Diagnostics of periostitis
Initially, the physical examination can provide a diagnostic indication of periostitis. If the patient reports pain when touching the skin over the corresponding bone, this could indicate periostitis. An x-ray is only meaningful in the case of severe and prolonged courses of the disease and would in this case be able to make visible an ossification (ossification) at the edge of the corresponding bone. In case of doubt, an MRI of the respective region or a skeletal scintigraphy can still be performed, which can detect increased metabolic processes in the area of the bone. Here too, however, severe courses and chronic inflammation in particular can make such periostitis visible.
Treatment of periostitis
The treatment is rather symptomatic and can be divided into drug therapy and non-drug therapy. Non-drug therapy can be attempted with cooling and a pressure bandage to alleviate the symptoms. Furthermore, the triggering factors, such as incorrect footwear or excessive training, should be remedied.
Medicinal anti-inflammatory and pain-relieving drugs should be used. For temporary use, drugs such as ibuprofen or Voltaren® are suitable, which fulfil both tasks. If there is severe pain, the corresponding bone should also be spared.
General symptoms, such as fever, should be treated with calf compresses if the temperature cannot be lowered with the above-mentioned medications. Only chronic inflammations that recur repeatedly are operated on. In this case a splitting of the periosteum would be performed.
Ointments that help with periosteal inflammation are primarily cooling and pain-reducing ointments. These include Voltaren® and Docsalbe®, for example. Voltaren® contains the active ingredient diclofenac, while Docsalbe® contains ibuprofen.
Both active ingredients are drugs that have both analgesic and anti-inflammatory effects.When applied to the skin in the immediate vicinity of periosteitis, the active ingredients can quickly reach the inflamed area and soothe the pain. In addition, the ointment with its gel is cooling and thus also counteracts the inflammation and overheating of the affected part of the body. An ointment bandage is particularly useful if the ointments are to have a slightly longer effect.
Here, some ointment is applied to a compress and this is then placed on the skin over the painful area. The compress can then be bandaged with gauze. Ideally, such an ointment bandage is applied in the evening so that the ointment can take effect overnight.
Contrary to some recommendations circulating on the Internet, the use of heparin ointment is not recommended in cases of periostitis. This is effective for bruises by acting as a blood-thinning agent and can remove the bruises more quickly. However, this active ingredient is not helpful in the case of periostitis!
home remedies that help against periostitis are primarily aimed at cooling the affected part of the body. For this purpose, a simple cooling pack is usually sufficient. This should be wrapped in a towel to protect the skin in the affected area and used for about ten to twenty minutes to cool it.
A wet cold towel or a bag of ice cubes can also be used. Other household remedies include quark compresses, cabbage and rescuer’s pointy wraps, which also have a cooling effect. The same effect can be achieved by a cold water bath of the affected body part.
Cold is the most important therapeutic agent in the case of periostitis in addition to physical protection. Among other things, an inflammation leads to overheating of the affected body part. Similar to a fever with a cold, the body tries to destroy the trigger of periosteitis with heat.
However, this reaction causes pain, which is why cooling the affected region has an analgesic effect. The swelling is also reduced by cooling and elevating the affected body part. Cooling can be done with cooling packs, ice bags or cold water.
Other household remedies such as quark compresses can also be used. Quark wraps are a frequently used household remedy for cooling all kinds of injuries and inflammations. To make a quark wrap, you can use conventional food quark from the supermarket.
This should come from the refrigerator. The quark is put on a kitchen towel or plastic wrap, then the quark wrap is placed on the aching part of the body. The cold quark has an immediate cooling effect.
This is usually more moderate and therefore not as skin damaging as an ice pack. Due to its moisture, the cooling effect nevertheless lasts for a long time. The quark wrap should remain on the skin for as long as it releases cold (usually a maximum of 30 minutes).
A new poultice can then be usedSaving poultice can be used to alleviate pain as well as to inhibit inflammation of the periosteum. For this purpose, the Rescuer Spitz is put on a cloth and placed on the affected body part. Due to its various active ingredients, it can counteract periosteal inflammation in different ways.
For example, Arnica is contained in Retterspitz, which can have a pain-inhibiting effect. Essential oils like thymol and rosemary oil also have an anti-inflammatory effect. The combination can be a very effective therapy for osteomyelitis.
In addition, the Rescue Spitz itself has a cooling effect and can thus also alleviate the symptoms. In the case of periostitis, different homeopathic remedies are used depending on the severity of the condition. Apisinum and Apis mellifica are particularly effective when swelling is the main symptom.
Potassium iodatum on the other hand is more effective against the inflammation itself. If the symptoms are weather-dependent and even improve slightly with light exercise, Ruta graveolens can also be used. In combination with cooling household remedies, the symptoms of periostitis can usually be effectively relieved.
If this is not sufficient, however, the use of painkillers is also recommended. There are two different types of tape:
- Stabilizing firm (mostly white) tape is used mainly on joints. Since the joints are rarely affected by periostitis, the stabilizing tape often does not help.However, if the inflammation occurs close to the joint, relief can be achieved.
- In general, however, the use of Kinesiotape is more helpful and effective.
This very elastic tape supports especially the musculature in its function and can thus relieve overloaded areas muscularly. Kinesiotape can be very effective in the treatment of osteomyelitis of the shin bone
Cortisone is not the first agent of choice for periostitis. Much more helpful are pain-relieving and anti-inflammatory agents.
However, cortisone can be very helpful, especially in the case of particularly persistent periosteal inflammation, which has already become chronic. Inflammation of the periosteum only leads to the typical symptoms when the immune system reacts to the bone. Cortisone can downregulate this immune response and thus stop the inflammation.
