether it explains your symptoms, an examination can help separate a nerve-related problem from local joint pain. You can reach either center through the Bukit Damansara contact page and the Bandar Sri Damansara contact page, or call directly:
- Bukit Damansara (KL, main center): Call +603 2093 1000 or WhatsApp +60 17 269 1873 to see the Bukit Damansara / KL center.
- Bandar Sri Damansara (KL): Call +603 6262 5777 or WhatsApp +60 12 455 6939 to see the Bandar Sri Damansara center.
Why Bone Spurs Form
- Age. Spurs become more common with each decade.
- Osteoarthritis. Cartilage change and spur formation go together.
- Load and joint history. Previous injuries, repetitive heavy loading and joint instability are associated with spur formation.
- Body weight. Higher body weight increases load on the knees and hips and is associated with knee osteoarthritis.
- Inflammatory and metabolic conditions. Some conditions, such as diffuse idiopathic skeletal hyperostosis, produce extensive new bone in the spine.
Bone Spurs in the Spine
Spinal spurs form at the edges of the vertebral bodies and at the facet joints, most often in the neck and lower back. This pattern of change is often called cervical spondylosis in the neck. Many people have spurs on a scan with no symptoms, and a spur only explains symptoms when the findings match the examination.
Neck (Cervical) Spurs
In the neck, spurs are most often seen in the lower segments, such as C4-C5, C5-C6 and C6-C7, with the upper and transitional levels such as C2-C3 and C7-T1 affected less often. A spur narrowing an exit opening can irritate a nerve root and cause pain, numbness or tingling into the arm. A spur narrowing the central canal can press on the spinal cord, which may show as clumsy hands, unsteady walking or symptoms in both arms or the legs.
Lower Back (Lumbar) Spurs
In the lower back, spurs are common at L4-L5 and L5-S1. Together with disc and ligament changes, they can narrow the spaces nerves pass through, producing leg pain that is worse with standing and walking and eased by sitting or bending forward.
Bone Spurs in the Shoulder, Knee and Heel
Shoulder. A spur under the acromion can reduce the space for the rotator cuff tendons and is sometimes part of shoulder impingement. Stiffness from frozen shoulder is a different problem and should be ruled out. See also shoulder pain.
Knee. Spurs at the knee are a feature of osteoarthritis. Exercise, weight management and activity pacing are central to knee pain care: a Cochrane review of 54 trials found that land-based exercise reduced knee osteoarthritis pain and improved physical function, and in overweight and obese older adults, diet-based weight loss combined with exercise eased pain more than either alone.
Heel. Heel spurs are common on X-ray, including in people without heel pain. When heel pain is present, the plantar fascia or the fat pad is often involved, and a large study found spurs and plantar fascia thickening frequently occur together. A spur at the back of the heel can sit near the Achilles tendon attachment.
Symptoms
- Local joint pain and stiffness, often worse after rest or at the end of the day.
- Reduced range of movement.
- Pain, numbness, tingling or weakness spreading into an arm or leg when a spinal nerve root is involved.
- Heel pain on the first steps in the morning when the plantar fascia is involved.
- No symptoms at all, which is common.
How Bone Spurs Are Assessed
The history and examination decide whether a spur is relevant. The examination looks at joint movement, which movements reproduce the pain and, for spinal spurs, reflexes, strength and sensation in the arms or legs. X-rays show spurs well. MRI is used when nerve or spinal cord compression is suspected, because it shows discs, nerves and the cord, and CT shows bone detail when surgery is being planned. Bring your images as well as the written report to an appointment, since the images show where a spur sits in relation to a nerve.
Conservative Care Options
No exercise, adjustment or machine dissolves a bone spur, and any claim to remove one without surgery is not accurate. Conservative care is aimed at the pain, stiffness, weakness and nerve irritation around it. Depending on the location, a plan may include:
- Exercise to restore movement and strength, including deep neck flexor and shoulder blade work for neck spurs, and hip and thigh strengthening for knee arthritis.
- Manual therapy and chiropractic techniques to improve joint movement, using lower-force methods where appropriate.
- Advice on positions and load, such as limiting long periods of looking upward when neck spurs narrow the nerve openings.
- Weight management and activity pacing for knee and hip osteoarthritis.
- Modalities such as shockwave therapy or laser therapy in selected cases, used alongside exercise. The evidence for these specifically in bone spurs is limited.
At Chiropractic Specialty Center, chiropractic combined with physiotherapy is planned from one assessment by the chiropractors and physiotherapists. Medicines and injections prescribed by a doctor can also have a role, and surgery is considered as a last resort when there is significant nerve or spinal cord compression or when a fair trial of conservative care has not helped.
When to See a Doctor Promptly
- A loss of bladder or bowel control. This needs same-day medical attention.
- Clumsy hands, dropping objects, unsteady walking or symptoms in both arms or both legs, which can point to spinal cord pressure. Don't ignore these; have them assessed promptly by a competent provider, as imaging may be needed.
- Weakness in an arm or leg that is getting worse. It should be assessed promptly; depending on the findings, conservative care may still be a reasonable route.
- A hot, red, swollen joint, especially with fever.
- Pain with unexplained weight loss, night pain that wakes you, or a history of cancer.
Where to Be Seen in Kuala Lumpur
Assessment and care are available at both of our Kuala Lumpur centers. The main one is described on the page for chiropractor in Kuala Lumpur at CSC Bukit Damansara.
A second center serves the northwest of the city. You can read about chiropractor in Bandar Sri Damansara with physiotherapy.
For travel, parking and opening hours, see Bukit Damansara address, hours and phone or Bandar Sri Damansara address, hours and phone.
Planning a visit? You can review the current chiropractic price in Kuala Lumpur and physiotherapy fees in Kuala Lumpur before you come in.
Frequently Asked Questions
Can a bone spur go away without surgery?
No. A spur is bone and does not dissolve with treatment. Many people become pain-free while the spur remains, because the pain often comes from the tissues around it.
Does a bone spur on my X-ray explain my pain?
Not necessarily. Spurs are common in people with no pain. The examination is what shows whether your symptoms match the spur’s location.
Is manipulation safe with neck bone spurs?
It depends on the findings. Where there is spinal cord compression, instability, or inflammatory arthritis affecting the upper neck, forceful manipulation is not appropriate, and lower-force methods and exercise are used instead if conservative care is suitable at all.
Should I stop exercising?
Usually not. In knee and hip osteoarthritis, reviews of many trials have found that exercise reduces pain and improves function. The type and amount may need adjusting, particularly for activities that provoke nerve symptoms.
References
- van der Kraan PM, van den Berg WB. Osteophytes: relevance and biology. Osteoarthritis Cartilage. 2007;15(3):237-244.
- Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816.
- Menz HB, Thomas MJ, Marshall M, et al. Coexistence of plantar calcaneal spurs and plantar fascial thickening in individuals with plantar heel pain. Rheumatology (Oxford). 2019;58(2):237-245.
- Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;1(1):CD004376.
- Fransen M, McConnell S, Hernandez-Molina G, Reichenbach S. Exercise for osteoarthritis of the hip. Cochrane Database Syst Rev. 2014;(4):CD007912.
- Messier SP, Mihalko SL, Legault C, et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA. 2013;310(12):1263-1273.
- Jordan KM, Arden NK, Doherty M, et al. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis. Ann Rheum Dis. 2003;62(12):1145-1155.
- Leach RE, Baumgard S, Broom J. Obesity: its relationship to osteoarthritis of the knee. Clin Orthop Relat Res. 1973;(93):271-273.
These references describe bone spurs, osteoarthritis and imaging findings in general. None of them evaluates care at Chiropractic Specialty Center.
The Author of Bone Spur: Causes, Symptoms and What Imaging Means
Bone Spur: Causes, Symptoms and What Imaging Means was written by Yama Zafer, D.C., who has 30+ years in chiropractic and physiotherapy and founded Chiropractic Specialty Center in Kuala Lumpur in 2006.
Last Updated: Bone Spur: Causes, Symptoms and Imaging Findings
Bone Spur: Causes, Symptoms and Imaging Findings was last reviewed and updated on October 5, 2026.
Good evening. I have a heel bone spur. Both heel. May l know the cost of treatment. Can l use my medical insurance? Thank you.
On cost: the assessment is priced separately from treatment and takes longer, follow-up visits are priced separately again, and how many are needed depends on the examination rather than on the diagnosis. Current figures for both are given by the reception team on request and are explained before care begins. On insurance, coverage for these services in Malaysia varies widely between policies, so ask your insurer three specific questions: is physiotherapy covered, is a doctor's referral required first, and will they issue a guarantee letter or must you pay and claim back.
More important than either is a point about the diagnosis itself.
A heel spur is very often not the cause of heel pain. Spurs appear on the X-rays of large numbers of people who have no heel pain at all, and where heel pain does exist alongside one, the pain usually comes from the plantar fascia or the fat pad rather than from the bone. Removing or targeting the spur is therefore rarely the point, and treatment aimed at the tissue that actually hurts is what changes things.
The second point concerns both heels. Heel pain on one side is usually mechanical. Heel pain on both sides at once is worth investigating further, because it is one of the recognized presentations of an inflammatory condition affecting the points where tendons attach to bone. The features that point that way are specific: morning stiffness in the back or heels lasting more than half an hour, pain that improves with movement and worsens with rest, pain in the second half of the night, other joints involved, or a personal or family history of psoriasis, eye inflammation, or bowel inflammation. If several of those fit, ask your doctor to investigate for inflammatory causes with blood markers, because the treatment is entirely different.
Where it is mechanical, the measure with the best support for long-standing heel pain is progressive strength work for the fascia rather than rest: a slow heel raise with the toes held extended over a rolled towel, progressed with added load, done every second day over about three months. Restricted ankle movement is the most consistent contributing factor and is worth testing and addressing directly.
Bring any X-rays with you, along with a note of whether the pain is worst on the first steps in the morning or builds through the day, since those two patterns point in different directions.
Hi, I would like to visit your clinic regarding bone spur. May I know your business hours?
The centers are open seven days a week, generally 8:00 AM to 8:00 PM Monday to Friday and 8:00 AM to 6:00 PM on Saturday and Sunday. Hours can vary slightly between centers, so check the contact page for the one you plan to visit, or call ahead.
Book rather than walk in for a first visit. An initial appointment needs a full assessment slot rather than a gap between bookings, and being seen properly the first time avoids a second trip.
Two things worth bringing, since you are coming about a bone spur specifically. Your imaging as images rather than only the typed report, because the report will say a spur is present but not what it is doing, and the images show whether it contacts a nerve root, narrows an exit opening, or is simply an incidental finding at the joint margin. And a written note of what your symptoms do across a day, particularly whether anything travels into an arm or leg and how far it goes at its furthest point.
That last detail matters because it determines what the visit is about. A spur that is not touching anything is an age-related finding that appears on a great many scans and is often unrelated to the pain someone is having. A spur narrowing the opening a nerve exits through is a different matter and is managed differently. The examination is what separates the two, and it is worth knowing that no treatment removes a spur, so the plan will be aimed at everything around it.
Ive bone spurs touching canal on c1 and c6 n c7.
The C1 finding is the one that changes how this should be approached, and it deserves attention before anything else.
The upper cervical spine is different from the rest of the neck. At C1 the spinal cord is at the top of its course, and the joint between C1 and C2 depends on ligaments rather than on a disc for its stability. Bone changes contacting the canal at that level are therefore assessed differently from spurs at C6 and C7, and they are a reason to be cautious about who treats your neck and how.
Three questions should be put to whoever holds your images. Is there any instability at C1-C2, and has that been assessed with flexion and extension views. Is there any signal change within the spinal cord itself, which is a separate and more serious finding than contact alone. And what is the canal measurement at the narrowest level.
One further question matters a great deal: do you have rheumatoid arthritis or any long-standing inflammatory joint condition. Inflammatory arthritis can affect the ligaments at C1-C2 and produce instability there, and where that is present or suspected, forceful manipulation of the upper neck is not appropriate until it has been excluded. The same caution applies after significant neck trauma. This is worth raising yourself rather than assuming it has been considered.
Then the signs that indicate the cord is affected, which are not neck pain: clumsy hands, dropping objects, difficulty with buttons and keys, deteriorating handwriting, unsteady walking especially in the dark, symptoms in both arms or in the legs, or any change in bladder control. If any of those are present, this needs neurological or neurosurgical assessment with current imaging rather than a course of treatment.
If none of them are, and your symptoms are neck pain with or without symptoms into one arm, conservative care is reasonable, with one honest limitation. Bone spurs are bone. No treatment dissolves them, and any claim to remove them without surgery is untrue. What can be addressed is the movement lost at the affected segments, the irritation around a nerve root, the sustained positions that reduce the available space further, and the strength of the deep neck flexors and the muscles holding the shoulder blades. That combination changes symptoms in many people even though the spurs remain exactly as they were.
Position is worth using deliberately. Extending the neck, meaning looking upward or holding the head back, narrows the canal and the exit openings. Overhead work, long periods looking up, and a pillow that is too high are the everyday versions of that.