7 causes of shin pain

Article featured on MedicalNewsToday, medically reviewed by Angela M. Bell, MD, FACP — Written by Anna Smith on July 23, 2020

People may typically associate shin pain with shin splints. However, other issues can also cause shin pain.

Medial tibial stress syndrome, or shin splints, is the inflammation of the tendons, muscles, and bone tissue around the tibia. People describe shin splint pain as sharp, or dull and throbbing.
According to the American Academy of Orthopaedic Surgeons (AAOS), shin splints are a common cause of shin pain, there are many other causes of shin pain, such as an injury, bone bruise, or stress fracture.
This article will cover a range of reasons why a person may have shin pain, as well as symptoms, treatments, and how to prevent them.

1. Minor injury

A person who has an injury to their shinbone from a fall or blow may experience some pain or bruising.
Symptoms of a minor injury can include:

  • swelling
  • pain
  • bruising
  • a bump
  • bleeding
  • weakness or stiffness in the leg

Minor injuries due to a blow to the shin will generally heal quickly. A person with a minor injury to their shin can treat it in the following ways:

  • resting
  • using an ice pack, making sure not to place ice directly on the skin
  • lightly wrapping the injury in a bandage
  • elevating the leg above the heart to help stop any bleeding or swelling

2. Bone bruise

A bone bruise on the shin can occur due to injury, such as a fall or playing sports.
A bone bruise occurs when a traumatic injury to a bone damages blood vessels and blood and other fluids build up in tissues. This causes discoloration to the skin around the damaged area, but the injury is typically deeper than the familiar bruises that appear on the skin. Although a person can bruise any bone, bones nearer the skin, such as the shin, are most common.
It is not always possible to detect whether the bruise is a superficial skin injury or on the bone. Symptoms of a bone bruise on the shin can include:

  • prolonged pain or tenderness
  • swelling in the soft tissue or joint
  • stiffness
  • discoloration in the injured area

A person can treat their bone bruise in the following ways:

  • resting
  • applying ice
  • using pain medication
  • raising the leg to reduce swelling
  • wearing a brace to limit movement if required

For more severe bruises, a doctor may need to drain the bruise to remove excess fluid.

3. Stress fracture

Stress fractures occur when muscles become tired through overuse, and they are unable to absorb any extra stress.
When this happens, the muscle transfers the stress to the bone. This causes tiny cracks, or stress fractures, to form. According to the AFP, females, athletes, and military recruits are at higher risk of developing stress fractures.
Stress fractures can be the result of:

  • increasing physical activity suddenly
  • wearing improper footwear, such as worn or inflexible shoes
  • running more than 25 miles per week
  • repetitive, high-intensity training

Females, athletes, and military recruits are all at a higher risk of developing stress fractures, according to the AFP.
Symptoms of a stress fracture in the shinbone include:

  • shin pain when touching or putting weight on the leg
  • prolonged pain
  • tenderness at the site of injury
  • swelling at the site of injury

A stress fracture requires immediate treatment to prevent the small crack from getting bigger.
A person who has a stress fracture can treat it in the following ways:

  • reducing activity
  • taking anti-inflammatory drugs
  • using a compression bandage
  • using crutches

4. Bone fracture

The shinbone is the long bone that people fracture most often, according to the AAOS. A fracture to the shinbone can occur due to significant trauma to the leg, such as from a car accident or a bad fall.
Symptoms of a fractured tibia include:

  • severe, immediate pain
  • deformity of the leg
  • possible loss of feeling in the foot
  • bone pushing out skin, or poking through the skin

If a doctor suspects a person has broken their shinbone, they will confirm it with an X-ray.
Treatment for a fracture will depend on the type of fracture a person has. For less serious fractures, treatment involves:

  • wearing a splint until the swelling reduces
  • wearing a cast to immobilize the leg
  • wearing a brace to protect and support the leg until fully healed

If the person has an open fracture or one that does not heal with nonsurgical methods, it may require surgery.

5. Adamantinoma and osteofibrous dysplasia

According to the AAOS, adamantinoma and osteofibrous dysplasia (OFD) are rare forms of bone tumors that often begin growing in the shinbone. There are many similarities between the two tumors, and doctors think that they are related. Adamantinoma is a slow-growing, cancerous tumor that accounts for less than 1% of all bone cancers.
Adamantinoma can spread to other parts of the bone. According to the National Cancer Institute, adamantinoma typically appears in young people after their bones have stopped growing. OFD also accounts for less than 1% of all tumors in bones. It is a noncancerous tumor that does not spread and often forms during childhood.A third type of tumor called OFD-like adamantinoma contains cancerous and noncancerous cells and does not spread to other parts of the body.
The most common symptoms of both tumors include:

  • swelling near the tumor site
  • pain near the tumor site
  • fracture due to the tumor weakening the bone
  • bowing of the lower leg

A healthcare professional will observe and suggest X-rays for both OFD and OFD-like adamantinoma.

  • If the tumor causes the leg to bow, the doctor may recommend wearing a brace.
  • If the tumor causes deformity or bone fractures, a doctor may recommend surgery.

Adamantinomas will require surgery to remove them as they do not respond to chemotherapy or other cancer treatment.

6. Paget’s disease of the bone

Paget’s disease of the bone is a disease of the skeleton that causes newly forming bone to become abnormally shaped, weak, and brittle. Although Paget’s disease can affect any bone in the body, it mainly appears in the spine, pelvis, femur, and shinbone.
Up to 70%of people with Paget’s disease will have no symptoms. However, if symptoms are present, they can include:

  • bone pain
  • dull pain
  • bending of bones
  • bone fractures
  • loss of sensation or movement
  • fatigue
  • loss of appetite
  • constipation
  • abdominal pain

If a person does not experience any symptoms from Paget’s disease, a doctor may simply monitor it. Treatments for Paget’s disease can include:

  • anti-inflammatory drugs
  • using a cane or brace
  • bisphosphonate medications
  • surgery