Metatarsal stress fractures are common foot injuries caused by trauma or repetitive stress. Symptoms include pain and swelling, and diagnosis may require a bone scan. Treatment involves rest and gradual return to activity, with surgery rarely necessary.
A metatarsal stress fracture is a fracture of the long bones of the foot, between the toes and the heel. It is the most common of all foot injuries caused by trauma and typically begins as a small crack in the outer shell of one of the five metatarsal bones. These bones help balance, propel and support the body. If left untreated, the initial fracture can progress to a fracture that travels through the bone, causing severe pain and immobility.
Metatarsal stress fractures were originally called march fractures, because they were common among soldiers in the early 19th century. Today they occur more frequently in professional athletes and are second only in the incidence of tibial fractures. A metatarsal stress fracture is caused by direct trauma or repetitive stress to the foot, such as during jumping, dancing, marching, or running. Improper footwear, a rapid increase in activity, weak muscles, and low bone density can all contribute to the development of a metatarsal stress fracture.
Restless hyperactivity is also a cause of stress fractures in the metatarsal bones. Bones in the human body are continually breaking and rebuilding, and naturally repair themselves during periods of rest. When there is high-impact activity or unusual stress on restless bones, the body is sometimes unable to keep up with the rebuilding process. This results in a stress fracture or several small cracks in the bone.
Symptoms of a metatarsal stress fracture include gradually increasing pain on the top of the foot, which may be accompanied by swelling or bruising. At first, the pain is only felt after playing sports or activity. Over time, the pain will become severe and be felt during daily activities or when no stress is placed on the foot. In many cases, the sufferer will have no recollection of sustaining an injury, as pain is usually not felt at the moment of impact.
Diagnosing stress fractures requires an examination of the foot and a review of symptoms. An X-ray can be taken, but it’s not always an accurate tool for diagnosis. If x-rays reveal no fractures, but symptoms suggest metatarsal stress, a bone scan may be used to confirm the diagnosis.
Treatment of a metatarsal stress fracture includes at least three weeks of rest from activity, and if the pain is severe, crutches or a special walking boot may be prescribed to carry out daily activities. After the initial rest period, there is a gradual return to normal activity over the course of two to four weeks. In some cases, physical therapy, special foot inserts, or calcium supplements may be needed to speed healing. Surgery is rarely needed, but may be needed in extreme cases.
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