Inflammation of the skin around the bones (periostitis): treatment and duration

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Periostitis (periostitis) affects the skin surrounding a bone (periosteum). Inflammation can occur as a result of infection or from overuse. Periostitis mostly affects bones that are close to the skin, such as the shinbone (tibia) or the collarbone (clavicle), but periostitis can also occur on the elbow, head, wrist or foot or heel. Since the periosteum is traversed by many nerves, periosteum inflammation is usually accompanied by severe pain. Sporty people who jog or run a lot are often affected.

At a glance:

Causes of periosteum inflammation

There are various causes that can lead to periosteum inflammation. A distinction is made between inflammatory causes and those caused by external influences.

One of the most common external triggers is overexertion during sports, especially running, dancing, soccer, hiking or cross-country skiing. However, other sports can also lead to periosteum inflammation. The periosteum of the tibia is usually affected (shin splints). Causes in sports can then be:

Pathogens such as viruses and bacteria can also cause periosteum inflammation. Periostitis often occurs together with bone marrow inflammation (osteomyelitis). The pathogens can get into the body from outside through injuries or operations, or they can get to the periosteum as part of another infection. Typical infections that can lead to inflammation of the periosteum due to the transfer of pathogens are:

Symptoms of periosteum inflammation

Periostitis is usually very painful, especially with pressure and strain. The reason is the strong supply of nerves and blood vessels to the periosteum. Typically, the mostly stabbing and/or dull pain subsides with rest, but there are also people who feel pain at rest. The frequent inflammation of the periosteum on the shin (shin splints) causes very severe shin pain. In addition, the typical signs of inflammation usually appear:

In addition, abnormal sensations such as tingling, numbness and pulling in the affected and adjacent areas can occur. Sometimes there is also a fever and a general feeling of illness due to the infection.

Diagnosis: when to seek medical advice?

In the case of typical, recurring pain, for example in the shinbone, medical advice should be sought as soon as possible. The doctor can usually make the diagnosis based on the symptoms and a physical examination. X-rays or an MRI can be used to rule out other diseases, such as stress fractures or compartment syndrome. In the case of shin splints, a running analysis makes sense in order to identify the cause, such as technical errors or misalignments, and to be able to include it in the treatment.

Therapy for periosteum inflammation

In the case of periosteum inflammation, conservative measures are particularly suitable for treatment in order to relieve symptoms and inflammation. Physical protection is very important - it is important to take an absolute break from training. In addition, cooling and anti-inflammatory drugs can be used.

After the acute stage, physiotherapy is important for functional and coordinative training. The training must be individually adapted. In addition, there is an optimal supply of shoes and insoles. Those affected can stretch the calf muscles several times a day in the event of acute periosteum inflammation of the shinbone.

In extremely rare cases, if the periosteum persists, the focus of inflammation must be surgically removed.

Duration and course of periostitis

Periosteal inflammation can be very persistent and last from a few weeks to several months. If training is resumed too early, pain can return even after a symptom-free phase. Therefore, you should only start training again when the inflammation has completely subsided. Otherwise there is a risk of chronic periosteum inflammation.

At the beginning, the training should then be resumed very slowly and only gradually increased. Temporarily, gentle sports such as swimming can be used for training.

Prevent inflammation of the periosteum

People who like to run should have good, suitable shoes and ideally have done a running analysis. Anyone who runs more than 32 kilometers per week increases the risk of periosteum inflammation on the shin. The training intensity should be adjusted and only increased slowly. Above all, changing the floor covering should be carried out slowly. Soft floors are gentler on all tissue structures.

In order to prevent renewed periosteum inflammation, all causative factors should be eliminated.