Stress fracture

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at June 26, 2016
StartDiseasesStress fracture

Typically manifesting itself as a painful sensation when an individual places pressure on a body part, stress fractures are a common malady. Stress fractures can arise due to pre-existing medical conditions or from repetitive pressure being placed on a bone


Definition & Facts

Stress fractures are tiny fractures that appear in the structure of a bone. The most common place that stress fractures appear is in the legs. The bones in the lower legs experience more stress fractures than other regions of the human body.

Bones experience microfractures all the time. Given sufficient opportunity to heal, the body usually stays ahead of the problem. If too much stress is applied or the body is unable to deal with the damage, these microfractures can begin to accumulate. As they increase in number, they can compromise the overall integrity of a bone.

Symptoms & Complaints

Pain is often the most commonly reported stress fracture symptom, but other symptoms can appear. Due to the body’s attempts to heal itself, the area around a stress fracture may become red. If the body’s attempt at healing becomes too intense, this can also lead to symptoms that include excessive warmth in the skin above the bone that has suffered the injury.

Swelling in the muscles and skin around the area of the fracture may also occur, and tenderness is frequently reported too. Although considered rare, some people may see bruising or discoloration in the vicinity of the injured area. In extreme cases, individuals who’ve suffered stress fractures may experience further fracturing of the bone.

Individuals who’ve healed from a series of stress fractures may also develop bone spurs. These can cause discomfort long after the initial fracture has healed. They can also encourage further fracturing in the future. If a bone continues to heal poorly over many months, small malformations of the leg can develop. Due to the need to take pressure off the bone where the injury occurred, those who’ve suffered stress fractures frequently display a limp while trying to walk or run.


Stress fractures can be triggered by a number of causes. The most common source of stress fractures, however, is repetitive injury. Individuals who overwork their bones are the most likely to experience this problem. A bone can become overworked by heavy activity loads, including running or weightlifting on a regular basis.

Stress fractures are also more likely to appear in the bones of individuals who are overweight or obese, due to the excessive load being placed on the body. A single bad shock, such as a slip and fall, to the bone can also trigger a stress fracture, especially if the injury is not given enough time to heal.

People can also suffer stress fractures if they have a pre-existing condition that encourages the issue. The most common pre-existing condition that raises the risk of stress fractures is osteoporosis. Individuals who do not consume enough vitamin D or calcium, including pregnant women or those who are lactose intolerant, are at greater risk of developing stress fractures too. Workers whose jobs require them to stand or move on hard surfaces are also more likely to have stress fractures.

Diagnosis & Tests

Stress fractures do not usually require a complicated diagnosis process. An individual who is worried that they have suffered one can visit a general practitioner and discuss their symptoms. A doctor will often feel around the area, checking for indications of malformations and swelling. If a doctor is concerned that someone has a stress fracture, X-rays may be ordered.

In instances where the doctor believes that a pre-existing condition may be encouraging stress fractures, additional testing may be conducted in order to narrow down the list of potential causes. These tests may include bone density test and blood tests in order to determine why the bone is not healing as well as might be expected. A doctor may also wish to have a more thorough scan performed, such as an MRI or a nuclear bone scan, in order to get a deeper look at what is going on in the bone in question.

Treatment & Therapy

A variety of treatment and therapy options are available for people who are experiencing stress fractures. Most doctors will start treatment by encouraging their patients to reduce the loads they are placing on their bones. For athletes, this can mean scaling back their training regimens.

Workers may be given special footwear or specific limitations on how much time they can work in the areas that are suspected of causing their injuries. Once healing appears to be progressing as expected, a doctor may encourage a patient to slowly build back up to normal levels of stress on their bones.

Patients may also be encouraged to pursue less strenuous exercise options, such as swimming, in order to reduce the load a bone has to bear. In more difficult cases, a doctor may encourage the use of calcium and vitamin D supplements.

In the most extreme cases, surgery may be required. A surgeon can remove any bone growths that have formed around an injured area. In some instances, surgical options may include grafting new bone into the area in order to encourage healing. Specific medications may be prescribed for people with conditions like osteoporosis.

Prevention & Prophylaxis

Preventative and prophylactic options for stress fractures are similar to many of the less drastic treatment options. Individuals can obtain specially designed footwear in order to reduce the transfer of weight from their feet into their leg bones.

Those who exercise are encouraged to give their bodies sufficient time to heal. This can include reducing the number of days that they exercise and increasing the amount of resting time between exercises.

Conversely, an increased exercise regimen may be beneficial to those who are experiencing stress fractures due to conditions related to weight management. Additional stretching before exercise and work may also help reduce the chances that a person suffers a stress fracture.