A Metatarsal, or foot, stress fracture can occur in any bone of the foot or ankle. These fractures vary in severity from a “stress reaction” in the bone, or a visual “crack” seen on x-ray.
Unlike the usual bone fracture (complete separation or in multiple pieces), a stress fracture can result from simple overuse, intense exercise or shoe gear with poor support. The most common area for a stress fracture is the top of the foot in the middle, on the metatarsal bones.
The pain is characterized as sharp with the first few steps in the morning, and also in the evening after increased activities, or with minor relief as it is “warmed up” during light walking and massage.
If the bone is completely broken, or if there is a complex fracture, patients may need immediate surgical attention. That being said, surgery is fairly uncommon for the majority of stress fractures unless the pain becomes chronic and conservative treatments fail.
Fractures need protection from motion in most cases in the foot. Keeping pressure off the area is the best way to minimize separation of the bone that is fractured. Crutches, walkers, wheelchairs and strollers can be great tools depending on the severity of the fracture.
Temporary arch supports, supportive athletic shoes, or a custom made insole cushion in the shoe will all provide additional rest to the injured area. Custom molded orthotics are the best solution for immediate and long term treatment.
Using an insulated ice pack on and off the foot immediately after the injury and for 72 hours will help reduce swelling and bruising. After that time, alternate between ice and heat approximately every 20 minutes to help with bruising and continued swelling.
Similar to treating bone fractures, taking anti-inflammatory medication can help with chronic pain, while multivitamins rich in C and D with calcium will help the healing process continue.
Casts are used for protection of the fracture area. Casts can be removable with Velcro straps or molded to the foot and ankle with plaster or fiberglass. Non-weight bearing ranges from 3 to 6 weeks.
If the bone is completely broken, or if the fracture is complex, then you may need surgical treatment. However, foot stress fractures are a crack in the bone, so these injuries don’t typically warrant surgical treatment.
Follow the aforementioned conservative methods, such as pain medication and orthotics, as well as follow-up X-rays and MRIs for the best course of treatment.
The most common presentation of a stress fracture in your foot is swelling on the top of the foot. The pain usually comes with the first few steps in the morning, getting up after sitting for awhile, and again at night time. A more serious stress fracture can cause bruising on top of the foot and toes.
Doctors treat stress fractures in several ways. If the fracture is mild, a walking boot or CAM walker for 2-3 weeks with no exercise. If the fracture is more serious, if the patient is an athlete, or if you’re just looking for a quicker healing time, non-weight bearing with crutches is the treatment of choice.
Yes, a stress fracture can get worse. Essentially a stress fracture is like a crack in your car windshield. If there is more stress, the crack can open further to a complete fracture.
If a stress fracture is left untreated, it can advance to a complete fracture that will only heal with either surgery or non-weight bearing for 4 to 6 weeks depending on the fracture displacement.
The fastest way to heal a stress fracture is complete non-weight bearing with crutches and a CAM walker for 3 to 4 weeks.
If you’re suffering from a stress fracture in your foot, we can help with the paint. Contact Moore Ankle and Foot Specialists today and let’s go over your treatment options.
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