Fractures and Pain

The term fracture means that the integrity of the bone has been lost. Fractures or broken bones are caused by falls, motor vehicles accidents, direct blows and recurrent forces. Fractures occur commonly among athletes who participate in high-velocity sports such as football, rugby and soccer. Stress fractures (eg, metatarsal stress fracture) are caused due to repetitive application of force.   Causes   Fractures can occur in an otherwise normal bone or in a bone weakened by a disorder such as cancer, cysts, or osteoporosis. Pain in broken bones is caused due to several reasons: Bleeding occurs in broken bones and blood and resultant swelling (edema) causes pain. Symptoms   Pain is the commonest symptom of fracture and it occurs immediately. Pain generally begins to subside after 12 to 24 h. If the pain worsens after this period, compartment syndrome should be considered.Persistent or chronic pain can occur with: Poor alignment fracture Infection Inproperly fitted plaster cast (for example, too tight or too loose). Other symptoms like bone tenderness, ecchymosis, decreased or abnormal motion, deformity, and crepitation may be present in some people.   Tests and diagnosis   Fracture can be clinically diagnosed. In patients with an obvious deformity it is easy to detect but at times it is may not be easily diagnosed. X-rays: An X-ray can the site and type of fracture. Occasionally x-rays are normal if the fracture is  small or impacted or if osteoporosis is severe. Magnetic resonance imaging (MRI) scan: MRI scan may be done in patients whose X-rays are normal but a fracture is still suspected. If MRI not possible or contraindicated, computed tomography (CT) scan may be done Treatment The fracture may be managed by splinting, cast, or surgery as required. This significantly decreases the pain. Acute pain relief may be provided by acetaminophen or nonsteroidal anti-inflammatory pain relievers such as aspirin, ibuprofen. Some studies show that these drugs can interfere with bone healing. Rest and elevation of the limb (above the level of the heart) for the first 2 days can significantly decrease pain. Home care   If fracture is suspected consult a doctor at the earliest. Home care for fractures till you reach a medical facility includes RICE (rest, ice, compression, and elevation). These supportive measures can decrease pain. Rest decreases pain, limits further injury and after application of cast or splinting speeds healing.  Ice and compression minimize swelling and pain. Elevation of the fractured limb above the level of heart can decrease the swelling and pain. Simple analgesics like acetaminophen, aspirin or ibuprofen can help to relieve pain.   Alternative therapies   Massage therapy, relaxation techniques, hypnosis, breathing exercise can reduce pain and discomfort following a fracture. Massage therapy can help to reduce pain and discomfort in the soft tissue around the fracture injury.   Prevention   Some measures to prevent fracture and the resultant pain include: Take calcium and vitamin D supplements: These two nutrients are important for your bone health, and they provide powerful protection against fractures. Exercise: Regular exercise such as walking, running, stair climbing, dancing, and weight lifting can enhance your bone density and give you extra strength, agility, and balance to prevent fall...   Read more articles on Bone Health