The metatarsal bones are the long bones in your foot that connect your ankle to your toes. A stress fracture is a break in the bone that happens with repeated injury or stress. Stress fractures are caused by overly stressing the foot when using it in the same way repeatedly.

A stress fracture is different from an acute fracture, which is caused by a sudden and traumatic injury.

Broken foot bone; March fracture; March foot; Jones fracture

Stress fractures of the metatarsals occur most commonly in women.

Stress fractures are more common in people who:

• Increase their activity level suddenly.
• Do activities that put a lot of pressure on their feet, such as running, dancing, jumping, or marching (as in the military).
• Have a bone condition such as osteoporosis (thin, weak bones) or arthritis (inflamed joints).
• Have a nervous system disorder that causes loss of feeling in the feet (such as nerve damage due to diabetes).

Pain is an early sign of a metatarsal stress fracture. The pain may occur:

• During activity, but go away with rest
• Over a wide area of your foot

Over time, the pain will be:

• Present all the time
• Stronger in one area of your foot

The area of your foot where the fracture is may be tender when you touch it. It may also be swollen.

An x-ray may not show there is a stress fracture for up to 6 weeks after the fracture occurs. Your health care provider may order a bone scan or MRI to help diagnose it.

You may wear a special shoe to support your foot. If your pain is severe, you may have a cast below your knee.

It may take 4 to 12 weeks for your foot to heal.

It is important to rest your foot.

• Elevate your foot to decrease swelling and pain.
• Do not do the activity or exercise that caused your fracture.
• If walking is painful, your provider may advise you to use crutches to help support your body weight when you walk.

For pain, you can take ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), aspirin, or acetaminophen (Tylenol). You can buy these pain medicines without a prescription.

• Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ulcers or bleeding.
• Do not take more than the amount recommended on the bottle.
• Do not give aspirin to children.

Tell your provider about any other medicines you are taking as medicine interactions may occur.

As you recover, your provider will examine how well your foot is healing. Your provider will tell you when you can stop using crutches or have your cast removed. Also check with your provider about when you can start certain activities again.

You can return to normal activity when you can perform the activity without pain.

When you restart an activity after a stress fracture, build up slowly. If your foot begins to hurt, stop and rest.

Contact your provider if you have pain that does not go away or gets worse.

Bettin CC. Fractures and dislocations of the foot. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 89.

Rose NGW, Green TJ. Ankle and foot injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 49.

Smith MS. Metatarsal fractures. In: Eiff MP, Hatch RL, Higgins MK, eds. Fracture Management for Primary Care and Emergency Medicine. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 15.