Whether it's a slip on a rug, a sidewalk stumble, or a soccer turf spill, accidents happen. How do you know when it's serious? Broken bones (fractures), sprains and strains often have similar symptoms, so uncovering the truth can be a tough mystery to solve on your own.
If you think you or a loved one has a break, sprain or strain, your best step is to get to the doctor, ER or urgent care (depending on time of day and urgency). An x-ray can confirm or rule out a broken bone, and the physician can quickly diagnose your injury and provide the treatment for your road to recovery.
Is it a break?
A fracture is a broken bone. There are different types depending on whether the bone is partially or completely fractured. Signs of a broken bone include:
- Pain located directly on top of the bone – where there is no soft tissue
- Pain becomes worse when you apply pressure or move the injured limb
- Severe swelling, or bruising over the top of the bone, numbness or tingling
- A "cracking" (not "popping") sound at the time of the injury
- The area looks lopsided or "deformed," or the bone is poking through
- Inability to use the limb that's injured – with a foot or ankle, you can't put weight on it, or even take 3-4 steps
An x-ray is used to confirm a break, and then depending on the severity, the injury generally requires splinting or casting and immobilization. In more serious cases, surgery may be needed.
Know where to go for care
Broken bones - where should I go?
Urgent Care centers have x-ray capabilities and can diagnose, set, and splint a variety of fractures
ERs have x-ray capabilities and can diagnose, set, splint, and cast all types of fractures
Go to an ER if you suspect:
- the bone or joint is very broken or dislocated
- a break in a large bone such as the femur (thigh), pelvis, or hip
- a fracture in the skull, eye, or dental bones
- a spinal fracture (this may be better imaged by a CT scan)
Tulane Health System has two ERs conveniently located the greater New Orleans area, with some of the shortest wait times in the region. Also, both emergency rooms are prepared with equipment and care specially designed for your kids.
Is it a sprain?
Ligaments connect bone to bone at the joint. Stretching or tearing a ligament causes a sprain. The most common location for a sprain is the ankle, although it can happen to wrists, elbows or any other joint. Some signs of a sprain are:
- Pain that is in the soft, "squishy" tissue over a bone rather than directly on the bone itself
- You can usually put weight on it, even if it's painful
- Swelling and bruising around the area
- Limited movement or mobility of the affected area
- A "popping" (not "cracking") sound at the time of the injury
Treatment for a sprain
With any possible sprain it's best to see your physician or visit an urgent care center.
Until you see a doctor, use the RICE method (as described below) as soon as possible to ease some of the discomfort, swelling and bruising.
Is it a strain?
Tendons are tissues that connect muscle to bone. Stretching or tearing a tendon or muscle causes a strain. A strain can seem like a sprain because they both involve the tissue around a joint. Strains can be a result of overuse, trying out a new exercise or sport your muscles aren’t used to, or that first weekend of heavy yard work after the winter. Signs of a strain are:
- Difficulty moving the muscle
- Muscle spasms
Treatment for a strain
Any suspected strain should be diagnosed by your physician, or at an ER or urgent care center. This is especially important in children to ensure there is no growth plate injury. The treatment for minor strains is the same as for a sprain – rest, ice, compression and elevation (RICE). In more severe cases, physical therapy or exercise may be needed to help the injury fully heal.
Home treatment for minor strains and sprains
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, aspirin and naproxen can help reduce the pain and inflammation from a sprain or strain. They should be taken only as directed on the bottle (Please don’t take these types of medicines if your physician has advised avoiding them.)
Many experts also suggest the RICE method as soon as possible after the injury to ease some of the discomfort, swelling and bruising.
- Rest: Rest and protect the injured area for a day or two after the injury. Then try stretching and gentle exercise to help increase blood flow to the affected area, thus promoting healing.
- Ice: Apply ice or a cold pack to reduce or prevent swelling. Apply for 10 minutes, then remove for 10 minutes. Repeat this as often as possible while awake for the first one to two days. Make sure and wrap the ice or cold pack in a towel, don't apply directly on your skin.
- Compression: Wrap the injured wrist, ankle, foot, etc. in elastic bandaging to reduce swelling and maintain stability. Be careful not to wrap it too tightly because this can hinder your circulation. The compression should feel like a gentle squeeze to the area.
- Elevation: Rest your sore foot or ankle on a pillow any time you're sitting or lying down. The injured part should be elevated above your heart, which helps reduce swelling.
If after a few days, the pain is still severe, there is major bruising or blisters and you still can't put any weight on the sore limb, it's time for a trip to your doctor or urgent care for a definitive diagnosis and treatment plan.