Periostitis is inflammation of the periosteum, the thin but dense layer of connective tissue that covers the outer surface of almost every bone in the body. The periosteum is not merely a protective covering; it is a vital tissue rich in nerves, blood vessels and osteoprogenitor cells involved in bone regeneration. Inflammation of this tissue can cause severe pain that may appear disproportionate to the visible extent of the condition.<\/p>\n\n\n\n
Periostitis is mainly caused by repetitive mechanical strain and is therefore particularly common among runners, military personnel and endurance athletes.<\/p>\n\n\n\n
The classic form is commonly known as shin splints, or tibial periostitis, although the condition may also affect other bones, including the femur and the bones of the foot.<\/p>\n\n\n\n
Symptoms include:<\/strong><\/p>\n\n\n\n In advanced cases, pain may also occur at rest.<\/p>\n\n\n\n Periostitis develops when the forces placed on the periosteum exceed the tissue\u2019s ability to tolerate them. This may occur because of a sudden increase in training load, a change in running surface or footwear, or biomechanical abnormalities such as overpronation.<\/p>\n\n\n\n Insufficient recovery time between training sessions is often a major contributing factor.<\/p>\n\n\n\n When it is not treated promptly, chronic inflammation of the periosteum may lead to complications, including a periosteal reaction with the formation of abnormal new bone tissue, partial detachment of the periosteum or, in severe cases, progression to a stress fracture.<\/p>\n\n\n\n Early intervention is therefore essential both for relieving symptoms and for preventing more serious injury.<\/p>\n\n\n\n Diagnosis is based on clinical assessment and imaging, such as MRI or bone scintigraphy, particularly to exclude a coexisting stress fracture.<\/p>\n\n\n\n As a highly metabolically active and richly innervated tissue, the periosteum responds directly to changes in local oxygen availability. Studies have shown that periosteal inflammation is associated with increased levels of inflammatory cytokines, including IL-1\u03b2 and TNF-\u03b1, as well as oxidative stress. Hyperbaric oxygen therapy has been shown to have an inhibitory effect on both of these processes.<\/p>\n\n\n\n The activation of antioxidant enzymes and the reduction in inflammatory activity observed after hyperbaric oxygen therapy have also been documented in studies involving athletes with periosteal conditions, with findings indicating a faster return to functional activity.<\/p>\n\n\n\n In the management of periostitis, hyperbaric oxygen therapy may be used as an adjunctive treatment, particularly when conservative measures such as rest, cryotherapy and anti-inflammatory medication do not provide satisfactory results, or when the patient requires a faster return to activity.<\/p>\n\n\n\n The increased partial pressure of oxygen achieved inside the chamber acts through several mechanisms. It reduces the inflammatory response within the periosteum by inhibiting pro-inflammatory cytokines, activates osteoprogenitor cells involved in repairing micro-injuries and strengthens the tissue\u2019s antioxidant defences, which are often placed under strain by repeated mechanical loading.<\/p>\n\n\n\n Improved microcirculation in the affected area may also accelerate the removal of inflammatory metabolites and enhance the delivery of nutrients required for tissue repair. This may result in faster pain relief and a shorter recovery period.<\/p>\n\n\n\n A typical treatment course consists of 15 to 25 sessions, depending on how long the condition has been present. Treatment is always planned in collaboration with a sports medicine physician or physical and rehabilitation medicine specialist as part of a comprehensive programme that includes biomechanical assessment, physiotherapy and a gradual return to weight-bearing and physical activity.<\/p>\n","protected":false},"excerpt":{"rendered":" What Is Periostitis? Periostitis is inflammation of the periosteum, the thin but dense layer of connective tissue that covers the outer surface of almost every … <\/p>\n\n
When Does Periostitis Develop?<\/h2>\n\n\n\n
Scientific Research on Periostitis<\/h2>\n\n\n\n
The Role of Hyperbaric Oxygen Therapy<\/h2>\n\n\n\n