Broken foot: symptoms, treatment and how long it takes to heal

The NHS page on pain in the top of the foot lists severe pain, swelling, bruising and limited ability to move the affected foot as the symptoms that suggest a fracture or break in one of the foot bones. It says pain in the top of the foot will usually get better in a few weeks, but that sometimes it can be something more serious like a broken foot, and not to try to diagnose the cause yourself.

A fracture of the foot is an injury to one or more bones in the foot, according to University Hospitals Sussex. Fracture and break mean the same thing. The metatarsal bones are the long thin bones in the middle of the foot, and Cambridge University Hospitals says a metatarsal fracture is usually caused by a sudden forceful injury such as dropping a heavy weight on the foot, kicking a hard object or a sports injury.

Stress fractures are different. Cambridge says they happen over a longer period through overuse, such as repeated impact on the bone or a sudden increase in training without adequate rest.

The NHS says to contact NHS 111 if you have severe pain in the top of your foot, you are not able to walk, your foot has changed shape or is at an odd angle, you heard a snap, grinding or popping noise at the time of injury, you feel faint, dizzy or sick from pain, your foot is also hot and swollen, or you have a very high temperature or feel very hot, or cold and shivery. It says these might be signs of a broken bone after an injury or an infection.

The NHS also says to see a GP if the pain in the top of your foot is stopping you doing normal activities, is getting worse or keeps coming back, has not improved after 2 weeks of home treatment, or if you have any tingling or loss of sensation in the foot. If you have diabetes and foot pain, see a GP, because foot problems can be more serious if you have diabetes.

Treatment depends on which bone is broken and how. For many simple foot fractures, hospital leaflets describe treatment without an operation. Cambridge University Hospitals says metatarsal and stress fractures are minor and stable and can be managed in a supportive boot worn for up to 6 weeks, with crutches in the early stages if needed. University Hospitals Sussex describes a boot or rigid sole shoe given for comfort only.

Pain relief is usually with ordinary painkillers. University Hospitals Sussex says to take your usual painkillers or those given in the emergency department, following the dose on the packet, and to speak to your GP or pharmacist if you are struggling. Ice wrapped in a damp towel can be applied for up to 15 minutes every few hours, and the ice must never be in direct contact with the skin.

Cambridge advises taking painkillers as needed, using ice wrapped in a tea towel and elevating the foot, gently starting to move the ankle as pain allows to prevent stiffness, and avoiding contact sports that risk further injury. It also says not to drive while wearing the walking boot, as this may void your insurance if you have an accident.

University Hospitals Sussex says it usually takes 6 weeks for a foot fracture to heal, and that you may have foot pain and swelling for 3 to 6 months after the injury. Swelling is often worse at the end of the day and should be clearly improving from 4 weeks onwards; if not, contact the fracture clinic.

The leaflet sets out a staged approach. In the first 24 to 72 hours, rest and raise the foot above hip level. Keep moving and walk as much as is comfortable, doing gentle foot and ankle exercises about 5 times a day from the start, which helps blood circulate and lowers the chance of a blood clot. From about week 2 to week 5, reduce use of the boot and move on to gentle stretches, and avoid impact activity such as running, jumping and dancing for 3 months. From week 6, balance exercises are suggested and the fracture should be healed.

University Hospitals Sussex says you can return to driving when you are no longer using your boot or rigid sole shoe, can walk comfortably, can safely deal with emergency situations without pain or hesitation (for example stopping the car quickly and safely) and are covered by your insurance company. Always try driving in a safe place first.

Cambridge advises that when returning to training or running, you start slowly and build back up by no more than 10% in intensity, frequency and duration per week.

For a work note or a return to usual activities, the Sussex leaflet advises contacting the fracture clinic that treated you.

University Hospitals Sussex says that if you have diabetes there is a greater chance that pressure on the skin over a long period could cause skin ulcers, and that wearing a boot or rigid sole shoe could cause pressure on your skin. It advises asking the fracture clinic for boot care advice, checking your skin every day for redness (which may look different on black or brown skin) and getting in touch if you notice any changes.

It also says to contact the fracture clinic if after 6 weeks you still have a lot of pain and swelling, struggle to walk without your boot or rigid sole shoe, or are struggling to return to exercise 6 to 8 weeks after injury. Cambridge says to contact your GP if your condition is not improving or your pain relief is not adequate.

The NHS lists other causes of pain in the top of the foot that can look similar. Severe pain, swelling, bruising and limited movement suggest a fracture. Pain, swelling and bruising that start after intense or repetitive exercise suggest a sprain or strain. Long-lasting pain, swelling and stiffness with a grating or crackling sensation or a lump along a tendon suggest tendonitis or osteoarthritis. Red, hot, swollen skin with sudden severe pain when anything touches the foot, usually starting near the bottom of the big toe, suggests gout. Tingling, numbness or pain in the upper foot that may stretch up the back of the leg suggests sciatica.

Because these can look alike and a fracture needs an X-ray to confirm, an assessment is needed when you cannot be sure.

On the NHS, a suspected broken foot is assessed through NHS 111, an urgent treatment centre or an emergency department, where an X-ray can confirm the break. Many fractures are then managed through a fracture clinic, sometimes using a virtual clinic with advice by phone or message. Private orthopaedic and foot clinics can also assess and X-ray a foot. The decision on boot, cast or surgery depends on the type of break, not on where you are seen, and your GP should be informed of the outcome.