Fractures, or broken bones, are a common injury in the United States and around the world. In fact, the average person in a developed country can expect to sustain two fractures during their lifetime. Nearly 7 million fractures are reported each year in the U.S., with wrists and hips the most affected areas. The vast majority of fractures need to be casted by a health professional to heal properly, although there are many things you can do to help the healing process along.
Going to the Hospital
1See a doctor immediately. If you experience significant trauma (fall or car accident) and feel severe pain — especially in conjunction with a cracking sound or swelling — then head to the nearest hospital or walk-in clinic for medical attention. If a weight-bearing bone is hurt, like in the leg or pelvis, then don’t put any pressure on it. Instead, get assistance from someone nearby and get a ride to the hospital, or call for an ambulance to come pick you up.
- Common signs and symptoms of a broken bone include: intense pain, a visibly deformed or misshapen bone or joint, nausea, limited mobility, numbness or tingling, swelling and bruising.
- X-rays, bone scans, MRI, and CT scan are tools that doctors use to help diagnose broken bones and their severity — small stress fractures may not show up on x-ray until the related swelling abates (up to a week or so). X-rays are most commonly used for the diagnosis of traumatic fractures.
- If your broken bone is considered complicated — there’s multiple fragments, the skin is penetrated by the bone and/or the pieces are grossly misaligned — then surgery will likely be necessary.
2Get a cast or support. Before a broken bone can be casted, sometimes it must be put back together and straightened to its original shape. In many cases, the doctor will use a simple technique called “reduction”, which involves pulling on the ends of the bone (creating traction) and manually fitting the pieces together. With more complicated fractures, surgery is required and often involves the use of metal rods, pins or other devices for structural support.
- Cast immobilization with a plaster or fiberglass cast is the most common treatment for a broken bone. Most broken bones heal quicker when properly repositioned, compressed and immobilized. Usually the doctor will initially put on a splint, which is like a partial cast typically made of fiberglass. A full cast will usually be put on in 3-7 days after most of the swelling is improved.
- Casts are made of a soft padding and a hard covering (such as plaster of Paris or more commonly, fiberglass). They usually need to stay on for between 4-12 weeks, depending on which bone is broken and how badly.
- Alternatively, a functional cast (such as a plastic boot) or a supportive brace may be used instead of a hard cast — it depends on the type of fracture and its location.
3Take medications. Over-the-counter non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen, naproxen or aspirin can be short-term solutions to help you deal with pain or inflammation related to your broken bone. Keep in mind that these medications can be hard on your stomach, kidneys and liver, so it’s best not to use them for more than 2 weeks at a stretch.
- Kids under the age of 18 should never take aspirin, as it’s associated with Reye’s syndrome.
- Alternatively, you can try over-the-counter pain killers such as acetaminophen (Tylenol), but don’t take them concurrently with NSAIDS without talking to your doctor.
- Your doctor may give you a prescription for more powerful medications while at the hospital if your pain is severe.
Managing a Fracture at Home
1Rest your injury and ice it. Once you’re discharged, you’ll be told to elevate your broken bone and ice the area, even with the cast or splint on, in order to help decrease swelling and inflammation. Depending on your job and which bone is broken, you’ll likely have to take some time off to recuperate. You might also need crutches or a cane for support.
- Total bed rest is not a good idea for most stabilized fractures because some movement (even in surrounding joints) is needed to stimulate blood flow and healing.
- Ice should be applied for 15-20 minutes every 2-3 hours for a couple of days, then reduce the frequency as the pain and swelling subside — never apply ice directly to your skin, wrap it in a thin towel first.
2Put some weight on it. In addition to some light movements in the joints surrounding your broken bone, putting some weight on it after a week or so can be beneficial — especially for weight-bearing bones of the legs and pelvis. Make sure your doctor lets you know when to begin weight bearing. Lack of activity and complete immobilization, in proportion with the time spent healing, will induce loss of bone mineral, which is counterproductive for a broken bone trying to regain its strength. Some movement and weight bearing seems to attract more minerals to the bones, which makes them stronger and less apt to break in the future.
- There are three stages to bone healing: reactive stage (a blood clot forms between the two ends of the fracture), repair stage (specialized cells begin to form a callus, which spans the fracture), and remodeling phase (bone is created and the injury is slowly resculpted into its original shape).
- Broken bones take several weeks to several months to heal, depending on the severity and your overall health. However, the pain usually disappears before the fracture is stable enough to cope with the demands of normal activity.
3Take proper care of your cast. Don’t get your plaster or fiberglass cast wet, as it will weaken and no longer properly support your broken bone. If need be, use a plastic bag to cover the cast when you bathe or shower. If you’re wearing a plastic compression boot (commonly recommended for stress fractures of the foot), make sure you keep it pressurized properly.
- If your cast makes your skin itch, don’t poke anything underneath it, as a sore could form and then develop into an infection. See your doctor if your cast becomes wet, cracked, or has a bad odor or drainage around it.
- Exercise the joints that aren’t covered by the cast (elbow, knee, fingers, toes) to promote better circulation. Blood caries oxygen and nutrients to tissues.
4Consume the necessary nutrients. Your bones, like any other tissue in your body, need all the appropriate nutrients in order to heal properly. Eating a balanced diet rich in minerals and vitamins is proven to help heal broken bones  Focus on eating fresh produce, whole grains, leans meats and drinking plenty of purified water and milk.
- Minerals such as calcium and magnesium are important for bone strength. Rich food sources include: dairy products, tofu, beans, broccoli, nuts and seeds, sardines, salmon.
- Avoid consuming things that may hamper your healing, such as alcohol, soda pop, fast food and food with lots of refined sugar.
5Consider taking supplements. Although it’s best to obtain essential nutrients from a well-balanced diet, supplementing with key bone-healing minerals and vitamins will ensure you meet your higher requirements without increasing your caloric intake. More calories combined with less activity usually leads to weight gain, which is not a healthy outcome after your bone heals.
- Calcium, phosphorus and magnesium are the primary minerals found in bones — so find a supplement that contains all three. For example, adults need between 1,000 – 1,200 mg of calcium daily (depending on age and gender), but you may need a little more due to your broken bone — consult with your doctor or nutritionist.
- Important trace minerals to consider include: zinc, iron, boron, copper and silicon.
- Important vitamins to consider include: vitamins D and K. Vitamin D is crucial for mineral absorption in the gut — your skin produces it for free in response to strong summer sunshine. Vitamin K binds calcium to bones and stimulates collagen formation, which aids healing.
1Seek out physiotherapy. Once your cast is removed, you may notice that the muscles surrounding your broken bone look shriveled and weak. If that’s the case, then you need to consider some form of rehabilitation. A physical therapist can show you specific and tailored stretches, mobilizations and strengthening exercises for your injured area. Physiotherapy is usually required 2-3x per week for 4-8 weeks to positively impact an area that’s experienced a broken bone. Often the physical therapist can give you exercises to do at home, and you may not need to return many times.
- If need be, a physical therapist can stimulate, contract and strengthen your weak muscles with electrotherapy, such as electronic muscle stimulation.
- Even after your cast or brace is removed, you may need to limit your activities until the bone is solid enough for normal activity.
2See a chiropractor or osteopath. Chiropractors and osteopaths are musculoskeletal specialists who focus on establishing normal motion and function within joints, bones and muscles. Manual joint manipulation, also called an adjustment, can be used to unjam or reposition joints that are misaligned or stiff due to the trauma that caused your broken bone. Healthy joints allow bones to move and heal properly.
- You can often hear a “popping” sound with an adjustment, which is not at all related to the sounds related to a broken bone.
- Although a single adjustment can sometimes completely restore a joint to full mobility, more than likely it will take 3-5 treatments to notice significant results.
3Try acupuncture. Acupuncture involves sticking thin needles into specific energy points within the skin / muscle in efforts to reduce pain and inflammation (helpful for the acute phase of a broken bone) and to potentially stimulate healing. Acupuncture is not commonly recommended for healing broken bones, and should only be considered as a secondary option, but anecdotal reports suggest it can stimulate healing for many different types of musculoskeletal injuries. It’s worth a try if your budget allows for it.
- Based on the principles of traditional Chinese medicine, acupuncture reduces pain and inflammation by releasing a variety of substances including endorphins and serotonin.
- It’s also claimed that acupuncture stimulates the flow of energy, referred to as chi, which may be the key to stimulating healing.
- Acupuncture is practiced by a variety of health professionals including some physicians, chiropractors, naturopaths, physical therapists and massage therapists — whoever you choose should be certified by NCCAOM.
How many hours a day do I wear this boot on my foot? Do I sleep in the boot?
Ask your doctor how many hours a day you should wear the boot, as it depends on your personal situation. Most people do not sleep with the boot on.
How can I have fun with a cast?
If you broke your dominant arm, teach your other arm how to write. Or get a waterproof cast and swim with it. It may not be healthy for the fracture if you swim too aggressively, however.
When I start swimming again after having my cast removed, should I maintain a slow speed?
Yes. Over a couple of weeks, gradually build up to your regular swimming pace.
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- Always keep follow-up appointments with your doctor to make sure your bones are healing properly, and always let your doctor know if you are worried about anything during the healing process.
- Don’t smoke, as it’s proven that smokers have more difficulty healing broken bones.
- Osteoporosis (brittle bones) greatly increases the risk of broken bones in the limbs, pelvis and spine.
- Reduce repetitive motions because it can fatigue muscles and place more stress on bone, resulting in stress fractures.
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