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What is Periostitis?

D. Jeffress
D. Jeffress

Periostitis is a medical condition that involves inflammation, tenderness, and swelling around one or more bones. Most bones in the body are lined with a layer of connective tissue called periosteum, which provides protection and secures muscle fibers to bone tissue. Periostitis occurs when a layer of periosteum is damaged due to an injury, severe infection, autoimmune disorder, or cancerous condition. Depending on the underlying cause, it can cause acute pain in an isolated area of the body or widespread, chronic aches.

The most common cause of periostitis is injury from direct trauma to a bone or overuse of a particular body part. Athletes and casual runners are at risk of developing periosteum inflammation in their lower legs, a condition called shin splints. The frequent pressure put on the shins from running, stopping, jumping, and turning gradually irritates the periosteum surrounding the bones, and in some cases, the connective tissue can tear. Improper running technique can exacerbate the problem, and shin splints can become debilitating.

Athletes are at risk for developing periostitis.
Athletes are at risk for developing periostitis.

Inflammation can also arise as a complication of a chronic infection, such as syphilis or an autoimmune disorder. In an inherited condition called primary hypertrophic osteoarthropathy, the immune system releases chemicals that cause inflammatory responses in periosteum at many different bone sites, including the collarbone, femur, and humerus. As a result, the connective tissue becomes inflamed and swollen. With the periosteum damaged, new bone forms underneath that causes painful protrusions and further irritates the connective tissue. Leukemia, a blood and bone marrow cancer, may also cause this problem in the late stages of the cancer.

A doctor will need to perform bone X rays to diagnose periostitis.
A doctor will need to perform bone X rays to diagnose periostitis.

A medical professional can diagnose periostitis and look for underlying causes by asking about symptoms, evaluating the physical appearance of affected body parts, and taking X-rays of bones. Blood tests may be performed if an autoimmune disorder or infection is suspected. If diagnostic tests are inconclusive, a sample of bone and periosteum tissue might be collected and analyzed to check for signs of cancer.

A diagram of the anatomy of a bone, showing the periosteum.
A diagram of the anatomy of a bone, showing the periosteum.

Healthcare professionals usually focus treatment efforts on eliminating the underlying cause of symptoms. In the case of shin splints or other injury-related forms, patients are usually instructed to get rest, ice their sore bones, and take anti-inflammatory medications. The shins usually start feeling better after several weeks of rest, and an individual can gradually increase his or her activity level to rebuild strength. Antibiotics, antivirals, or immunosuppressant drugs may be needed to treat other causes. Surgery to remove or repair damaged tissue may be necessary if the condition causes debilitating pain or bone fractures.

Discussion Comments

anon927555

Is periostitis known to be misdiagnosed as fibromyalgia?

I have been struggling with this insidious ailment for eight years and my gut feeling has always questioned the label. I have withdrawn from the medical merry-go-round, but now wonder if more can be achieved than rest and Panadol for my worst cycles.

anon291728

My periostitis is caused from trauma to my spine, pelvis hips and hands. It drives me up the wall. I take lots of pain meds and anti inflammation meds but it only still just takes the edge off. I've become disabled because of it and use a wheelchair. I wish there was more my docs would do for me but they seem unwilling to go any further than medication as my treatment. I've had it for seven years now and I see no hope of it ever getting better. Can anyone give me hope with your stories?

sunshined

@John57 - I wish that my periostitis was just a matter of resting and giving it some time to heal.

Mine is caused my rheumatoid arthritis, which is an auto immune disease. The pain and tenderness can really limit many normal daily activities that a lot of people do easily without thinking.

My periostitis treatment consists of taking medications to help with the pain and swelling. Since my doctor knows the cause of this, he knows what to prescribe to help with the symptoms.

John57

The worst case of shin splints periostitis I ever had was when I was running in track in high school.

I think the best way to avoid getting shin splints is to gradually work your way up to a certain level. Like most people who suffer from this, I tried to do too much too fast.

What surprised me is how long it took for these shin splints to completely heal. It sure didn't take very long for this inflammation to happen, but I had to sit out for several weeks until they were completely healed.

I did learn my lesson though, and now when I tackle a new exercise program that involves the bones in my legs, I approach it much more cautiously.

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    • Athletes are at risk for developing periostitis.
      By: Shariff Che'Lah
      Athletes are at risk for developing periostitis.
    • A doctor will need to perform bone X rays to diagnose periostitis.
      By: Petrik
      A doctor will need to perform bone X rays to diagnose periostitis.
    • A diagram of the anatomy of a bone, showing the periosteum.
      By: Alila
      A diagram of the anatomy of a bone, showing the periosteum.
    • Shin splints, or periostitis of the lower legs, is a common ailment in athletes and runners.
      By: andreaxt
      Shin splints, or periostitis of the lower legs, is a common ailment in athletes and runners.
    • Shin splints occur as a result of not providing the feet and legs with proper support during exercise.
      By: michaeljung
      Shin splints occur as a result of not providing the feet and legs with proper support during exercise.