How are contusions treated?

A contusion is a bruise which occurs when you sustain a blow or force causing trauma. Most bruises heal quickly without the need for treatment. Some steps you can take to speed the healing process are medication such as ibuprofen and home care following the RICE method of rest, ice, compress and elevate.

Normally referred to as bruises, contusions are common injuries. You can get one if you slip and fall, get injured from sports, or even from moving furniture. 

In most cases, these contusions are minor and heal quickly. Proper contusion treatment and rest are necessary for a full recovery.

A contusion is the same thing as a bruise. Bruising happens when you sustain a blow or force from another source and receive some type of trauma. 

Bruising isn’t like most injuries where your skin breaks and starts to bleed. When you bruise, the force that hit you was not powerful enough to break your skin. Instead, it was powerful enough to break the tiny blood vessels beneath your skin and cause them to bleed. 

Contusions can range in severity. They can be small and harmless. They can also be larger and lead to serious complications. 

You can get a bruise from knocking your knee against a table or by sustaining a heavy blow to the head. A head injury can even bruise a part of your brain. This is called a cerebral contusion.

Anyone can get a bruise, but children, athletes who play sports, and people who are older are more likely to get contusions. Contusions can happen on the:

• Skin
• Muscle
• Bone

While all types of contusions will cause at least some discomfort, bone contusions are the most painful. They also take the longest to heal. It’s common for other injuries to happen alongside a bone bruise, such as a ligament sprain. 

People who have arthritis can also get bone bruises. That’s because arthritis affects the bone cartilage. If the protective bone cartilage is worn down, your bones can knock together and bruise. 

The typical signs and symptoms of a contusion involve: 

• Discoloration of the skin: Your skin may darken or turn a black-purple color when you first sustain a contusion. In the following days or weeks that color will change as the bruise heals. 
• Affected area is weak and stiff: You may feel pain when pressing on the affected area. 
• Swelling on the site: The area where you sustained the bruise could be swollen and painful. You’ll probably have limited range of motion in that area.

Only a licensed healthcare professional can diagnose whether your contusion is serious enough to need further medical care than simply rest and time.

You should see the doctor for your contusion if:

• The swelling on your contusion doesn’t reduce or show any signs of healing after 1 to 2 days.
• It’s a particularly large bruise.
• The trauma you sustained was to your head.
• The bruise limits your range of motion in a joint, like the knee or elbow. 

Your doctor will ask you about your symptoms and medical history. They may give you an x-ray to rule out any broken bones. If they suspect a bone bruise, they can recommend a magnetic resonance imaging (MRI) scan to confirm the diagnosis. An MRI is the only way to see a bone bruise.

Most bruises heal quickly without the need for careful treatment. There are steps you can take to speed the healing process and make sure your bruise doesn’t cause any complications. 

Medications

Your healthcare provider can prescribe a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen to help relieve your pain. The pain in a bruise should subside within the first week. 

You might still see some discoloration of the skin after the pain goes away.

Home care

During the first 24 to 48 hours after the bruising, it’s important to follow the RICE method to speed healing:

• Rest: This means avoid moving the affected area. If the bruise affects your joints or ligaments, the doctor may prescribe crutches or a supportive sling to use while the injury heals. 
• Ice: Icing the bruised area will help any swelling go down. Apply an ice pack for 10 to 20 minute intervals, three or more times a day to reduce swelling.
• Compress: Using a compression bandage, especially on a joint like the knee, will reduce the swelling and provide support. 
• Elevate: Elevate the affected area above your heart level. This will reduce the blood flow to the area and also work to reduce swelling so the healing process can take place. 

Alternative therapies

You may need to wear a brace or walk with crutches to limit movement in the bruised area. This will help speed your healing and ease your pain.

You might face these serious complications if you have a severe contusion and it is left untreated: 

• Avascular necrosis: This condition can happen if you have a very large bone bruise and your body has trouble returning blood circulation to the bone. This causes a portion of the bone tissue to die.
• Compartment syndrome: Compartment syndrome happens when your injury causes the pressure in your muscles to reach dangerously high levels. It decreases blood flow, which can prevent blood and nutrients from reaching your muscles.
• Myositis ossificans: This condition can cause you to develop bones inside of muscle tissue. This is often the result of repeated deep bone bruises to the same tissue.