The inflammatory process in the periosteum of the lower leg (periostitis) may begin to develop due to trauma or a regular strong load on the lower extremities. The first signs of pathology are tissue edema and severe pain. Do not get rid of only the symptoms, because the development of inflammation will continue. It is necessary to initially determine the type of disease and begin treatment as soon as possible.
Inflammation in the periosteum of the lower leg can be acute or chronic. If you look at the problem from an anatomical point of view, then the periosteum is connected directly with the bone. In this regard, inflammation that develops in the tissues can easily go to the bone. If treatment is not started on time, then not only the outer layers of the bone will be affected, but also the deeper ones. According to ICD-10, the periostitis code is M90.1.
Causes of the inflammatory process
Periostitis of the leg is very often diagnosed in those people who are engaged in athletics or martial arts on a professional level. In this case, the following reasons will influence the development of pathology:
- running in an area where there are many steep inclines and very sharp climbs;
- during exercise too much load;
- there was a violation of the integrity of the tendons or bones of the leg, there were severe bruises of the leg;
- inflammation is allergic or rheumatic;
- Due to constant contact with chemicals, a significant accumulation of toxins has occurred (this could also have happened as a result of some other diseases).
In medical practice, very often there are cases when the pathology arises due to a weak muscle system. Also, periostitis of the lower leg can develop as a complication of tuberculosis.
Types of pathology and its clinical picture
Not always the inflammatory process in the periosteum of the lower leg will proceed equally. In each individual case, there may be a different course. In this regard, specialists identify several main types of periostitis (code according to ICD-10 - M90.1).
Simple type
It occurs as a result of a bruise, myositis or fracture. Swelling appears in the periosteum of the leg, in the soft tissues of the joint or near the bones of the ankle. There are light aching painful sensations. Discomfort occurs due to overflow of tissues with blood and when pressing on the affected area. The chronic form of simple periostitis occurs only in isolated cases.
Fibrous inflammatory process
The disease begins to develop due to too long compression of the connective tissue. In most cases, it occurs against the background of such pathologies as arthritis, trophic ulcer. Fibrous inflammation of the periosteum of the lower leg develops very slowly, then gradually develops into a chronic form. If you press on the lower leg, then there will be no pain. Visually observed compaction and hyperemia of the skin. Treatment should begin with the elimination of the underlying disease.
Albuminous type
In the presence of periostitis of this type, exudate begins to accumulate in the connective tissue. A bone-like sac is almost always formed. It occurs most often as a result of an injury to the bone apparatus of the lower leg. Pathology can occur in a subacute or chronic form.
The main signs of albuminous periostitis include:
- pain in the lower leg when pressing on the affected area;
- at the initial stage of the development of the disease, body temperature rises;
- mobility is limited several times;
- hyperemia of the skin is manifested;
- at the first stage, edema and a noticeable compaction appear.
If albuminous periostitis is detected at an early stage of development, then only suction of exudate can be dispensed with. If you start the disease, then the only treatment option is surgery.
Purulent type
This form of pathology develops as a result of re-infection of the periosteum after the bone apparatus was injured. Another reason may be the appearance of a purulent process in the tissues that are nearby. These can be diseases such as phlegmon, osteomyelitis, abscess.
Inflammation of the periosteum of the leg of a purulent type always has an acute onset. Initially, exudate begins to accumulate in the tissues, which at a high speed turns into pus. Body temperature begins to increase rapidly, there is a severe headache, chills, body aches. The affected area swells, but when pressed, the pain does not appear.
If a diagnosis was made as purulent periostitis of the lower leg, then there may be two options for the development of pathology:
- A purulent sac breaks in, and its contents pour out inward, which leads to the development of an inflammatory process in soft tissues.
- The content goes out and at the same time tears the skin.
The purulent form of periostitis of the lower leg is considered the most severe and dangerous. As a complication, necrosis or even bone decay and oncology can occur.
Ossifying Type
This form of the disease occurs most often and involves the development of inflammation in the connective tissue of the lower leg due to irritation of the periosteal tissue. The inflammatory process may be:
- primary type;
- secondary type, which develops due to the presence of a chronic form of osteomyelitis, rickets, arthritis (tuberculosis, malignant bone formation or syphilis acts as a provoking fact).
The features of the ossifying type are the appearance of osteophytes, as well as bone-like swelling.
Diagnosis of the disease
Almost all forms of periostitis do not have clearly expressed symptoms, so it will not work to make a correct diagnosis, based only on external examination. To determine the provoking factors, palpation and a thorough history taking will be needed. Diagnostic methods are also used, such as:
- radiography;
- laboratory type studies.
Be sure to study a sample that contains an abscess.
Periostitis treatment
After the diagnosis is finally confirmed, the doctor will advise you to forget about training for a while and minimize physical activity on the ankle. At the same time, a complete lack of load will not positively affect the condition of the affected area. Exercises for the treatment of the periosteum of the lower leg are selected solely taking into account the clinical picture of the disease. The patient should regularly perform special exercises that help to rehabilitate and strengthen the muscle apparatus, but do not overload it.
An interesting fact is that pain in the lower leg can increase or disappear. But you need to remember that the disappearance of pain is not a sign of recovery. Even if the periosteum of the lower leg does not hurt, it is necessary to follow the recommendations of a specialist, otherwise the inflammation can quickly become chronic. Therefore, it is very important to seek help in a hospital on time and follow the doctor’s instructions.
Treatment of the initial stage of periostitis of the lower leg is carried out on an outpatient basis. But if complications begin to appear, then an urgent hospitalization of the patient is a prerequisite. In some cases, you can’t even do without surgical intervention. Regardless of the stage and form of the disease present, the patient must take the prescribed medications. They will help eliminate the inflammatory process and neutralize the allergic reaction. Also, the doctor prescribes the course of taking vitamin complexes and calcium directly.
If the periosteum of the lower leg hurts when walking, physiotherapy is often prescribed, which shows good results. It can also be prescribed massage, the use of dry heat or paraffin therapy.
Folk remedies
Folk remedies for the treatment of periostitis can be used both independently and together with the traditional method of therapy.
Many medicinal plants have an anti-inflammatory effect. They also reduce puffiness, redness, and remove pain. If you take decoctions or tinctures of special herbs, then the bone structures begin to recover several times faster.
For the treatment of periostitis, a plant such as comfrey is very often used. It contains a huge number of useful components that help cure pathology and prevent the development of other diseases of the joints and bones.
In order to treat the inflammatory process in the periosteum, you need to prepare a special ointment. For it, 100 grams of butter and comfrey root are used. The oil must be melted in a water bath and then add comfrey root powdered into powder . The mixture is thoroughly mixed and continues to warm up. After this, you need to give half an hour to the resulting product, so that it cools down and insists. The ointment is lubricated with a therapeutic ointment. You can store the medicine in the refrigerator.
The non-acute form of periostitis of the tibia is perfectly treated with an adam root (the tamus vulgaris is also called). To prepare the tincture, take 200 grams of root and pour half a liter of vodka. The remedy is infused for five days in a dark, cool place. Then the finished tincture can begin to rub into the affected area. Then wrap it with a woolen cloth.
If the disease proceeds in an acute form, then the affected area should never be warmed up. This can lead to the development of complications and the spread of the inflammatory process to neighboring healthy tissues.
Possible complications
If you go to the doctor too late or choose the wrong treatment, this can cause many serious complications. May appear:
- abscess;
- phlegmon;
- osteomyelitis;
- sepsis.
To avoid the appearance of various complications, you must strictly follow all the recommendations of your doctor. If a shin injury occurs, then it is worth starting treatment for the problem immediately. Also, patients with this disease should not wear high-heeled shoes. It is better to choose models that have a comfortable orthopedic sole, insole.
If you start treatment for the disease in time, then getting rid of the problem will be quite simple. Do not delay with a visit to a specialist if you notice discomfort in the lower leg or swelling and pain. Otherwise, the pathology can go into a chronic form and provoke the appearance of complications.