Question
I’ve been having constant pain in my lower leg recently. It’s very painful when I walk, and sometimes it’s even worse at night. When I gently press on my lower leg, it feels stiff and swollen. Could this be a symptom of peroneal and tibial periostitis?
Answer
Symptoms of peroneal and tibial periostitis: Severe pain in the lower leg and tibia that intensifies after intense exercise, with some patients experiencing pain at night. Pain points can be felt on the bone surface, often more pronounced. Regional soft tissue swelling with mild concave edema. Initially, pain in the lower leg often recurs during or after activity, but usually disappears with rest, only to reappear with further activity. In the acute phase, there may be indentable swelling; it is more noticeable at the lower part of the calf. There may be tenderness on the medial aspect of the tibia, the inner posterior margin, or the distal end of the fibula, but the tenderness points are generally not significantly related to the attachment sites of muscles. For patients whose symptoms do not improve over a long period and have significant localized tenderness, an X-ray examination should be carefully conducted to rule out stress fractures. For those with severe pain, in addition to rest, treatment options may include physical therapy, topical medications, traditional Chinese medicine, and nonsteroidal anti-inflammatory drugs.