Try ankle bone spur therapy before surgery

Q: My ankle has been chronically sore, so I had it X-rayed. It showed a bone spur. My doctor wants me to do physical therapy before deciding on surgery. Is PT really going to help, or should I just go ahead and have the operation? — Jerry H., Roanoke, Va.

A: As a general rule, always try physical therapy first. Bone spurs in the ankle (or anywhere) occur when the cartilage between bones breaks down and the bones generate lumpy outgrowths to try to make up for the lost cartilage. The cause of the cartilage loss is usually osteoarthritis, but bone spurs also can be caused by an accident or injury. In those cases, spurs may form because you injured a tendon or ligament and that caused local inflammation of the bone.

When you do PT, the goal will be to strengthen the muscles around the spur, which will then relieve some of the bone-on-bone/ tissue pressure and lessen your discomfort. If that solves your problem, you might avoid surgery — at least for a while. But if you do end up having the surgery, your joint will heal faster, because it will be stronger after PT.

Your PT probably will include heat, stretching and strengthening exercises, ultrasound, massage and ice. You also might ask your doc about taking an anti-inflammatory over-the-counter medication to reduce pain and possibly even a cortisone injection. Ultimately, you and your doc will decide on next steps based on how large the spur is and how much pain you're experiencing. But the good news is that if your bone spur isn't too severe, your chance of being able to manage the discomfort without surgery is pretty good.