Doctors can sometimes diagnose a stress fracture from a medical history and a physical exam, but imaging tests are often needed.
- X-rays. Stress fractures often aren't apparent on regular X-rays taken shortly after your pain begins. It can take several weeks — and sometimes longer than a month — for evidence of stress fractures to show on X-rays.
- Bone scan. A few hours before a bone scan, you'll receive a small dose of radioactive material through an intravenous line. The radioactive substance accumulates most in areas where bones are being repaired — showing up on the scan image as a bright white spot. However, many types of bone problems look alike on bone scans, so the test isn't specific for stress fractures.
- Magnetic resonance imaging (MRI). An MRI uses radio waves and a strong magnetic field to produce detailed images of your internal structures. An MRI usually can visualize stress fractures within the first week of injury, and can visualize lower-grade stress injuries (stress reactions) before an x-ray shows changes. This type of test is also better able to distinguish between stress fractures and soft tissue injuries.
To reduce the bone's weight-bearing load until healing occurs, you might need to wear a walking boot or brace or use crutches.
Although unusual, surgery is sometimes necessary to ensure complete healing of some types of stress fractures, especially those that occur in areas with a poor blood supply. Surgery also might be an option to facilitate healing for elite athletes who desire a more rapid return to sport or laborers whose work involves the stress fracture site.
Lifestyle and home remedies
It's important to give the bone time to heal. This may take several months or even longer. In the meantime:
- Rest. Stay off the affected limb as directed by your doctor until you are cleared to bear normal weight.
- Ice. To reduce swelling and relieve pain, your doctor might recommend applying ice packs to the injured area as needed — up to three or four times a day for 15 minutes at a time.
- Resume activity slowly. When your doctor gives the OK, slowly progress from nonweight-bearing activities — such as swimming — to your usual activities. Resume high-impact activities, such as running, gradually, increasing time and distance slowly.
Preparing for your appointment
You're likely to start by seeing your primary care provider. If you are a competitive athlete, you might go directly to a doctor who specializes in musculoskeletal problems.
What you can do
Before the appointment, make a list of:
- Your symptoms, including any that seem unrelated to the reason for your appointment
- Key personal information, including your level and type of physical activity and whether you've increased training recently
- All medications, vitamins or other supplements you take, including doses
- Questions to ask your doctor
Take a family member or friend along, if possible, to help you remember the information you're given.
For stress fractures, basic questions to ask your doctor include:
- What is likely causing my symptoms?
- What tests do I need?
- Do I need to stop my activity? For how long?
- Should I see a specialist?
Don't hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you questions, such as:
- When did your symptoms begin?
- Have you recently increased your physical activity?
- Have you broken bones in the past?
- Do you have regular menstrual periods?
- Do you take vitamin D and calcium supplements?