What Are Bone Spurs of the Foot & Ankle?

A bone spur, or osteophyte, is an abnormal growth of extra bone that develops when the body tries to repair a problem. Bone spurs can occur in any bone, but they are most common in the joints and are more likely to form in some areas of the body than others. The foot is one region in which bone spurs often develop, and aside from heel spurs, they are also fairly common in the toes and the middle of the foot (midfoot).

What Causes Bone Spurs?

Bone spurs in the foot form when the body tries to repair damage by building extra bone. This damage is typically due to pressure or stress being placed on a bone regularly for a long period of time. In response, a growth of calcium-one of the main components of bone that helps to keep it strong-develops on the affected bone. This becomes a bone spur. When the bone spur grows out of one of the joints on the top of the midfoot, it’s called a tarsal boss. A bone spur on the inside or outside any of the toes is usually referred to as a toe spur.

Any factor that creates too much friction within the foot can lead to a tarsal boss or toe spur. People who have arches in their feet that are either higher or lower than normal-especially runners-are one group that is at risk. High arches force the person to roll their foot too far outward (underpronation), while low arches lead to rolling too far inward (overpronation). Walking or running in normal shoes with these types of feet can cause bones and joints to rub against one another and may lead to a tarsal boss. Arthritis can also have a similar effect, since it causes the cartilage that normally protects bones to wear away. Once again, bones will come into contact and a spur can develop in the midfoot or the toes. Other risk factors for bone spurs in the foot include:

• Wearing shoes that are too tight and pinch the toes (especially for toe spurs
• Infections
• Aging
• Being overweight or obese
• Charcot foot: a condition that causes weakness in the bones of the foot due to nerve damage; this may or may not be due to diabetes

What Are The Symptoms of Bone Spurs?

Bone spurs in the foot do not always cause symptoms. If a tarsal boss or toe spur does lead to pain, it’s usually from the pressure of wearing a shoe or rubbing against any other surface. Symptoms tend to begin as an aching or soreness on the top of the midfoot or in any of the toes. Pain can range from mild to severe, but it generally occurs or gets worse when wearing any types of shoes that are too tight or restrictive. Other symptoms may include:

• Redness or swelling (inflammation)
• A corn (similar to a callus) on the toe or between toes
• Stiffness and loss of motion of the toe(s) or ankle(s)
• Difficulty walking and functioning normally due to pain and loss of motion

What Are The Treatment Options For Bone Spurs?

Since bone spurs in the foot don’t always create problems (some people don’t even notice them), treatment is not needed in every case. If the bone spur is very painful, continuing to grow or get worse, or preventing you from functioning normally, you should see a doctor like a podiatrist for an evaluation. Your doctor will ask you some questions about your feet and can usually identify a bone spur on the top of the foot or the toes by examining the area. X-rays and other tests may also be performed to determine the exact size and location of the spur and to check for any other conditions that may be present. Bone spurs often occur with corns, bursitis and some other conditions that can cause additional problems, so it’s best to determine if other issues are making the issue worse.

Most bone spurs in the foot can be treated conservatively (non-surgically) with some basic changes that can reduce pressure on the bump, and surgery is rarely needed. Although conservative treatment won’t remove the bump of a bone spur, it can relieve pain and other symptoms and make it easier to function. Here are some of the most effective conservative treatments your doctor may recommend:

• Padding: for a tarsal boss, placing some orthopedic padding between the bump and the tongue of the shoe can relieve some of the pressure from your shoes
• Footwear changes: if your shoes are part of the problem, you should change to wearing pairs that are less restrictive to the toes and the rest of the foot; it’s best to have a high and wide toe box, and stiff soles may also help; don’t tie your shoes too tightly, and for extra help, a shoe specialist may be able to create a soft area in your shoe so the material does not compress your foot so tightly
• Heat and/or ice: your doctor may recommend applying heat or ice to your bone spur when symptoms arise
• Weight loss: if you are overweight, your doctor may advise you to lose to some weight to reduce the amount of pressure on your feet
• Injections: if the pain keeps getting worse, an injection-usually a steroid called cortisone-can be injected directly into the bone spur for temporary relief
• Walking Boot: a walking boot on its own won’t make a bone spur go away. A walking boot can be worn after surgery or prior to surgery to help take the pressure off the affected area. A short walking boot is typically recommended due to the location of bone spurs typically being in the heel like the Aircast Airselect Short Walking Boot.

SURGERY

If the pain continues to get worse and the bone spur keeps growing after these conservative treatments, or if you have arthritis and your spur will likely progress, you may want to consider surgery. There are a few surgical options available, such as removing the spur completely or fusing together separate bones, so it’s best to speak with your doctor to determine which procedure is right for you. As always, there are risks involved and some recovery time will be needed after surgery.