General treatment concepts for stress fractures

Abstract

Stress fractures occur when the rate of new bone formation is unable to keep pace with the accumulation of microdamages from repetitive stresses. General treatment principles focus on either decreasing the demands placed on the bone or augmenting the body’s natural healing response. Identifying modifiable risk factors is a crucial step in the initial evaluation. Supplementation of calcium, vitamin D, and other pharmacotherapies are available to practitioners. Adjunctive therapies such as noninvasive pulsed ultrasound, extracorporeal shock-wave therapy, and electrical stimulation have also been introduced in order to accelerate fracture healing.