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 as dull and throbbing.

According to the American Academy of Orthopaedic Surgeons (AAOS), shin splints are a common cause of shin pain. But there are many other causes of shin pain, such as an injury, bone bruise, or stress fracture.

In many cases, a person with shin pain will not need to see a doctor. However, a person should seek immediate medical help if there is severe pain, swelling, and bruising, if the shin looks an unusual shape, or the person has heard a snapping sound. These could be signs of a fracture.

If there is unusual growth or a lump, they should see a doctor, who may carry out tests to see if there is a benign or malignant tumor.

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.

Sex and gender exist on spectrums. For the purposes of this article, we use “male” and “female” to refer to a person’s sex assigned at birth. Learn more.

A runner experiences shin pain not shin splints.Share on Pinterest
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A person who has an injury to their shinbone from a fall or blow may experience some pain or bruising.

Symptoms

Symptoms of a minor injury can include:

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

Treatment

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

A bone bruise on the shin results from direct trauma, such as a blow or impact to the leg. It can result from an injury, such as a fall or playing sports. They tend to appear within 48 hours of an injury and can take up to 6 months to heal. A bone contusion is another name for a bone bruise.

A bone bruise occurs when a traumatic injury to a bone causes microfractures. Unlike with a broken bone, an imaging scan or a bone bruise will not show a clear fracture line or change in bone shape.

The trauma also damages blood vessels and blood and other fluids build up in tissues. This causes discoloration to the skin around the damaged area. However, 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.

An X-ray may not show up a bone bruise. However, it will appear on an MRI scan.

Symptoms

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

Treatment

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 a hematoma or more severe bruising, a doctor may need to drain the bruise to remove excess fluid.

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.

Statistics suggest that females, athletes, and military recruits are at higher risk of developing stress fractures. This is due to repetitive stress on the bone. Carrying a heavy load while running can increase the risk, as can having lower bone density. These factors can lead to microcracks in the bone, which need time to heal.

Stress fractures can be the result of:

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

Symptoms

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.

Treatment

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

The best treatment for a stress fracture is rest. A person may need to rest for 6–8 weeks to allow the bone to heal fully.

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

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

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.

Fractures can occur at any time of life. However, a 2020 study found that the average age of people experiencing a fracture was 57.9 years. Moreover, 67.5% of all fractures in those aged 16 years or over were in females.

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. It usually appears before the age of 20 years.

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.

Symptoms

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

Treatment

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.

Paget’s disease of bone is a disease of the skeleton that causes newly forming bone to become abnormally shaped, weak, and brittle. It usually affects older people. However, 2–3% of cases occur before the age of 55 years, according to the AAOS.

After osteoporosis, Paget’s disease is the second most common bone disorder, according to a 2017 review.

Although Paget’s disease can affect any bone in the body, it mainly appears in the spine, pelvis, femur, and shinbone.

Symptoms

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

Treatment

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

Fibrous dysplasia is a rare, noncancerous bone condition.

According to the AAOS, around 7% of all benign bone tumors are fibrous dysplasia. It affects males and females equally.

People with fibrous dysplasia will experience abnormal fibrous tissue growth in the place of normal bone.

Fibrous dysplasia most commonly occurs in the:

  • femur
  • shinbone
  • ribs
  • skull
  • humerus
  • pelvis

Very rarely, fibrous dysplasia can become cancerous, although this occurs in less than 1% of people.

Symptoms

Symptoms of fibrous dysplasia include:

  • a dull ache that worsens with activity or gets worse over time
  • bone fracture
  • curving of leg bones
  • issues with hormones

Signs that fibrous dysplasia has turned cancerous include rapid swelling of the region and increasing pain levels.

Treatment

A doctor can treat fibrous dysplasia using:

  • observation
  • bisphosphonates
  • using braces
  • surgery

In some cases, shin pain can occur due to factors outside a person’s control, such as age or genetics.

However, certain factors may increase a person’s chances of experiencing shin pain.

Factors that may cause a person to be more likely to have shin pain from an injury include:

  • drinking more than 10 alcoholic drinks per week
  • excessive physical exercise
  • running more than 25 miles per week
  • smoking
  • running track
  • a sudden increase in physical activity
  • low levels of vitamin D
  • playing sports
  • having flat feet
  • compartment syndrome, which, if it happens after a trauma, needs urgent medical attention

It may not be possible to prevent some of the conditions that cause shin pain, such as genetic conditions and accidents. However, a person can help prevent shin pain from an injury in the following ways:

  • being careful not to over-exert themselves
  • wearing shock-absorbing shoes
  • wearing shin pads
  • increasing activity level gradually

A person with a minor injury, such as a bruise or scrape, will usually not require medical assistance.

However, large bruises that do not disappear after a few days may require draining from a doctor to speed up healing.

A person who has a more severe condition, such as a bone fracture, should see a doctor immediately.

Signs of a fracture include:

  • pain
  • swelling
  • bruising
  • a change in shape
  • having heard a cracking sound
  • inability to put weight on the leg

In general, a person who has shin pain that is not shin splints will not require a doctor, and in most cases, the injury will heal with minimal treatment.

However, a person with a bone fracture should seek immediate medical attention.

Very rarely, shin pain can indicate a rare form of cancer. A person experiencing any worrying symptoms should consult their doctor.