Introduction
A bone bruise is a contusion of the bone. Bone Bruises are closely related to bone fractures. They are caused by blunt blows or direct violent impact on a bone, but do not break it. The cause of the pain caused by a bruise is the destruction of the surrounding tissue and the smaller blood vessels. The extent of a Bone Bruise ranges from not noticeable to severe pain with an externally visible bruise and consequential damage.
Treatment
A Bone Bruise can occur on any bone in the body. However, the basic treatment remains the same. Immediately after the bruise develops, the affected part must be spared.
Often the violent impact occurs during sports or in an accident. The bruised region should not be stressed any more and should be immobilised immediately. In addition to relief, the affected area should be elevated.
The effect of elevation is that less blood flows through the bruise due to gravity and any bleeding with subsequent haematoma is reduced. The duration of treatment of a bone bruise depends on the severity and degree of injury. It can last from 3 weeks to 2 years in complicated cases and depends largely on the general condition and behaviour of the person affected.
The size of the edema can provide information about the severity of the bone injury. First of all, in the case of a bone bruise, care should be taken, especially from the loads that exert pressure on the injured bone. In the further course of the disease, it is then advisable to slowly increase the load in accordance with the intensity of the pain.
During the process, painkillers such as aspirin, ibuprofen or diclofenac can be taken and the bone metabolism can be supported by taking vitamin D. By continuing with all usual activities and sports, the healing process is unnecessarily prolonged. The location of the bone bruise is also related to the duration of treatment. For example, an injury to the pubic bone is sometimes the site that requires much longer therapy than other sites.
A splint or support bandage can also be used for immobilization. A support or pressure bandage additionally counteracts bruising by reducing swelling and bleeding through targeted external pressure. Cooling from the outside is also beneficial.
The cold causes the small affected blood vessels to contract and less blood can escape from them and cause bruising in the tissue. A smaller bruise will disappear within a few days to a few weeks. In addition to these immediate measures after the bruise, some medications can make the healing period more bearable.
Non-prescription painkillers can alleviate the ongoing and load-dependent pressure pain. The time cannot usually be shortened by medication or other therapies. Painkillers reduce the pain until it heals on its own and thus treat it symptomatically.
Typical means for this are the group of NSAIDs. These include ibuprofen and diclofenac. In the case of large bruises, the body is not able to reduce them on its own.
In this case it may be necessary to puncture the effusion or open it surgically to remove the fluid. An invasive procedure always carries risks, but in this case it can prevent infections in the tissue. Bleeding that affects the bone marrow, among other things, can damage bones for weeks.
This can lead to osteoporosis, which can lead to fractures in other parts of the body. In the case of severe bone bruises, which are accompanied by bone loss, bisphosphonates are the means of choice to strengthen the bone again. The total healing time of a contusion is determined by the extent of the bruise.
Especially the immediate measures consisting of rest, cooling, pressure bandage and elevation can facilitate healing in a preventive way. The knee is a typical location for a bone bruise. Due to its prominent exposed position, it is often affected by direct, blunt force.
It is often harmless. In case of severe pain, however, a doctor should be consulted to rule out further damage to the knee structures or bone fractures. Under the kneecap there is a large number of soft tissue structures and bones which are affected depending on the extent of the bone bruise.
Often only the fatty tissue is affected. However, small blood vessels and the joint capsule can also be damaged, resulting in bleeding into the knee joint and a painful hematoma. The knee swells, overheats and can sometimes appear visibly blue-reddish in colour.
Since it is used for a variety of everyday movements, the pain results in severe movement restrictions. For treatment, the typical immediate measures must also be taken immediately after the injury has occurred. Painkillers can be used as tablets or creams on the knee.
In the case of pronounced haematomas, the effusion in the knee can be largely suctioned out with a cannula. A bone bruise of the shoulder occurs mainly during sports with intensive body contact or during falls in which the affected person falls on the shoulder without supporting himself. Blue-reddish discolorations visible from the outside can quickly develop.
In the event of severe pain, a doctor should rule out injury to the shoulder blade, collarbone, humerus or even the tendons and muscles in the shoulder girdle. Immediate measures must also be taken for the shoulder in order to limit the bruising in advance. Only the elevation of the shoulder can be fulfilled here only under certain circumstances.
In more severe cases, it may be necessary to immobilize the arm with a bandage or a sling. In most cases, only large rotational movements in the shoulder should be avoided. Bone bruises in the ankle joint often occur during ball sports, but can also be caused by accidents and other blunt violent impacts on the foot.
They should not be confused with ligament damage, for example when twisting the ankle. They cause similar pain, often with bruising and discoloration of the skin. The occurrence and walking is hindered in the case of a bone bruise.
After two to three weeks at the latest, most complaints should subside on their own. This is where the immediate measures are of great benefit. However, if the necessary rest for healing is not maintained, the process can be delayed up to months and be accompanied by constant pain.
Due to its prominent position on the arm, the elbow is also susceptible to bruising of the bone. In order to get a Bone Bruise, it does not even require an accident or sporting activity at the elbow. In most cases, only a pressure pain and a slight movement pain occur after the bruise.
If the pain is severe and excruciating, a doctor must be consulted and often a radiological image must be taken. In the case of severe contusions, the arm must be protected and cooled. Afterwards, only waiting and possibly pain-relieving medication will help.
Bone bruises on the elbow can affect the joint structure. Injuries to the bursa within the joint are also conceivable. If one of these structures is damaged, the healing process becomes more protracted.
Since the calcaneus is exposed to body weight on a daily basis and is surrounded by a cushioning layer of fat, bruises are rather rare. Especially in sports involving heavy weights or jumps, bone bruises on the heel bone are mainly found. Pain when pressure is applied to the heel indicates that a bruise is present.
Depending on the degree of pain and if there is a bruise, the extent of the injury must be estimated. For complete healing, straining sports should be stopped and the foot should be relieved and protected. In this case, too, waiting in combination with pain-relieving medication is the most effective method of treatment.
