As your broken bone heals, it should go through different phases, each involving its own set of characteristics. The amount and type of pain and other symptoms will change, as will your range of motion and strength. Knowing these phases and what you should feel as you go through them can help you spot any abnormalities or complications early, so your doctor can deal with them right away.
Broken bones take a varying amount of time to heal, mostly depending upon the type of bone broken, the age of the person, and the way in which the bone is broken. Additionally, diseases that degenerates bone tissue like osteoporosis, may cause one to have far longer healing times for broken bones. As well one may need more complicated treatment like surgery.
In general, small broken bones with simple fractures take about four weeks to heal in small children. In teenagers and adults, small bones, such as a finger or wrist bone, will take about six weeks to heal. Larger broken bones, such as the bones in the thigh, usually take six weeks to three months to heal in the average healthy adult.
Types of Bone Fractures
Let’s look at some small details on different types of fractures:
- Greenstick Fracture: Mostly found in children, in which bone is bent but not broken all the way.
- Buckle Fracture: Occurs when two bones press together.
- Growth Plate Fracture: Affects the layer of growing tissue near the ends of a child’s bones.
- Comminuted Fracture: Happens when your bone breaks into three or more pieces.
- Transverse Fracture: The break is perpendicular to the way the bone runs.
- Pathologic Fracture: Usually occurs because of a disease for weak bones.
- Oblique Fracture: A break which has a fracture line that runs diagonal to the bone shaft.
- Hairline Crack: Also known as a stress fracture, is a small crack or severe bruise within a bone.
3 Fracture Healing Stages
Inflammatory Stage:
The first phase of the fracture healing process starts the moment after bone breaks. At this point, the body goes into action right away. A small blood clot, known as a hematoma, forms around the fracture site which then attracts molecules called white cells. White cells form part of the body’s defense system. Along with many other proteins, they cause the swelling, redness, and inflammation that we see and feel right after an injury. Although inflammation causes pain, it also triggers the growth of new blood vessels as well as the recruitment of other proteins. This trigger will go on to help with the bone building process.
Reparative Stage:
The second phase of bone healing is where the real business of healing takes place. The reparative stage starts within about a week of the injury. A soft callus (a type of soft bone) replaces the blood clot that formed in the inflammatory stage. The callus holds the bone together, but isn’t strong enough for the body part to be used. Over the next few weeks, the soft callus becomes harder. By about 2–6 weeks, this hard callus is strong enough for the body part to be used.
Remodeling Stage:
In the last phase, the callus matures and remodels into what we recognize as strong, healthy highly-organized bone. From start to finish, the whole process of the 3 stages of fracture healing can take anywhere from a few months to years depending on many different factors.
Stages of Pain During the Healing Process of a Fracture
In general, there are three stages of pain following a bone fracture. These are referred to as acute pain, subacute pain and chronic pain. All fractures cause either all or some of these types of pain.
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Acute Pain Immediately After the Injury
Acute pain is that sudden, intense, kind of pain you get right after the fracture (or any kind of trauma) that lets you know something is wrong. During this stage, medication is often prescribed to reduce the worst pain. The acute pain will decrease with time.
Inside your body, the break has caused damage to sensitive nerves that send rapid, sharp pain signals to the brain. Over the next few hours, the cells at the fracture site release healing chemicals and signals that cause new nerves to sprout. You may need surgery so the doctor can realign your broken bone, you may need a cast or other device to keep the broken bone immobile or you may require some other medical treatment. No matter which method is used to treat your broken bone, the key is to realign the bone ends and immobilize the fracture for several weeks so the bone can set and heal properly.
Once you have moved past the initial acute pain, if it returns, it could be a signal that something is wrong. You may have bumped the bone or moved it in a way that hurt, or maybe it is not healing properly. You should let your doctor know about any unexplained return to the acute pain phase.
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Sub-Acute Pain While the Bone is Healing
After about a week or two, the worst of the pain will be over. What happens next is that the fractured bone and the soft tissue around it start to heal. This takes a couple of weeks and is called subacute pain. You may still be on pain medication, but it may be a lower dosage or a weaker drug.
Subacute pain is primarily caused by the lack of movement that was necessary to help the bone heal. The inactivity may have stiffened the soft tissue around the injury and weakened the muscles. The source of sub-acute pain is partly from the break—especially from scarring and any inflammation you may still have—but much of it stems from the immobility that’s needed for your bones to heal properly. The connective tissues get stiff and the muscles lose strength. You may also lose bone mass.
Physical therapy is often recommended at this stage of recovery. Physical therapists may help you reduce the stiffness by providing exercises that also strengthen the weakened muscles and improve your range of motion. This will help to reduce pain and improve the function of your body that was affected by the injury.
If all goes well, your bone will heal and your soft tissues will recover. The nerves that sprouted during the acute phase should stop sending those signals and the lingering pain will go away.
- Chronic Pain After the Healing is Complete
When you suffer a fracture, it will eventually heal and recover to the point that you no longer experience pain. When pain continues beyond the sub-acute phase, it is called chronic pain. Many people never get to this phase, but for those who do, the pain continues for long after the injury is healed. It may be caused by:
- Nerve damage (neuropathy)
- Scar tissue development
- Underlying disease, such as arthritis
- Changes in the brain called central sensitization
Chronic pain may be caused by nerve damage, the development of scar tissue, aggravation of underlying arthritis, or other causes. Luckily, this type of pain often can be treated. The type of treatment depends on the initial injury and the cause of your chronic pain.
The most commonly used treatments for chronic pain are:
- Physical therapy
- Exercise
- Medication
These treatments are not guaranteed to resolve your pain, but they may help control and reduce the chronic pain. Most people are able to control their chronic pain so they can get on with their day-to-day activities and enjoy a better quality of life.
Healing Time Depends On:
- The specific bone you broke (smaller ones heal faster)
- The severity of the break
- How quickly and how effectively it was treated
- How well you take care of it
- The health of your bones and connective tissues
- Whether you smoke, drink alcohol, or have nutritional deficiencies
- Your age
- Your overall health
Help Bones Heal
With an understanding of this process, you should now have a better idea of how you can support it. Firstly: it is imperative that you see a medical professional who can ensure that the bone is correctly set before the healing starts. Failure to do this may mean that the bone heals in the wrong position, which can cause more issues in the long run!
It is also important to make sure that you rest the area so that the body can go to work and heal it again. But while all this is true, you also need to recognize that the inflammation plays a key role in the healing process. Inflammation does need to be controlled to prevent serious discomfort or tissue damage, but if you make it your aim to completely suppress inflammation, then this will actually prevent you from being able to recover fully.
However, you can take steps to help your body heal the break:
- Stop smoking: Smoking alters the blood flow to the bone, which can delay or prevent healing.
- Eat a balanced diet: Healing bone requires more nutrients than simply maintaining them. Be sure to get adequate nutrition from all food groups, and especially ensure you get calcium and vitamins A, B12, C, D, and K. (You only need to get the recommended dosages. Taking more than that won’t help.)
- Manage chronic conditions: If you have diabetes, a disease of the blood vessels, or a hormone-related condition, it can make you heal more slowly. Talk to your doctor about how to better manage your illness.
- Beware of certain drugs: While they are often used to manage pain, non-steroidal anti-inflammatories (NSAIDs) such as Advil/Motrin (ibuprofen) or Aleve (naproxen) and glucocorticoids like prednisone can slow healing, as can immunosuppressants.
- Do not rush to use it: Moving and using the injured body part too soon can cause damage and make it harder for the bone to heal.
- Watch for infection: If you notice an increase in pain, swelling, redness, and heat around the fracture, and especially if you have a fever, chills, and pus drainage, talk to your doctor right away so you can be treated for infection.
- Augmenting fracture healing: Ask your doctor about devices that may speed healing, including bone-growth stimulators, electrical stimulation, and ultrasound treatment.
When to Call a Doctor
Catching problems early and getting prompt treatment for them can prevent delays in the healing process. Contact your doctor if:
- Your pain or inflammation suddenly increases
- Your pain lingers for months or weeks beyond when the bone is healed
- You see signs of infection
- You have a change in your health that could impact the healing process
- You think the healing process is taking too long
- You do not progress in the way your doctor said to expect
Ask Your Doctor
A fracture can be painful and can lead to significant functional loss and disability. Depending on the severity of the injury, the loss may be temporary or permanent. Working to gain mobility and strength after a fracture should be your main goal after a fracture. Physical therapy can help you return to optimum functional mobility as quickly as possible.
If you are concerned about your bone health, our specialists are always willing to help you reach your optimal health. Osteoporosis is a very serious disease.
To learn more about bone health or to schedule an appointment with one of our specialists, call us at 800-698-1280.
