Inflammation of the skin around the bones (periostitis)

Inflammation of the skin around the bones

Athletes are primarily affected by periosteum inflammation. It occurs particularly frequently on the shins of joggers and athletes. In addition, the inflammation can also make itself felt on the elbows, wrists, knees or heels. The cause of the periosteum is usually an overload, but a bacterial infection is also possible. Typical symptoms are pain and swelling of the affected areas. Physical protection is critical in the case of periosteum inflammation, which can be traced back to overexertion. A bacterial infection is treated with antibiotics

Causes of periosteum inflammation

The periosteum is a layer of connective tissue covering almost the entire bone surface. In periostitis, this covering is inflamed. Since the periosteum contains blood, lymphatic vessels, and many nerves, such an inflammation is usually relatively painful. 

There can be various causes behind periosteum inflammation. It is particularly often caused by overexertion,  for example, during sports. Possible triggers include:

  • too intense or extensive training
  • Changing the training conditions, for example, changing the floor covering
  • change in technology
  • wrong shoes or unsuitable insoles
  • foot deformities


Periosteum inflammation caused by pathogens

In addition to overloading, periosteum inflammation can also be caused by pathogens such as viruses or bacteria. The symptoms often occur in the context of bone or bone marrow inflammation.

 The pathogens can enter the body through an injury or an operation . On the other hand; it is also possible that the pathogens from other sources of disease in the body reach the periosteum via the bloodstream. This can be the case with syphilis, tuberculosis and typhoid, among others.

Typical symptoms of periosteum inflammation

Whether on the shin, elbow or heel, periosteum inflammation is always accompanied by pain. These are particularly noticeable during movement or pressure. However, sometimes, they can also occur at rest.

However, it is typical that the pain subsides when you are resting but flares up again the next time you exercise. Sometimes, the painful area is red or feels warm.

In addition to pain, swelling of the affected area is one of the symptoms that can occur with periosteum inflammation. In addition, there is often a restriction on freedom of movement.


Treat periosteum inflammation

The treatment of periosteum inflammation depends on the underlying cause. If a bacterial infection is behind the symptoms, it is usually treated with antibiotics. When you are overloaded, it is essential to get enough rest. The pain can also be relieved by cooling and anti-inflammatory medication. In rare cases, surgical removal of the source of inflammation may be necessary.

Inflammation of the periosteum can be extremely lengthy; it sometimes takes several months for the pain to disappear completely. Even after a long period without symptoms, pain can suddenly appear again. This is particularly the case if exercise training is started too early.

Generally, it is advisable only to increase your training slowly after the inflammation has subsided: only train for a short time or too often at the beginning. If pain occurs, you should stop training. Switching to other sports, for example, swimming instead of jogging. If you continue to train despite an inflammation of the periosteum, the inflammation can become chronic in the worst case.

When to see a doctor?

In the case of intense or constantly recurring symptoms, you should consult a doctor early. This can rule out another cause and determine the exact trigger of the periosteum inflammation. Imaging methods such as an X-ray examination, magnetic resonance imaging or bone scintigraphy are usually used to make the diagnosis.

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