Periostitis: Causes, Symptoms, Treatment, Rehab, Prognosis

One of the medical conditions mostly seen among runners, soccer, football players, race walkers etc. is Periostitis. Overusing the muscles actually causes Periostitis. Periostitis is a medical condition where there is an inflammation of the periosteum. One can encounter periostitis with an excessive bout of exercise. If you are looking for the symptoms, treatments and diets for periostitis then this would be a beneficial read for you. In this article we will talk all about Periostitis.

Periostitis is an inflammation of the periosteum which is the dense connective tissue protecting and securing muscle fibers to the bone tissue. In such a condition, the patient meets with an inflammation, tenderness and swelling around one or more bones. Usually periostitis occurs when there is an injury, severe infection, cancerous condition or any autoimmune disorder that damages a layer of periosteum.

There are various causes for Periostitis and depending on the underlying causes there can be acute periostitis or chronic periostitis. In case of acute periostitis there is an acute pain in an isolated area of the body and in case of chronic periostitis there are chronic aches.

Though periostitis can occur in people after heavy workout of exercises; it is mostly seen in athletes who are in to running, or football, soccer players etc.

There are various forms of periostitis which can be classified as below.

1. Simple Periostitis: This is the type of periostitis which develops with bruises and broken bones and the presence of the inflammation is focused near the periosteneum. Pain and swelling can be the initial symptoms here.
2. Simple Fibrous Periostitis: Simple fibrous periostitis is characterized by thickening of the horny periostenum due to prolonged irritant.
3. Suppurative Periostitis: This is the type of periostitis which grows when there is a penetration of infection from neighbouring purulent focus of injury or peristoneum. Fever, extreme swelling, pain etc are some common symptoms of suppuratuve periostitis.
4. Albuminozny Periostitis: Sometimes the chronically affluent abscess in periostitis can cause congestion at the periosteum of sero mucous fluid and is known as Albuminozny periostitis.
5. Periostitis Ossificans: In chronic stimulation of the periostenum, there occurs an excessive outgrowth of the bone and known as Periostitis ossificans.

Person suffering from Periostitis can experience the following symptoms:

• The individual suffering from Periostitis can experience symptoms of pain; especially the pain is at the front part of the shin bone or the tibia.
• In rare cases there may be symptoms of pain over the outer portion of the shin bone.
• There may also be swelling in periostitis.
• Tenderness of the bone may be one symptom in periostitis.
• Stiffness may be one more symptoms of periostitis.
• It is usually noticed that the pain and the stiffness increases when the patient comes out of the bed in the morning and also while standing up from a sitting position after a long time.
• Though prolonged exercise can worsen the symptoms in Periostitis, the symptoms of pain tend to fade with a moderate range of physical activity.

There may be various causes for the occurrence of periostitis. Here below we will list down some of the common causes of periostitis:

• Overuse of the periosteum in the lower leg region, especially in athletes and runners causes periostitis. Overuse of periosteum may also be due to excessive workouts/ exercise or any other physical activity.
• Any external trauma to the shin bone can also cause periostitis.
• Improper running techniques worsen the conditions in Periostitis.
• Leukemia is also known to be a reason leading to Periostitis.
• Complication in some chronic disorder like syphilis can cause perostitis.

There are various ways to diagnose the condition of Periostitis. Here in this section we will list down some of the procedures done to diagnose periostitis.

Usually general physical examination done by the physician like checking tenderness and swelling along the shin bone may be the first phase of diagnosis for periostitis. Your doctor may also ask you your medical history that helps in the diagnosis. Apart from this, following are some diagnostic and imaging tests used for detecting the condition of Periostitis.

• X-Ray: This is one procedure which aids in eliminating the possibility of a stress fracture in the shin bone. However, an x-ray would not be very useful in detecting any damage or irritation caused in the periostenum.
• Magnetic Resonance Imaging: MRI tests may sometime help in displaying a stress fracture caused by an untreated periostitis injury. It also shows a localized edema where the muscles are being attached to the bones. Mainly MRI tests help in ruling out stress fractures.
• Bone Scan: This is highly beneficial for confirming the diagnosis of periostitis. In such a scan, low level of radioactive tracer is tagged to blood and is injected in to the affected area. In case of inflammation, the scan shows high blood flow and enhanced activity level in the shin bone region.

Usually treatment for periostitis includes two phases namely a healing phase and a rehabilitation phase. In the healing phase, the treatment for periostitis aims at settling down the symptoms while in a rehabilitation phase the treatments aims in building the area back up and minimize the risk of further recurrence.

• Rest: It is essential to have relative rest and stop all precipitating activities. People with periostitis must limit the activities like walking, running or jumping. However, swimming and other non weight bearing activities can be included during this phase.
• Stretching: Gentle stretching of the muscles at the front of the lower leg is essential for recovering from the symptoms of periostitis. Gentle stretching for one minute at a time and doing the same 4-5 times at once and two times in a day can be highly beneficial in treating the symptoms of periostitis. Added to this, calf stretching would be beneficial.
• Icing: Cold treatment works great in healing periostitis. Applying ice to the shin in 10-15 minutes of interval can help reduce the symptoms and can reduce the inflammation in periostitis.
• Deep Tissue Massage: This is a crucial technique for reducing the symptoms and treating periostitis. You must go for the massage from a qualified physical or massage therapist for reducing the pain and preventing the recurrence.
• Anti-inflammatory Medications: NSAIDS or the Anti- Inflammatory medications are essential to treat periostitis. A short course of the medications can be beneficial. Ibuprofen can help you reduce the pain in periostitis. It is essential to consult with a doctor and take the medications as per his or her prescription.
• Leg Elevation: It is known that elevation of your legs above your heart aids you in reducing the blood flow to the legs and aids in reducing the inflammatory process. This can assist you in reducing the pain and healing time in periostitis.

Once the symptoms of periostitis have settled down in healing phase; the patients are brought in to a phase that is designed in a way to gradually return them to their desired level of activity in daily life. Below are some of the ways of treating Periostitis in rehabilitation phase.

1. Heat Treatments: Applying heat to the shin bone, especially before workouts can help greatly.
2. Continued Stretching: Stretching the lower leg muscles is highly essential and it must be continued so as to control the symptoms associated with the periostitis condition.
3. Taping: Taping the shins is known to provide some benefits in periostitis in some patients. So, you can try this out.
4. Shock Absorbing Shoes or Shoe Inserts: You must go for the shock absorbing shoes or wear shoe inserts so that you can reduce the repetitive load on the shin that usually is experienced with running, walking, jumping or exercising.
5. Medical Arch Supports: Medical arch supports are usually beneficial for people with flat feet. Using them would help you reduce pain as you get enough support at the arch in your feet.
6. Calf Support Stockings: A calf support stocking helps in providing gentle compression to the muscles of the lower leg and also may help to dampen the forces that muscles exert to the bone. Apart from this, calf support stockings also help in retaining heat in the area. So, you can try this device in case you are suffering from periostitis.
7. Gradual Return to Activity: It is essential for you that you must gradually increase your activity and return to your normal activity level so as to prevent the risk of recurrence of periostitis.

It is noted that in most cases of patients suffering from Periostitis the outcome is pretty good with proper and effective treatments. However it is not recommended to return back to their usual level of activities immediately after treatment of periostitis. It is essential for you to be recommended by your doctor to go for your normal activities before you continue doing so. Moreover it is also essential for you that once you have been completely treated and advised by your doctor to proceed on with your normal activities, you must gradually increase the activity level so as to prevent any recurrence.

• Diet and supplements are highly essential for healing any condition.
• Fruits and vegetables that are rich in antioxidants can be beneficial for people with periostitis and shin splits.
• It is essential to take vitamin E, omega- 3 fatty acids and selenium in diet that aids in defending the body against inflammation.
• Whole grain breads, cereals, rices, nuts and seafoods like salmon would make a great periostitis diet.
• Supplements like Chondroitin and Glucosamine may be beneficial in reducing inflammation and pain in periostitis.

Usually it takes about 2 weeks to one month for completely heal out from periostitis.

Yes! Periostitis can also occur in infants. One month to six month old babies may show physiological periostitis. Congenital syphilis infection may be a reason for such a disorder in the infants.

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