Bone Spurs in the Shoulder
In this article, Ross Hauser MD discusses non-surgical treatments and prevention of bone spurs in the shoulder utilizing such treatments as Prolotherapy, Stem Cell Therapy, Platelet Rich Plasma Therapy.
What is a bone spur?
A bone spur (more technically known as osteophyte) is defined as a pathological bony overgrowth that forms along the edges of bones. Simply put, a bone spur is an abnormal bony overgrowth that extends out over the normal bone. They mainly develop as a pathological condition resulting from osteoarthritis and joint instability.
How Do Bone Spurs Develop?
Bone spurs can develop from underlying joint instability, which can occur from traumatic injuries, repetitive motion injuries, or genetic ligament laxity. When any joint becomes unstable, the body instinctively reacts in a few different ways. Bone spurs can also develop after surgery surgery when instability occurs.1
Bone Spurs and Joint Instability
First, the joint can swell in order to help keep everything in place. When there is too much force on the ligament tissue, the joint may no longer be stable. Patients may notice that their knees, ankles, and any other joints become swollen or warm to touch after they workout. This usually means that during exercise, they are doing something to create instability in the joint. Thus the body swells as a natural response to the injury (loose ligaments).
When that no longer works long term, the body then recruits nearby muscles to help stabilize the joint. These muscles can be in a constant state of contraction as they try to stabilize the joint, but then also have to allow for regular movement. In the process, patients can develop painful muscle spasms (as it is not the muscle’s job to constantly contract to stabilize joints) from the extra load of work they are incurring.
The muscles may then start to degenerate and the body is left with one other option for stabilization: to start to overgrow bone tissue as a permanent way to stabilize the joint. This overgrowth of bone is what we call a “bone spur” (as it typically spurs out from the joint). If left untreated, bone spurs can become very large and very painful. They may cause pain with certain motions (i.e. a shoulder bone spur could cause pain when it pinches on tissue every time you raise your arm over your head) or significantly limit range of motion due to pain.
Shoulder Bone Spurs Healed with Prolotherapy at Caring Medical
Recently, we had a young man come to see us at Caring Medical with shoulder pain and limited range of motion. His pain could be explained by various tendon and ligament injuries of the shoulder but the restriction of motion could not, thus an x-ray was ordered.
As you can see on this x-ray, this person has a huge bone spur on the bottom of his humeral head (essentially the “ball” that helps the shoulder rotated around the way it does). This could explain why his range of motion was so limited. The extra bony growth prevented him from fully moving his shoulder. While Prolotherapy is working to resolve the pain, some patients still may end up needing surgery to remove the bone spur and get back the full range of motion.
At Caring Medical, we see many patients whose only desire is to get out of pain. Had this been the case with this gentleman, Prolotherapy would be a great solitary treatment option by itself. However, at such a young age, he also desires full range of motion to stay active the rest of his adult life. In this case, surgery may be warranted to allow him greater motion while Prolotherapy will ease pain and treat the underlying cause: joint instability.
Prolotherapy is always a great option when it comes to chronic joint pain but if you have significant restriction of motion in a joint, a plain and inexpensive x-ray may provide valuable information. It illustrates that “yes” sometimes surgery is needed! However, if you don’t treat the underlying cause of the bone spur (the joint instability), it will most likely come back.
Treatment Options for Bone Spurs
If you have a bone spur in your shoulder, as evidenced by an x-ray or MRI, you have a few treatment options. If you do not have any pain associated with the spur, you can do nothing. Not all bone spurs are painful and require treatment. If you do have pain, however, you can take medications and/or do physical therapy to manage the pain. You also may get a surgical consult and possibly receive surgery to shave the bone spurs, resurface the bone, or replace the shoulder joint. This may be necessary depending on the size and/or number of spurs. Lastly, you can receive Prolotherapy treatments to help stabilize the joint and ease pain. Prolotherapy is an injection technique used to stimulate healing of injured tissue. While Prolotherapy itself cannot get rid of a spur, it can treat the underlying cause: joint instability. It can help to alleviate pain and allow for better shoulder range of motion as well, depending on the size and location of the spur. Physical therapy is also a great adjunct treatment to Prolotherapy for the proper management and treatment of bone spurs.
1. Roche CP, Marczuk Y, Wright TW, Flurin PH, Grey S, Jones R, Routman HD, Gilot G, Zuckerman JD. Scapular notching and osteophyte formation after reverse shoulder replacement: Radiological analysis of implant position in male and female patients. Bone Joint J. 2013 Apr;95-B(4):530-5. doi: 10.1302/0301-620X.95B4.30442.