How Do I Know If I Have a Sprain or Fracture?

Madeleine A.

To differentiate between a sprain or fracture the basic anatomy and physiology needs to be understood. A sprain happens as the result of the accidental tearing or stretching of a ligament, while a fracture is result of a broken bone. Symptoms of a sprain include pain, swelling, joint instability and bruising. While the symptoms of a fracture are similar, a fracture may cause segments of the broken bone to pierce the skin and poke through the tissue. This is called an open fracture, where a fracture that does not penetrate the skin is called a closed fracture.

Bruising will be a sign of a sprain.
Bruising will be a sign of a sprain.

When treating a sprain or fracture, ice should be applied to the area as soon as possible after the injury occurs. If a fracture is suspected, the individual should seek emergency medical treatment to avoid permanent deformity of the bone. At the hospital, doctors will take x-rays and usually set the fractured bone back into place before applying a cast. Open fractures may require surgery to repair the bone with wires or screws.

A person with a broken leg.
A person with a broken leg.

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Treating a sprain generally does not require surgery, but recovery time for severe sprains can be up to three months. Sometimes, physical therapy will be recommended to restore mobility and strength, however, the majority of sprains heal nicely with rest, elevation, ice, and anti-inflammatories. When an ankle sprain occurs, patients should avoid putting weight on the foot until this is deemed safe by the health care provider.

X-rays are good for diagnosing bone injuries.
X-rays are good for diagnosing bone injuries.

Regardless of whether the injury is a sprain or fracture, pain-relief measures will need to be considered. For either a sprain or fracture, anti-inflammatory medications are typically very effective in relieving pain and inflammation. In people who cannot tolerate anti-inflammatory medications, acetaminophen can be taken. Acetaminophen-based pain relievers are helpful for managing pain, though they do nothing to reduce inflammation.

An x-ray can be used to diagnose a fracture, but an ultrasound or MRI may be necessary to diagnose a sprain. Traditional x-rays are excellent tools for diagnosing bone injuries, but they do little to evaluate the condition of soft tissues, such as muscles and ligaments. Pain is usually not a diagnostic factor when determining if the injury is a fracture or sprain. Pain and other symptoms can be similar in both injuries, except in cases of open fractures. Whether the injury is a sprain or fracture, treatment needs to get underway quickly so that permanent disability does not occur and to facilitate the healing process.

Treating a sprain generally does not require surgery.
Treating a sprain generally does not require surgery.

Discussion Comments


Sometimes, it doesn't matter if there is a sprain or a fracture, because the treatment is the same. I had a very severe sprain a few months ago and I had to wear a cast for a whole month. If I had fractured my arm, I would have still worn a cast for a month!


@burcinc-- Yes, an x-ray is needed to diagnose the injury. But if your symptoms do not match those of a fracture, the doctor may not see the need for an x-ray. A fracture causes immense pain, swelling and the inability to move. A sprain causes these symptoms as well, but to a much lesser degree. For example, if you don't have any swelling and just some pain, you clearly don't have a fracture, just a mild sprain.

An x-ray is best when the symptoms are severe and the doctor can't tell if it's a fracture or a very serious sprain. An x-ray won't show the sprain, but if there is not fracture, there is only one other possibility. An MRI would be best to diagnose a sprain, but it's not usually preferred.


So technically, I need an x-ray to know whether I have a sprain right?

I injured my ankle today and went to the hospital. The doctor looked at my symptoms an examined my ankle. He told me it's sprained, told me to use ice packs and sent me home. Shouldn't he have asked for an x-ray?

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