Why Do the Front of My Shins Hurt?

Shin pain is pain that occurs along the front of the leg, below the knee, and along the shinbone. 

Depending on the condition, shin pain may:

• Occur both during and after exercise
• Be sharp and razor-like or dull and throbbing
• Be aggravated by touching the sore spot
• May go away with rest

Symptoms that may accompany shin pain may include: 

• Swelling in the area 
• Inability to perform the activity

The cause of shin pain is diagnosed with a patient’s medical history and a physical examination of the lower leg.

Imaging tests to help diagnose the cause of shin pain may include: 

• X-ray
• Bone scan 
• Magnetic resonance imaging (MRI) scan
• Ultrasound
• Measuring the pressure within the leg compartments before and after exercise

Treatment for shin pain depends on the specific cause. 

Treatment for shin pain due to shin splints (medial tibial stress syndrome) may include: 

• The RICE method:
  • Rest
    • Especially if you are a runner: avoid running
    • Try low-impact activities such as swimming or cycling
  • Ice the affected area
    • Use a cold pack or ice wrapped in a towel
    • Ice 20 minutes at a time, several times a day
  • Compression with a compression bandage or stocking
  • Elevation of affected leg
• Over-the-counter (OTC) pain relievers, such as aspirin, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn)
• Flexibility exercises to stretch the lower leg muscles 
• Wear supportive shoes with sufficient cushioning 
• Orthotics such as shoe inserts may benefit people who have flat feet or recurrent problems with shin splints 

Patients should be pain-free for at least two weeks before returning to activities that caused or aggravated shin splints. Warm ups are important and training should begin at a lower intensity and increase gradually, and if pain returns, stop exercise immediately. 

Surgery to treat shin splints is uncommon and used only in very severe cases that do not respond to nonsurgical treatment. 

Treatment for shin pain due to stress fracture may include: 

• Rest from the activity that caused the stress fracture
  • It takes six to eight weeks for most stress fractures to heal
• Shoe inserts or braces may help the injury heal

Treatment for shin pain due to tendinitis may include: 

• RICE method (rest, ice, compression, elevation)
  • The best home treatment for mild tendinitis injury 
• Physical or occupational therapy
  • Modifications for daily activities and work habits to prevent re-injury 
  • Exercise program
  • Hot/cold treatments
  • Ultrasound (sound wave)
  • Soft tissue or joint mobilization (manual therapy)
  • Laser and water therapy
  • Orthotics or pressure-relieving devices 
  • Analysis of posture and walking
  • Education regarding appropriate activities
  • Assistive devices
• Pain medications
• Corticosteroid injections
• Splints, braces or slings 
• Surgery
  • Used for tendon ruptures or lesions on the tendons
• Other procedures and treatments
  • Platelet-rich plasma (PRP)
  • Dry needling
  • Ultrasound treatment

Treatment for shin pain due to chronic exertional compartment syndrome may include: 

• RICE method (rest, ice, compression, elevation)
• Use orthotics, other shoe inserts, or athletic shoes that have a better fit or are more comfortable 
• Physical therapy to address deficiencies in strength or flexibility of the lower extremities and core
• When returning to activity:
  • Run on softer surfaces
  • Reduce training volume
  • Try cross training 
• Surgical fasciotomy for patients whose symptoms do not improve with non-surgical interventions and who wish to continue with sport or exercise