Bone spurs are the result of extra bone that has grown out of an existing bone, usually causing a lump or bony hook. Bone spurs form when new bone growth occurs at the site of ongoing inflammation or injury. The cells that make up the bone are trying to heal this injury or inflammation by producing extra bone. Bone spurs can be located anywhere on the bone but are most common near a joint or an area where the bone is subjected to constant pressure, such as shoes rubbing up against the tops of the feet.
The most common cause of bone spurs on the top of the foot is the pressure and irritation from shoes. With every step, the shoe rubs the top of the foot. Ill-fitting or tight shoes can cause micro-injuries to the top of the feet just by walking or standing. The micro-injuries are exacerbated by aggressive activities such as running or playing sports. While a micro-injury may not hurt or even be noticed if it happens once or twice, the constant rubbing and pressing on the top of the foot can cause a bone spur to grow.
Bone spurs by themselves are not dangerous or painful; in fact, many people never realize they have a bone spur. The pain and irritation of a bone spur arises from it pressing on nerves and tendons. This is especially true for bone spurs on the top of the foot, where footwear applies pressure to the spur, and also when they occur on the heel, which can often trigger the onset of plantar fasciitis, or the heel spurs can be a response to a plantar fascia injury.
Symptoms of a bone spur include pain, inflammation, and the presence of extra bone growth which can sometimes be felt on physical examination. Whilst most bone spurs can only be detected by x-rays, when they occur on the top of the foot they can often be felt or even seen with the naked eye. The skin on the top of the foot is very thin and there is not a lot of muscle covering the bones of the top of the foot. In addition to pressing on an internal nerve or tendon, a bone spur on the top of the foot can also cause pain on the external surface of the foot when the bone spur rubs the skin against a shoe.
Treatment for a bone spur on the top of the foot should include taking measures to reduce the pressure of the bone spur on the surrounding areas. Shoes should not be too tight, and can be worn with the laces loosened, shoes can be purchased in a larger size, or shoe stretchers can help to make footwear a little roomier. Using padding to level the surface touching the foot can relieve the pain. Place padding in the top of the shoe with a hole cut out for the bone spur, like a donut or just apply directly on top of the spur for extra cushioning.
To treat the inflammation and pain stemming from a bone spur, apply ice to the area around the bone spur up to five times per day. Ice should not be applied for longer than twenty minutes at a time and should be removed immediately if the ice causes pain or numbness. Anti-inflammatory medications such as ibuprofen (Advil) or naproxen (Aleve) are also used to treat the pain and inflammation associated with bone spurs.
If conservative treatments fail to produce the desired results, surgical removal of bone spurs may be an option.
orthoinfo.aaos.org, merckmanuals.com, emedicine.medscape.com
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