Bone Spurs in the Shoulder

What is a Bone Spur in the Shoulder?

Does your shoulder feel stiff or painful, especially after repetitive use? Chances are you might be dealing with shoulder bone spurs.

Bone spurs, medically known as osteophytes, are bony projections that develop along the edges of bones. These growths are often a result of the body trying to repair itself by adding extra bone in areas where there is joint damage.

Bone spurs are commonly seen in the spine and are often associated with age-related degenerative changes. However, bone spurs can also occur in the shoulder and are a cause of shoulder pain.

The Bone spurs in the shoulder can cause:

• Shoulder pain
• Restricted movement
• Rotator cuff tear
• Shoulder impingement

Proper medical treatment, and potentially surgery, can help you return to your daily activities with little restriction.

Let’s explore a bit more about how bone spur shoulder occurs and ways to effectively treat it below.

Causes

Bones can undergo small, not noticeable injuries from regular activity. Our bodies are always fixing these small injuries for stability. But, when this mechanism overcompensates, a spur forms in areas subjected to ongoing stress or injury. Commonly affected areas include:

• Shoulders
• Spine
• Hands
• Hips
• Knees
• Feet

So, what causes bone spurs in the shoulder?

The most common reasons for development of bone spurs in the shoulder joint include:

• Degenerative shoulder disease
• Rheumatoid arthritis
• Osteoarthritis
• High-stress shoulder movements
• Joint injury
• Obesity

These joint issues cause local inflammation and wear down the cartilage, which normally cushions the bones. Without enough cartilage, the bones start to rub against each other. To protect the joint, the body creates extra bone, making bone spurs more likely.

In addition, lifestyle and genetics play a significant role in the development of these growths.

Which Part of the Shoulder is Affected?

Bone spurs can form in any part of the shoulder, but they are commonly found in the areas that experience the most wear and tear. When bone spurs develop in the shoulder (glenohumeral) joint, they push out (displace) the humerus bone from its normal position. This can cause joint instability and increase the risk of shoulder dislocation.

These areas include the following:

Acromion

The acromion is the tip of the scapula (shoulder blade) that connects with the clavicle (collar bone). On the acromion, bone spurs typically form on the underside. This is where it interacts with the rotator cuff tendons.

Spurs here are fairly common, especially in older adults and those involved in activities that put stress on their shoulders.

Top of the Shoulder

Bone spurs on top of shoulder often form in the acromioclavicular (AC) joint, where the collarbone meets the shoulder blade.

This location is one of the most common sites for shoulder bone spurs, particularly in older adults and athletes. These are typically due to osteoarthritis and repetitive stress.

Shoulder Blade

Bone spurs on the shoulder blade (or scapula) usually develop along the edges, near the acromion and the glenoid cavity.

These spurs often occur due to osteoarthritis or chronic shoulder injuries. They are less common than spurs on the acromion. They typically occur in people with chronic joint conditions such as gout, bursitis, and arthritis.

Symptoms

One notable aspect of bone spurs is that they do not always show symptoms. You might not know if you have developed a bone spur sometimes until you undergo a medical check-up.

However, if these bony projections keep growing, you may experience the following symptoms.

• Shoulder pain
• Stiffness of joint
• Restricted movement while doing various activities
• Swelling and inflammation around the affected areas
• Muscle Weakness
• Numbness and Tingling

These symptoms can be further exacerbated in individuals with osteoarthritis and impingement syndrome. These co-conditions can lead to periods of intense pain and decreased range of motion. However, proper treatment can help manage these issues effectively.

Shoulder Impingement vs. Spurs

While shoulder impingement and bone spurs have similar symptoms like pain and limited range of motion, these are separate conditions; however, bone spurs are a common cause of shoulder impingement syndrome.

Bone spurs are the pathological overgrowth of bone fragments that can cause frequent pain and stiffness. You might also experience clicking or popping sensations due to the extra bone growth.

Impingement syndrome usually causes pain when lifting your arm, especially overhead, because the rotator cuff tendons get pinched. This can be caused by bone spurs, shoulder bursitis, rotator cuff tendonitis or other injuries, shoulder dislocation, and repetitive motions, among others.

Let’s briefly overview the severity of symptoms for both conditions in the table below.

Symptoms	Bone Spurs	Shoulder Impingement
Pain	Constant, worse with movement	Pain while lifting the arm, especially over the head, worse at night
Clicking/Grinding	Common, due to bony projections interfering with joint movement	Less Common
Inflammation	Tissue surrounding affected bone	Tendons and Bursa
Numbness and Tingling	Can occur if the spur presses on nerves	Rare
Range of motion	Limited, affecting various shoulder movements	Limited, particularly with overhead motions

Treatment for Shoulder Bone Spurs

If you are diagnosed with bone spurs, your shoulder surgeon will tailor the most suitable shoulder bone spur treatment based on:

• The severity of your symptoms
• Underlying causes such as osteoarthritis or rotator cuff injuries
• Location of the spurs
• Your response to previous treatments

In most cases, conservative approaches are appropriate. These can alleviate pain, restore normal shoulder movement, and prevent further joint damage. Some of these effective non-surgical techniques are as follows:

Non-Surgical Options

Physical Therapy: Your physical therapist can recommend a range of rehab exercises to strengthen your shoulder muscles. These exercises also help with mobility.

Over-the-counter medication: Over-the-counter ibuprofen, naproxen, or acetaminophen can help reduce pain and inflammation.

Corticosteroid Injection: These injections can provide significant relief from pain and discomfort. This is especially true in cases where oral medications are insufficient. These injections work by locally decreasing inflammation in the joint space.

Ice and Heat: Applying cold compresses can help relieve pain and swelling on the site of spurs. In contrast, heat therapy treats the joint stiffness. It also stimulates blood circulation to the affected area, helping your joints to heal.

Activity Modifications: Reducing shoulder activities and resting your shoulder not only helps pain but also allows time for inflammation to heal. Rest is very important and return to activity should be discussed with your doctor.

Weight management: Regular exercise and weight loss practices have also proved to treat bone spurs by helping to improve osteoarthritis. However, if the above treatment approaches fail to relieve symptoms, the only option left is surgical treatment.

Surgery

For severe cases of bone spurs, the most commonly recommended types of bone spur surgery are:

Arthroscopic Shoulder Surgery: This minimally invasive approach involves removing bone spurs and any damaged tissue through small incisions with use of a camera.

Open Surgery: In more severe cases, open surgery might be necessary to remove larger bone spurs and repair any significant damage to the shoulder structures.

Some other effective surgical techniques involve subacromial decompression (bone spur removal and fixing the injured tendon on the acromion bone) and arthroplasty (shoulder replacement). These procedures are typically considered after treatment failure by other approaches.

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