As a result of rubbing, friction or repetitive stress on the bones within a joint, the body may attempt to ameliorate the damage by growing a bone spur at the affected site. Also known as osteophytes, bone spurs commonly grow in joints and on the heel, and often come as a result of osteoarthritis. Many bone spurs can go unnoticed because they are merely rounded bumps of extra bone helping to relieve the specific condition in the joint; however, when a bone spur begins to cause loss of motion or rubs or pinches the soft tissues surrounding it, such as nerves, tendons and cartilage, it can become quite painful, and the suffering patient seeks relief.
Treatments for Pain Relief
The first objective will be to relieve the pain so that more extensive physical therapy may commence. Pain treatments might include:
- Ice packs and/or heat
- Over the counter anti-inflammatory medications
- Cortisone shots in the joint
- Ultrasound treatments
Alleviating the Causes of Damage
Once the pain is under control, the physical therapy can proceed to treating the conditions which brought on the bone spur in the first place. These procedures may incorporate:
- Changing the faulty movement. Since the bone spur arose from movement in a way the joint is not meant to move, the therapist will work with the patient to literally change the faulty joint motion to the physiologically correct one. Although this process seems relatively rare among physical therapists, its benefits include immediate pain reduction and continued ease of movement.
- Improving the posture. Often, joints suffer when the person has poor overall posture or situational posture when moving the particular joint. A physical therapist can help guide the patient to develop habits that improve posture where needed.
- Joint movement. If the joint in question developed the bone spur because of repetitive activities from work or sports, the physical therapist may recommend ways to move the joint such that the activity no longer stresses the joint in the same place. This may necessitate the use of devices such as orthotics in the shoes or knee, back, shoulder and ankle braces.
- Stretching. Careful stretching and assisted movement can help limber up a joint and contribute to easing the pressure of the bone spur on soft tissue.
- Strengthening. Building strength in the surrounding muscles can help the joint move properly without rubbing bones together. The physical therapist can prescribe an exercise regimen tailored to the patient's ability and age.
- Deep tissue massage. Massaging the tissues around the spur increases circulation to the joint, helps eliminate built-up toxins and relaxes the muscles so that the rest of the physical therapy plan has a much better chance at success.
Facilitating the Reabsorption of the Bone with Iontophoresis
Bone spurs comprising calcium carbonate, sometimes can resolve without the need for invasive surgery. Surgical removal has been the last resort treatment for those that do not reabsorb on their own. However, once the conditions that brought on a bone spur are corrected, a relatively new treatment for osteophytes, called iontophoresis, can further accelerate the breakdown and reabsorption of the excess bone in a rather short period of time.
Iontophoresis is the act of sending charged ions of therapeutic substances into the skin using a weak electrical current. While the technique has many uses, from delivering medications without needles to treating excessive sweating, for bone spurs, it can painlessly transport the chemical, acetic acid, to break down the calcification without disrupting any other subcutaneous structure. The acetic acid used with the electrical charge reacts with the calcium carbonate of the bone spur and forms calcium acetate which is more soluble than the calcium carbonate, thus facilitating easier dissolution. The process is painless, requiring no injections or other invasions of the skin. The patient only feels a slight tingling as the electrical charge pushes the acetic acid into the affected area. The body's natural ability to dispose of waste carries the excess bone material out of the body through the capillaries and lymph system.
By avoiding surgery, the patient eliminates the inherent risk of infection or a failed procedure. Additionally, iontophoresis, precisely because it is not surgery, costs far less than resorting to the scalpel for relief.
If you would like to know more about treating bone spurs with physical therapy, please contact a knowledgeable and experienced physical therapist who can answer all your questions.