Bone stress reaction – what, why and how to fix it

  • Bone stress reaction causes a dull, usually prolonged, ache around the injury site
  • A bone stress reaction can occur due to impact loading or connective tissue traction
  • Reactions caused by impact loading can progress to bone stress fractures with ongoing overload


  • Bone stress reactions often occur with other injuries and can be difficult to diagnose in its early stage
  • The symptoms from bone stress reactions are significantly relieved by anti-inflammatories, however use of these medications can worsen the condition due to their effect on bone healing
  • The duration of soreness after activity can be an effective gauge of the severity of the reaction


  • Not all bone stress reactions are at risk of progressing to stress fracture. Reactions caused by the pulling force from tendons or other connective tissues cannot progress to stress fractures
  • Treatments that ease the symptoms, such as medication or ice packs, do not directly assist the recovery of the injury
  • Rest alone won’t resolve a bone stress reaction. It will ease the symptoms within a few days but the condition is much slower to respond and usually flares up soon after the return to loading