Possible Causes for Shin Pain That Aren’t Shin Splints

Shin pain doesn't always mean you have shin splints. It might be a sign of some other problem. Review some common causes of shin pain that are sometimes mistakenly diagnosed as shin splints.

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Common Causes of Shin Pain

Shin splints are a common cause of shin pain, especially for runners. Sometimes, your running shoes, running form, or even nutrition can attribute to shin splints. However, not all shin pain is caused by shin splints. Review the injuries below to help determine the cause of your shin pain and how to treat it.

Compartment Syndrome

Pain on the anterior (outside) part of the lower leg may be compartment syndrome, a swelling of muscles within a closed compartment, which creates pressure. To diagnose this condition, special techniques are used to measure the amount of pressure.

"With compartment syndrome, the blood supply can be compromised, and muscle injury and pain may occur," says podiatrist Stephen Pribut, D.P.M., of Washington, D.C. Sometimes surgical "decompression" is required.

So how do you distinguish compartment syndrome from shin splints?

"Symptoms of compartment syndrome include leg pain, unusual nerve sensations and, later, muscle weakness," Pribut says.

Stress Fracture

Pain in the lower leg could also be a stress fracture (an incomplete crack in the bone), which is a far more serious injury than shin splints. A bone scan is the definitive tool for diagnosing a stress fracture. However, there are clues you can look for that will signal whether or not you should get a bone scan.

Press your fingertips along your shin, and if you can find a definite spot of sharp pain, it's a sign of a stress fracture; the pain of shin splints is more generalized.

"Usually stress fractures feel better in the morning because you've rested the bone all night," says Letha Griffin, M.D., an Atlanta orthopedic surgeon who specializes in sports medicine. "Shin splints are worse in the morning because the soft tissue tightens overnight you get out of bed, and you can hardly walk."

"Shin splints will be most painful if you forcibly try to lift your foot up at the ankle," says Sheldon Laps, D.P.M., a podiatrist in the Washington, D.C., area. "If you flex your foot and it hurts, it's probably shin splints."

Also, a horizontal rather than vertical line of tenderness across the bone is typical of a stress fracture, Pribut says.

Bone Bruise

A bone bruise is the result of trauma to the leg, typically from a blow or impact. Often, these injuries happen from falling or the general roughness of playing sports. This trauma causes microfractures. They won’t show up on an x-ray, but can take up to six months to fully heal.

Symptoms of a bone bruise include prolonged pain or tenderness, swelling, stiffness, and discoloration. Depending on the severity of the issue, you can typically treat a bone bruise with rest, ice, pain medication, and elevation. A brace can be worn if needed to limit movement.

If the bruising is severe, a doctor may have to drain the area to eliminate excess fluid.

Adamantinoma and Osteofibrous Dysplasia

Least likely on the list, adamantinoma and osteofibrous dysplasia are rare forms of bone tumors that grow in the shin bones. Both tumors account for less than 1% of all bone cancers.

Symptoms include swelling, pain, bowing of the lower leg, and bone fractures due to weakened bone from the tumor.

These tumors require surgery to correct.

Paget's Disease of the Bone

Paget’s disease affects the shape and strength of newly-forming bone. It typically affects older people, but 2-3% of cases occur in people under 55 years old.

It is the second most common bone disorder and can affect any bone in the body, however, the shinbone is a common location.

Symptoms include bone pain, dull pain, bone fractures, fatigue, loss of appetite, loss of sensation, constipation, and abdominal pain. Treatment options vary based on severity and range from anti-inflammatory drugs to surgery.

Fibrous Dysplasia

Fibrous dysplasia involves the growth of abnormal fibrous tissue in the place of normal bone. This condition is rare and noncancerous, though it may become cancerous (in less than 1% of people with the condition). It accounts for around 7% of all benign bone tumors.

It doesn’t always occur in the shinbone, though that is one common location. Symptoms include a dull ache that worsens with activity, bone fractures, hormone issues, and the curving of leg bones.

Treatment varies depending on the progression of the disorder and may range anywhere from observation to surgery.

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