Metatarsal stress fractures - aftercare
Description
The metatarsal bones are the long bones in your foot that connect your ankle to your toes. A stress fracture is a break in the bone that happens with repeated injury or stress. Stress fractures are caused by overly stressing the foot when using it in the same way repeatedly.
A stress fracture is different from an acute fracture, which is caused by a sudden and traumatic injury.
Alternative Names
Broken foot bone; March fracture; March foot; Jones fracture
About Your Injury
Stress fractures of the metatarsals occur most commonly in women.
Stress fractures are more common in people who:
- Increase their activity level suddenly.
- Do activities that put a lot of pressure on their feet, such as running, dancing, jumping, or marching (as in the military).
- Have a bone condition such as osteoporosis (thin, weak bones) or arthritis (inflamed joints).
- Have a nervous system disorder that causes loss of feeling in the feet (such as nerve damage due to diabetes).
Pain is an early sign of a metatarsal stress fracture. The pain may occur:
- During activity, but go away with rest
- Over a wide area of your foot
Over time, the pain will be:
- Present all the time
- Stronger in one area of your foot
The area of your foot where the fracture is may be tender when you touch it. It may also be swollen.
What to Expect
An x-ray may not show there is a stress fracture for up to 6 weeks after the fracture occurs. Your health care provider may order a bone scan or MRI to help diagnose it.
You may wear a special shoe to support your foot. If your pain is severe, you may have a cast below your knee.
It may take 4 to 12 weeks for your foot to heal.
Self-care at Home
It is important to rest your foot.
- Elevate your foot to decrease swelling and pain.
- Do not do the activity or exercise that caused your fracture.
- If walking is painful, your doctor may advise you to use crutches to help support your body weight when you walk.
To Treat Pain
For pain, you can take over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs).
- Examples of NSAIDs are ibuprofen (such as Advil or Motrin) and naproxen (such as Aleve or Naprosyn).
- Do not give aspirin to children.
- If you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or bleeding, talk with your provider before using these medicines.
- Do not take more than the amount recommended on the bottle.
You may also take acetaminophen (Tylenol) as instructed on the bottle. Ask your provider if this medicine is safe for you, especially if you have liver disease.
Follow-up
As you recover, your provider will examine how well your foot is healing. The provider will tell you when you can stop using crutches or have your cast removed. Also check with your provider about when you can start certain activities again.
Activity
You can return to normal activity when you can perform the activity without pain.
When you restart an activity after a stress fracture, build up slowly. If your foot begins to hurt, stop and rest.
When to Call the Doctor
Call your provider if you have pain that does not go away or gets worse.
References
Bettin CC. Fractures and dislocations of the foot. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 89.
Rose NGW, Green TJ. Ankle and foot injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 49.
Smith MS. Metatarsal fractures. In: Eiff MP, Hatch RL, Higgins MK, eds. Fracture Management for Primary Care and Emergency Medicine. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 15.
Review Date:4/16/2022
Reviewed By:Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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