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Periostitis of the tibia
Last reviewed: 05.07.2025
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Periostitis of the leg can be acute, subacute or protracted over a long period of time. In addition, the following forms of pathology should be distinguished, the division of which is based on the causal factor, structural changes and clinical manifestations of the disease.
So, they are divided into simple, purulent, fibrous, and serous, based on the form of the inflammatory reaction. In addition, they distinguish ossifying, tuberculous, and syphilitic periostitis.
Periostitis is an inflammatory reaction of the periosteum to the impact of a damaging factor. The pathological process can affect many bones, but now we will talk about periostitis of the leg. The onset of the disease is noted in one of the layers of the periosteum (internal or external) with subsequent spread to other layers. In addition to the periosteum, due to the close location of the bone, the latter is also involved in the inflammatory process.
[ Causes of periostitis of the leg
Based on the clinical forms of periostitis manifestation, several leading causes can be identified that provoke the occurrence of inflammation in the periosteum. Most often, the disease is observed in professional athletes and people exposed to significant physical exertion.
As for athletes, it is important to choose the right sports shoes and strictly monitor the loads. It is unacceptable to sharply increase the load and change the track surface. The causes of shin periostitis in this case will be the unprofessional approach of the trainer to the athlete's training.
Inflammation in the periosteum can be provoked by various bruises, injuries, a rapid increase in the load on an unprepared body, starting classes with excessive physical exertion without a preliminary warm-up or other preparation.
In addition, the causes of periostitis of the lower leg may include weak muscles, exhausting physical activity, prolonged emphasis on the forefoot, and prolonged running uphill on an inclined surface.
One should also not forget about such a disease as tuberculosis, which can affect not only the lungs, but also other organs. The tuberculosis pathogen is carried by the bloodstream from the nearest pathological focus throughout the body and can affect the periosteum, causing the development of an inflammatory process.
The cause of periostitis may be tertiary syphilis, in which the diaphysis of the tibia is affected. As a result, a significant, sometimes symmetrical thickening of the bone structure is observed.
Symptoms of periostitis of the leg
Depending on the cause of the inflammatory reaction from the periosteum, as well as structural changes, it is necessary to distinguish the clinical manifestations of each individual form. Thus, a simple form of inflammation most often develops as a result of exposure to a traumatic factor, as a result of which aseptic inflammation is observed, that is, without an infectious agent.
Symptomatically, it is customary to distinguish pain syndrome and tissue swelling over the affected area of the periosteum. Most often, this type of inflammation is recorded in the tibia. In most cases, periostitis heals on its own and does not leave any consequences, but osteophytes may form.
The fibrous type of inflammatory process in the periosteum is characterized by a chronic course, the cause of which is constant irritation of the periosteum. A similar condition is observed in ulcerative lesions of the shin, necrosis of bone structures and in the presence of chronic arthritis. The forming fibrous tissue can provoke the destruction of bones. Regression of the pathological process is noted if the negative provoking factor is eliminated.
Purulent inflammation of the periosteum develops as a result of infection of the periosteum due to a penetrating wound or by the spread of pathogenic microorganisms from nearby tissues. Symptoms of periostitis of the leg with purulent inflammation are expressed by an acute onset, hyperthermia up to 39 degrees and accompanying chills.
Serous inflammation is characterized by the formation of exudate, the accumulation of which is noted under the periosteum. The exudate has a lot of protein (albumin). The amount of accumulated fluid can reach 2 liters, which contributes to the detachment of the periosteum from the bone with subsequent necrosis of the latter. Symptoms include pain and swelling of the tissues surrounding the pathological focus. The temperature may increase slightly and normalize on its own.
Ossifying chronic inflammation of the periosteum is observed as a result of the action of an irritating factor. Bone tissue growths appear in the area of inflammation. Pathological bone formation stops as soon as the pathological effect of the provoking factor is eliminated. In the case of a rapid progression of the disease, the periosteum may detach with the appearance of purulent exudate. In some cases, the accumulation of a large volume of pus can lead to a rupture of the periosteum, after which the process of bone formation begins, which contributes to the progression of the pathological process.
Periostitis of tuberculous etiology most often develops as a result of the spread of the infectious process from a nearby pathological focus. As for tertiary syphilis, here periostitis is most often localized on the diaphyses of the tibia. As a result of thickening of the bones, sometimes even a symmetrical process, bone "growths" are visualized on the radiograph. Symptoms of periostitis of the shin with syphilitic lesions are as follows: pain syndrome is characterized by an increase in intensity at night, swelling of soft tissues on palpation is densely elastic, and can be round or spindle-shaped in shape. The skin is not subject to significant changes. Gumma in rare cases undergoes destruction with a breakthrough and subsequent ulcerative defect.
Where does it hurt?
Diagnosis of periostitis of the leg
When a patient contacts a doctor, a detailed survey of complaints that currently bother him is first conducted. In addition, it is necessary to find out when and under what circumstances the symptoms first appeared. A detailed survey will help in finding the causes of the development of the pathology, as well as in making a preliminary diagnosis.
Based on clinical symptoms and objective examination, some leading syndromes can be identified, which also facilitates rapid diagnosis. Then, instrumental and laboratory studies must be performed.
For example, in the presence of purulent exudate, in addition to the acute onset of the disease and high temperature, an increased number of leukocytes is detected in the blood. In addition, as pus accumulates under the periosteum, fluctuation is noted above the affected area.
Diagnosis of periostitis of the shin also includes radiography of the pathological focus to determine the area and nature of the disease. In case of tuberculous lesions, the lungs, lymph nodes and nearby organs should be additionally examined. A low level of leukocytes may be noted in the blood.
Syphilitic periostitis most often affects the diaphysis of the tibia, causing the bone to thicken significantly. Sometimes this process can be symmetrical. Clinically, syphilitic lesions are manifested by pain, which is characterized by an increase in intensity at night. The swelling is dense and elastic to the touch, rounded or spindle-shaped. In rare cases, gumma disintegrates with a subsequent breakthrough and the formation of an ulcerative defect.
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Treatment of periostitis of the leg
If you experience pain in the shin area, it is not recommended to continue training, even if you reduce its intensity after a short break. Exclusion of physical activity is not the only therapeutic method for periostitis.
Treatment of shin periostitis involves the use of a special set of exercises aimed at strengthening the muscles. Thanks to it, there is no muscle overload and progression of periostitis. Exercises such as transferring body weight to the toes and walking on the toes can be performed even with pain. If there is no pain syndrome, then shin wraps and thigh lifts should be added to the set of physical exercises. You can do a small amount of running on straight legs. It is necessary to perform all exercises with soft foot movements.
With intense physical activity, a persistent inflammatory process develops. It manifests itself in painful sensations that can become more intense or disappear on their own, which does not mean a decrease in inflammation. In addition, some athletes, when the pain syndrome decreases, return to their previous training loads. Thus, repeated damage can be superimposed on the injured periosteum, which aggravates the recovery process.
Treatment of periostitis of the lower leg takes quite a long period of time, and therefore returning to heavy physical activity can lead to an exacerbation of the disease and a delay in the moment of recovery.
In the case where the inflammatory process is not expressed, the patient adheres to the prescribed regimen and uses ointments with a warming effect, then it is soon possible to achieve regression of periostitis and resume training, but first reviewing the load.
Running with periostitis should not be done at a fast pace (at a speed of no more than 1 kilometer in 7 minutes). In addition, it is necessary to take into account that the running surface should not be hard. For this purpose, it is good to use terrain with sand, grass or loose soil, and then move on to compacted soil and an even harder surface. Returning to previous physical activity after recovery should be done smoothly, necessarily starting with a warm-up and slowly increasing the intensity.
Treatment of periostitis of the shin in a more severe form cannot be limited to just reducing physical activity and warming ointments. In such a case, a traumatologist's conclusion on the stage of the disease and further therapy using physiotherapy and other procedures is necessary.
Treatment of periostitis of the leg with folk remedies
Traditional medicine can be used as monotherapy or in addition to the main treatment areas of traditional medicinal approaches.
The natural herbs used provide an anti-inflammatory effect, reducing hyperemia, swelling and pain. In addition, they help bone structures to regenerate faster and restore their previous shape.
Treatment of periostitis of the shin with folk remedies can be carried out with comfrey. It has a huge set of biologically active substances that help treat not only periostitis, but also many other pathologies of bones and joints.
Thus, comfrey contains allantoin, alkaloids, lipospermic acid and other phenolic carboxylic acids, phytosterols and pyrocatechol tannins. Comfrey decoction is taken internally for anti-inflammatory purposes in respiratory pathology, and externally - for fractures, dislocations and other diseases of bones and joints.
To prepare the ointment, melt 0.1 kg of butter (cream) in a water bath and add the root (also 100 g), crushed almost into powder. After mixing, heat in a water bath and leave for half an hour. After cooling, lubricate the pathological focus, and the ointment itself can be stored in the refrigerator.
At the end of the acute phase, treatment of periostitis of the shin with folk remedies can be carried out with Adam's root. To prepare a tincture for rubbing, grind 200 g of the root with a grater and pour half a liter of vodka. The root should be infused for 5 days in a dark place. As soon as the tincture is ready, it is necessary to rub the affected area with it at night and cover with a warm scarf.
If warming up is performed during an active inflammatory process, the risk of further activation of the process and its spread to surrounding healthy tissues increases.
Prevention of periostitis of the leg
In order to avoid or reduce the risk of developing periostitis, it is necessary to follow some recommendations. This is especially true for athletes who have a busy training schedule, which is why they have the highest probability of developing pathology. However, periostitis can also occur in other people.
Thus, physical activity should be carefully selected, given that impact training while running on a hard surface can provoke the occurrence of a focus of inflammation in the periosteum.
Prevention of shin periostitis has another effective method. It consists of gradually strengthening the shin muscles by performing a specially selected course of physical exercises, the main ones of which are jumping and running.
Particular attention should be paid to the selection of footwear for training. It should be of the appropriate size so as not to cause discomfort during physical exercise. In addition, the footwear should be soft to avoid microtraumatization of bone structures. Professional athletes are advised to strictly follow the training schedule, as it is selected individually, taking into account the characteristics and capabilities of the body.
Periostitis of the leg prognosis
The prognosis for further development or regression of the pathological process depends on the correctness of the person's compliance with the recommendations. The more carefully he or she follows the recommended training and exercise regimen, the faster the recovery will be.
Depending on the severity of the disease, the course of periostitis of the leg can be of different nature. In most cases, the disease ends with recovery, provided that the treatment regimen is followed. However, there are cases when the pathology becomes chronic with frequent exacerbations.
The recurrent course is caused by an incompletely cured pathological process. As a result, clinical symptoms occur again and again. The process of restoring the normal bone structure takes a long period of time, since the regeneration process is not characterized by a fast speed.
The prognosis for shin periostitis largely depends on the athlete's and trainer's approach to treatment. Correctly selected physical exercises can strengthen the shin muscles and prevent the progression of the inflammatory process in the periosteum. It is better to give up intense exercise for several months than to suffer from constant relapses of chronic shin periostitis in the future.
Periostitis of the shin is a common pathology, but it is not always diagnosed in a timely manner, which entails progression and deterioration of the condition. To avoid this, it is recommended to exercise in a measured manner, gradually strengthening the muscles, and also to choose special shoes for training.