Why is a fracture painful
In more serious situations, surgery is required. A medical professional uses these techniques to restrain the bone long enough to allow the fracture to heal. In addition, patients are required to rest so that the bone does not move to decrease healing time.
After receiving follow-up instructions after a bone set, you must not aggravate the fracture or it will worsen the injury. Understand what movements to avoid and modify your daily activities. As fractures can take from six weeks to a few months to heal, the pain will become problematic while the muscles and tissue around the bone weaken because of immobility. Most especially if inflammation is present, a patient will experience pain that requires medical intervention that includes pain medication or physical therapy that augments bone fracture exercise and function.
Although pain may still be present after two or three months, your movements will become more relaxed and natural which will allow you to function and return to your normal daily activities. There are several risks associated with a bone fracture. Like a wooden pencil, bones will bend under strain. But if the pressure is too much, or too sudden, bones can snap. You can break a bone by falling off a skateboard or crashing down from the monkey bars. When a bone breaks it is called a fracture say: FRAK-chur.
It hurts to break a bone! Some people may experience sharper pain — especially with an open fracture. And if the fracture is small, a kid may not feel much pain at all. Breaking a bone is a big shock to your whole body. You may feel dizzy, woozy, or chilly from the shock. A lot of people cry for a while. The worst thing for a broken bone is to move it.
This will hurt the person and it can make the injury worse! In the case of a broken arm or leg, a grown-up may be able to cushion or support the surrounding area with towels or pillows.
Wait until a trained medical professional has arrived! To treat the broken bone, the doctor needs to know which kind of fracture it is. X-rays are like pictures that give doctors a map of fractures so that they can set the bones back in their normal position. After your bone has been set, the next step is usually putting on a cast , the special bandage that will keep the bone in place for the 1 to 2 months it will take for the break to mend.
Sometimes casts are made of fiberglass or plastic — and some are even waterproof, which means you can still go swimming and get them wet! And sometimes they come in cool colors or patterns that you can choose.
With breaks in larger bones or when a bone breaks in more than two pieces, the doctor may need to put in a metal pin — or pins — to help set it. When your bone has healed, the doctor will remove the pin or pins. Fractures typically cause swelling, but swelling may take hours to develop and, in some types of fractures, is very slight.
When muscles around the injured area try to hold a broken bone in place, muscle spasms may occur, causing additional pain. Bruises appear when bleeding occurs under the skin. The blood may come from blood vessels in a broken bone or in the surrounding tissues. At first, the bruise is purplish black, then slowly turns green and yellow as the blood is broken down and reabsorbed back into the body. The blood can move quite a distance from the fracture, causing a large bruise or a bruise some distance from the injury.
It can take a few weeks for blood to be reabsorbed. The blood can cause temporary pain and stiffness in the surrounding structures. For example, shoulder fractures can bruise the entire arm and cause pain in the elbow and wrist. Pain, as well as the fracture itself, often prevents a person from moving the fractured part normally. Because moving the injured part is so painful, some people are unwilling or unable to move it.
If people such as young children or older people cannot speak, refusal to move a body part may be the only sign of a fracture. However, some fractures do not keep people from moving the injured part. Being able to move an injured part does not mean that there is no fracture. Fractures can be accompanied by or lead to other problems complications. However, serious complications are unusual. The risk of serious complications is increased if the skin is torn or if blood vessels or nerves are damaged.
Some complications such as blood vessel and nerve damage, compartment syndrome, fat embolism, and infections occur during the first hours or days after the injury. Others such as problems with joints and healing develop over time. Many fractures cause noticeable bleeding around the injury. Rarely, bleeding within the body internal bleeding or from an open wound external bleeding is massive enough to cause a life-threatening drop in blood pressure shock Shock Shock is a life-threatening condition in which blood flow to the organs is low, decreasing delivery of oxygen and thus causing organ damage and sometimes death.
Blood pressure is usually low For example, shock may result when fractures of the thighbone femur or pelvis cause severe internal bleeding. If a person is taking a drug to prevent blood clots from forming an anticoagulant , relatively minor injuries can cause substantial bleeding. A dislocated hip or knee can disrupt blood flow to the leg.
Thus, the tissues in the leg may not get enough blood called ischemia and may die called necrosis. If enough tissue dies, part of the leg may have to be amputated. Sometimes fractures of the elbow or upper arm can disrupt blood flow to the forearm, causing similar problems.
A disrupted blood supply may not cause any symptoms until several hours after the injury. Sometimes nerves are stretched, bruised, or crushed when a bone is fractured. A direct blow can bruise or crush a nerve. These injuries usually heal on their own over weeks to months to years, depending on the severity of the injury.
Some nerve injuries never heal completely. Rarely, nerves are torn, sometimes by sharp bone fragments. Nerves are more likely to be torn when the skin is torn. Torn nerves do not heal on their own and may have to be repaired surgically. Pulmonary embolism Pulmonary Embolism read more is the most common severe complication of serious fractures of the hip or pelvis. It occurs when a blood clot forms in a vein, breaks off becoming an embolus , travels to a lung, and blocks an artery there.
As a result, the body may not get enough oxygen. Forced immobility having to stay in bed for hours or days, slowing blood flow and thus giving clots the opportunity to form.
About one third of people who die after a hip fracture die of pulmonary embolism. Pulmonary embolism is much less common when the lower leg is broken and is very rare when the arm is broken. Fat embolism rarely occurs. It can occur when long bones such as the thighbone are fractured and release fat from the bone's interior marrow. The fat may travel through the veins, lodge in the lungs, and block a blood vessel there, causing pulmonary embolism Pulmonary Embolism read more.
As a result, the body does not get enough oxygen, and people may become short of breath and have chest pain. Their breathing may become rapid and shallow, and their skin may become mottled or blue. Rarely, compartment syndrome Compartment Syndrome Compartment syndrome is increased pressure in the space around certain muscles.
It occurs when injured muscles swell so much that they cut off their blood supply. Pain in the injured limb increases For example, it may develop when injured muscles swell a lot after an arm or a leg is broken. Because the swelling puts pressure on nearby blood vessels, blood flow to the injured limb is reduced or blocked.
As a result, tissues in the limb may be damaged or die, and the limb may have to be amputated. Without prompt treatment, the syndrome can be fatal. Compartment syndrome is more likely to occur in people who have certain fractures of the lower leg Leg Fractures Leg fractures occur in one or more of the three long bones in the legs: the thighbone femur , the shinbone tibia , and the smaller bone in the lower leg fibula.
See also Overview of Fractures See also If the skin is torn when a bone is broken, the wound may become infected, and the infection may spread to the bone called osteomyelitis Osteomyelitis Osteomyelitis is a bone infection usually caused by bacteria, mycobacteria, or fungi.
Bacteria, mycobacteria, or fungi can infect bones by spreading through the bloodstream or, more often, by Fractures that extend into a joint usually damage the cartilage at the ends of bones in the joint called joint surfaces. Normally, this smooth, tough, protective tissue enables joints to move smoothly. Damaged cartilage tends to scar, causing osteoarthritis Osteoarthritis OA Osteoarthritis is a chronic disorder that causes damage to the cartilage and surrounding tissues and is characterized by pain, stiffness, and loss of function.
Arthritis due to damage of joint The knee, elbow, and shoulder are particularly likely to become stiff after an injury, especially in older people. Physical therapy is usually needed to prevent stiffness and help the joint move as normally as possible. Surgery is often needed to repair the damaged cartilage.
After such surgery, the cartilage is less likely to scar, and if scarring occurs, it tends to be less severe. Some fractures can make a joint unstable, increasing the risk of repeated injuries and osteoarthritis.
Appropriate treatment, often including a cast or splint, can help prevent permanent problems. In children, if a growth plate Growth Plate Fractures Growth plate fractures occur in areas at the ends of bones. These areas called growth plates are what enable children to grow. Growth plate fractures occur only in children and adolescents Growth plates, which are made of cartilage, enable bones to lengthen until children reach their full height. If a fracture does not involve the growth plate, it may stimulate bone growth from the fracture site itself.
If it stimulates growth, the fractured leg may grow too much and be longer than the other leg. The broken bones are not kept next to each other and are not kept from moving meaning they are not immobilized with a cast or a splint. Certain disorders, such as diabetes Diabetes Mellitus DM Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar glucose levels to be abnormally high.
Urination and thirst are When blood flow to a bone is disrupted, part of the bone may die, resulting in osteonecrosis Osteonecrosis Osteonecrosis is the death of a segment of bone caused by an impaired blood supply. Osteonecrosis can be caused by an injury or can occur spontaneously.
Typical symptoms include pain, limited Certain injuries such as scaphoid wrist fractures and hip fractures in which the broken bones are out of place are more likely to cause osteonecrosis. If people think that they may have a broken bone, they should go or be taken to an emergency department.
Possible exceptions are some toe or fingertip injuries. People should also be taken to an emergency department, often by ambulance, if any of the following apply:. The problem is obviously serious for example, if it resulted from a car crash or if people cannot use the affected body part. They have symptoms of a complication—for example, if they lose sensation in the affected body part, they cannot move the affected part normally, the skin feels cool or turns blue, or the affected part is weak.
To check for severe injuries and complications, such as an open wound, nerve damage, significant blood loss, disrupted blood flow, and compartment syndrome Compartment Syndrome Compartment syndrome is increased pressure in the space around certain muscles.
Check pulses and the color and temperature of the skin: Absent or weak pulses and pale, cool skin may indicate that blood flow is disrupted. These symptoms may mean that an artery is damaged or that compartment syndrome has developed.
Check sensation in the skin to determine whether the person can feel normally: Doctors ask whether the person has abnormal sensations, such as a pins-and-needles sensation, tingling, or numbness. Abnormal sensations suggest nerve damage. If any of these injuries and complications are present, doctors treat them as needed, then continue with the evaluation. Doctors ask the person or a witness to describe what happened.
Often, the person does not remember how an injury occurred or cannot describe it accurately. Knowing how the injury occurred can help doctors determine the type of injury.
For example, if a person reports that a snap or pop occurred, the cause may be a fracture or an injury to a ligament or tendon. Also, doctors ask in which direction the joint was stressed during the injury. This information can help doctors determine which bones and other structures are damaged.
If the pain is more severe than expected for the injury or if the pain steadily worsens during the first hours after the injury, compartment syndrome may have developed or blood flow may be disrupted. Checking for damage to blood vessels near the injured body part—for example, by checking pulse and skin temperature and color.
Doctors gently feel the injured part to determine whether bones are in pieces or out of place and whether the area is tender. Doctors also check for swelling and bruising. If no swelling develops within several hours after the injury, a fracture is unlikely.
Doctors test the stability of a joint by gently moving it, but if a fracture is possible, x-rays are done first to determine whether moving the joint is safe.
Doctors check for grating or crackling sounds crepitus when the injured part is moved. These sounds may indicate a fracture. Doctors also check the joint above and below the injured joint and check for ligament, tendon, and muscle injuries.
Or the injured part may be immobilized until the spasms stop, usually for a few days, and then examined. X-rays are the most important and usually the first and only test done to diagnose a fracture.
However, x-rays are not always needed, depending on which body part is affected and what doctors suspect. For example, if an injured body part such as the toes, except the big toe would be treated the same way regardless of whether it is a fractured, x-rays are usually not needed.
X-rays are usually taken from at least two angles to show how the fragments of bone are aligned. These routine x-rays may not show small fractures when the pieces of broken bone remain in place that is, they do not separate into fragments.
Such fractures are called occult hidden fractures. So sometimes additional x-rays are taken from different angles. Occasionally, doctors wait to take x-rays for a few days or even weeks because some occult fractures, such as rib fractures Rib Fractures A rib fracture is a crack or break in the bones enclosing the chest. Rib fractures cause severe pain, particularly when a person breathes deeply.
A chest x-ray is usually taken. People are given The wrist consists of The two long bones in the When x-rays do not show a fracture, but doctors still suspect one, doctors may apply a splint and re-examine the person days later. If symptoms are still bothersome they may take another x-ray.
Fractures may be easier to see on x-rays after they have been healing How bones heal A fracture is a crack or break in a bone. Fractures usually result from injuries or overuse. The injured part hurts especially when it is If x-rays show a fracture in a bone that looks abnormal for example, if areas of bone look unusually thin , the fracture probably occurred because a disease such as osteoporosis weakened the bone.
CT and MRI may also be done to provide more detail about fractures than routine x-rays can show. CT can show the fine details of a fractured joint surface and areas of a fracture that are covered by undamaged bone. CT and particularly MRI can show soft tissues, which are not usually visible on x-rays. MRI shows the tissues around the bone and thus helps detect injury to nearby tendons, ligaments, cartilage, and muscle.
It can show changes caused by cancer. MRI also shows injury swelling or bruising within the bone and can thus detect small fractures before they appear on x-rays. Angiography Angiography In angiography, x-rays are used to produce detailed images of blood vessels.
It is sometimes called conventional angiography to distinguish it from computed tomography CT angiography and magnetic Nerve conduction studies Nerve conduction studies Diagnostic procedures may be needed to confirm a diagnosis suggested by the medical history and neurologic examination.
Electroencephalography EEG is a simple, painless procedure in which The broken pieces of bone are not in a straight line. One is at an angle in relation to the other. A piece of bone is pulled off from the main part of the bone.
A ligament may pull off a piece of bone if the external force is strong enough, as may occur in a fall. A tendon may pull off a piece of bone if the attached muscle contracts forcefully enough, as may occur in young athletes. Avulsion fractures usually occur in the hand, foot, ankle, knee, or shoulder. The bone is broken into three or more pieces.
Often, the bone is broken into many very small pieces. These fractures are often caused by a great force, as occurs in a car crash. They can also occur in people with osteoporosis Osteoporosis Osteoporosis is a condition in which a decrease in the density of bones weakens the bones, making breaks fractures likely. Compression Compression Fractures of the Spine In a compression fracture of the spine, the drum-shaped part body of one or more back bones vertebrae collapses into itself and becomes squashed compressed into a wedge shape.
The bone collapses into itself. These fractures usually occur in older people particularly those with osteoporosis. The backbones vertebrae are often affected called vertebral crush fractures. Greenstick fractures occur only in children. Growth plate Growth Plate Fractures Growth plate fractures occur in areas at the ends of bones. These fractures occur in the growth plate, which is made of cartilage. Growth plates enable bones to lengthen until children reach their full height.
When growth is completed, growth plates are replaced by bone. When a growth plate is fractured, the bone may stop growing or grow crookedly.
Growth plate fractures occur only in children and adolescents. Fractures may extend into the cartilage at the ends of bones that form a joint called joint surfaces.
Normally, this cartilage reduces the amount of friction that occurs when bones in a joint rub against each other.
When this cartilage is fractured, people cannot move the joint as well, and osteoarthritis is more likely to develop in the joint. The pieces of broken bone are still in place aligned normally , and there is no space between them.
The bone is broken in a straight line diagonally across the long middle part shaft of the bone. These small fractures are difficult or impossible to see on x-rays, but they may be seen on other imaging tests such as computed tomography CT or magnetic resonance imaging MRI. After a few days or weeks, changes occur in the new bone that forms as the bone heals. Then occult fractures may be seen on x-rays. Some stress fractures are occult. The skin and tissues covering the fractured bone are torn, and the bone may be sticking out of the skin.
Dirt, debris, or bacteria can easily contaminate the wound and may cause an infection in the broken bone. Osteoporotic fractures result from osteoporosis Osteoporosis Osteoporosis is a condition in which a decrease in the density of bones weakens the bones, making breaks fractures likely. Osteoporotic fractures sometimes called fragility fractures occur in older people, usually in the hips, wrists, spine, shoulders, or pelvis.
Pathologic fractures are caused by a disorder that weakens a bone, such as osteoporosis, certain bone infections, or bone tumors including metastases to the bone from cancers elsewhere in the body to the bone. Spiral fractures occur when the bone is twisted apart. As a result, the ends of the bone may be sharp, jagged, and slanted.
Stress Stress Fractures of the Foot Stress fractures are small, incomplete fractures breaks in bones that result from repeated stress rather than a distinct injury. A stress fracture occurs when force is repeatedly applied to a bone during certain activities, such as walking with a heavy pack or running.
Stress fractures are often small cracks in bone sometimes called hairline fractures. Stress fractures commonly occur in bones that bear weight, such as those of the foot or lower leg. The bone buckles rather than breaks. Torus fractures usually occur only in children. Bones in children can buckle rather than break because their bones are more rubbery than those in adults. Serious fractures and serious related injuries and complications, if present, are treated immediately for example, shock Treatment Shock is a life-threatening condition in which blood flow to the organs is low, decreasing delivery of oxygen and thus causing organ damage and sometimes death.
Without prompt treatment, such injuries may get worse, becoming more painful and making loss of function more likely. These injuries can cause serious problems or even death. If people think that they have a fracture or another severe injury, they should go or be taken to an emergency department. If they cannot walk or have several injuries, they should go by ambulance. Until they can get medical help, they should do the following:.