Bone Spurs in the Shoulder
Treating bone spurs in the shoulder is difficult. This according to a new paper published by doctors at the University of California at Los Angeles (UCLA) in the journal Clinics in Sports Medicine.
This is what they said:
- The management of glenohumeral osteoarthritis is difficult in young, active individuals.
- After nonoperative management fails, arthroscopic debridement with concomitant procedures such as:
- loose body removal,
- capsular release, unfreezing a frozen shoulder
- shoulder labral debridement, please see our article Doctors question effectiveness of shoulder labrum surgery
- synovectomy (inflamed synovial tissue removal),
- osteophyte resection (Scraping down bone spurs),
- bursectomy (removing the shoulder bursa),
- subacromial decompression (removing bone that is compressing tendons), Please see our article Shoulder impingement syndrome | Surgeons tell patients say no to surgery in new research
- microfracture (drilling holes into the shoulder bone to inspire cartilage repair),
- and biceps tenotomy or tenodesis (Cutting away damaged bicep tissue) (1)
What you see in these treatments is “cutting away,”,”removing,” “scraping, drilling.” You do not see repairing. This is why treating bone spurs in the shoulder is difficult with surgical treatments.
Bone Spurs and Shoulder Instability
A bone spur (more technically known as osteophyte) is an abnormal bony overgrowth that extends out from the normal bone.
The shoulder reacts in many ways to its own instability.
- First, the joint can swell in order to help keep everything in place.
- 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 the “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 your range of motion due to pain.
Shoulder Bone Spurs Healed with Prolotherapy at Caring Medical
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 the number of spurs.
- Lastly, you can receive Prolotherapy treatments to help stabilize the shoulder 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.
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 for 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 a 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.
If you have questions about your shoulder problems, you can get help and information from our Caring Medical Staff.
1 Takamura KM, Chen JB, Petrigliano FA. Nonarthroplasty Options for the Athlete or Active Individual with Shoulder Osteoarthritis. Clinics in Sports Medicine. 2018 Oct 1;37(4):517-26. [Google Scholar]