Stress Fractures: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Stress Fractures?
An orthopedic doctor, a doctor for bones and joints, or a sports medicine doctor, who treats sports injuries, usually treats stress fractures. A primary care doctor can often do the first exam and order tests. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What are stress fractures?
A stress fracture is a tiny crack in a bone. It is an overuse injury. Your bones break down a little every time you run and jump, and rest and sleep let them build back up. If bone breaks down faster than the body can rebuild it, a bone stress injury occurs. In the early stage, the bone may swell or bruise, which is called a bone stress reaction. The weightbearing bones of the foot and lower leg are especially vulnerable to stress fractures.
Symptoms
At first, you may notice discomfort in a specific spot along the bone. It may happen only at the end of activity and go away with rest. If the injury becomes more severe, these signs can appear:
- Discomfort throughout activity and during daily tasks, sometimes causing a limp.
- Aching while lying in bed at night.
- Swelling and bruising.
- Tenderness in the foot or ankle when pressure is applied to the area directly over the injured bone.
Causes and who gets it
Bone stress injuries happen when a bone is overloaded again and again with a rapid increase in physical activity. They are often seen 3 to 4 weeks after starting a new exercise routine or sports season. Even people who are not athletes can get one after a sudden increase in activity. Other risk factors include weak or tight muscles, tired muscles, worn-out shoes, and hard training surfaces.
Not eating enough for your level of exercise raises the risk. So does getting less than 7 hours of sleep each night and not taking rest days. Conditions that weaken bone, such as osteoporosis, can make a stress fracture more likely, even during normal everyday activities. Female athletes in cross country, gymnastics, and outdoor track have the highest rates of stress fractures. People in the military are also commonly affected.
How doctors diagnose it
A doctor will look for bone tenderness at the spot where you feel pain when you exercise. For a leg injury, the doctor may have you hop on your leg to see if this causes pain. The doctor will order an X-ray, but in the early stages the X-ray may look normal. An MRI, a detailed scan, can show bone swelling. A bone scan can also find stress fractures earlier than an X-ray. A bone density scan checks the strength of the bones if you have factors that raise the risk of weaker bones.
Treatment
Treatment is aimed at unloading the bone to allow it to heal. These injuries are typically treated with rest from activities that cause pain. Swimming and cycling are good alternative activities that still allow your injury to heal. If you have pain when walking, a hard-sole shoe, boot, or crutches can take pressure off the bone. Over-the-counter anti-inflammatory medicines, such as ibuprofen or naproxen, can help relieve pain and reduce swelling. Bones that take a long time to heal might require surgery, which often uses pins, screws, plates, or rods. Bone stress injuries usually take at least 3 weeks to heal, but more severe ones can take up to 3 months or longer. Going back to activity too early can make the injury worse and delay healing.
When to see a doctor
See your doctor or provider as soon as possible if you think you have a bone stress injury. Ignoring the pain can lead to worse injury, and the bone may break completely. If you feel pain, stop your activity and rest for a few days. If the pain continues, see your doctor and do not try to play or exercise through the pain.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can examine the painful area, order an X-ray, and refer you to an orthopedic or sports medicine doctor when needed.
Common questions
How long does a stress fracture take to heal?
Bone stress injuries usually take at least 3 weeks to heal, but more severe ones can take up to 3 months or longer. After a doctor has cleared you to return to sports, your return should be slow and gradual so the bone can adjust.
Should you keep exercising with a stress fracture?
No, you should not try to exercise through the pain. If you feel pain, stop your activity and rest for a few days, and see your doctor if the pain continues.
Does a stress fracture show up on an X-ray?
Not always, because the X-ray may look normal in the early stages. An MRI or bone scan can find stress fractures earlier than an X-ray.
What is the difference between a stress reaction and a stress fracture?
A bone stress reaction is the early stage, when the bone swells or bruises. A stress fracture happens when you keep exercising through the pain and the pressure causes the bone to crack or break.
Sources
- American Academy of Orthopaedic Surgeons - OrthoInfo - Stress Fractures
- American Academy of Orthopaedic Surgeons - OrthoInfo - Stress Fractures of the Foot and Ankle
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
