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What is a Contusion? Causes and Treatment

cartoon man with a black eye bruise

A contusion is the medical term for a bruise. It refers to bleeding under the skin, which causes the bruised area to look red, blue, purple, or black. Contusions can also occur in the bones, muscles, and other organs. Please continue reading to learn more about what causes contusions, how to treat them, and when to seek evaluation by a healthcare professional.

What are the different types of contusions?

Subcutaneous contusion

This is a common injury. Most people have experienced subcutaneous contusions at some point in their lives. It is a type of bruise that develops just below the skin’s surface. It happens due to injuries to tiny blood vessels in the affected area. Parts of the body such as the hands, elbows, and knees are particularly vulnerable to subcutaneous contusions because you tend to use them to stop falls or protect your face.

Muscle contusion (bruise)

A deeper contusion that causes injuries to the blood vessels in a muscle can cause severe pain. Muscle contusions are sometimes mistaken for sprains, strains, or broken bones.

Bone bruise

Bone contusions can cause symptoms similar to a fracture (broken bone). For example, a bone bruise in a rib can make it difficult to breathe. Damage to the hard outer part of the bone can cause tiny fractures. The soft bone marrow inside can also be damaged by a bone contusion. A complication of a bone bruise called osteochondritis dissecans can occur in joints like the knee and ankle. It happens when a bruise interferes with blood flow, and a small piece of bone separates from the main bone. 

Cartilage contusion

Cartilage is a connective tissue that is softer than bone but harder than muscle. The outer ear and tip of the nose are made of cartilage. A sharp blow or bending of the cartilage can cause a bruise in this tissue. 

Organ contusion

Organs inside the body, such as the heart, lungs, kidneys, and liver, can develop contusions as well. 

Eye contusion

A bruise around the eye can be painful, but it usually heals without problems. However, a contusion of the tissues inside the eye, such as the cornea, is more serious and usually requires treatment from a healthcare provider.

What is most likely to cause a contusion?

Bruises can occur due to a fall, bump, direct blow, or motor vehicle collision. Playing contact sports is a risk factor for suffering a severe contusion. In fact, bruises are common sports injuries. Physical abuse can also lead to bruises.

Some people are at higher risk of developing bruises, such as:

  • Professional athletes and people who participate in vigorous exercise.
  • Elderly people because they have thinner and more fragile skin.
  • People with a bleeding disorder. 
  • People taking blood thinner medicines.

What are the signs and symptoms of a bruise?

When a bruise occurs, you may experience:

  • Throbbing or aching pain in the bruised area.
  • Reddish or bluish discoloration of the skin.
  • Swelling in the injured area.
  • Difficulty moving the area in case of severe contusions.

What is the treatment for a contusion?

Most bruises on the skin, muscles, cartilage, and bone heal on their own without any specific treatment. The RICE protocol can help with symptoms and speed healing of bruises. 

  • R (Rest): You should avoid exercise and sports until the injured area heals. Your healthcare professional may perform a physical examination and recommend splinting or wrapping the area.
  • I (Ice): You can apply ice packs or cold packs to the area for 20 minutes several times to reduce swelling and pain. 
  • C (Compress): Gentle compression bandages or wraps can help to reduce swelling and pain
  • E (Elevate): Raising the injured area above the level of the heart can help with swelling and pain. You can do this by placing the affected area on a few pillows.

In addition, you can take over-the-counter medications for pain relief. The discoloration of the skin caused by a bruise in the acute phase slowly fades with time. 

Can contusions be serious?

Contusions can be serious. You should see a healthcare provider and be medically reviewed in the following situations:

  • Seek immediate medical care from a doctor for severe pain if you feel weak or if you have suffered a hard blow to the chest, back, or head.
  • See your doctor immediately if you have a large bruise, have suffered other injuries, or have active bleeding in the injured area.
  • Consult a doctor following any serious trauma, such as a car accident, a fall from a great height, or a fight. You may have further injury that is not obvious but needs to be treated.
  • Seek medical care if you have a large volume of blood that has collected and is causing painful swelling. This is called a hematoma, and it can cause tissue damage. Left untreated, it can lead to a serious complication called compartment syndrome.
  • You should have bruises evaluated by a medical professional if you have certain health conditions like bleeding disorders or if you take medications called blood thinners that can cause easy bruising. 
  • Bruises of the internal organs can be serious and may require treatment in the hospital. This may include surgery to perform repairs or stop bleeding. Seek immediate medical help for signs and symptoms such as difficulty breathing or changes in heart rate.

Wrapping up

A contusion is an injury to the small blood vessels in the soft tissues under the skin’s surface. It usually occurs without breaking the skin. Contusions or bruises can also occur in bones, muscles, and other internal organs. 

People who have experienced bumps, blows, falls, or car accidents can develop bruises. Contact sports are a common cause of bruises. If you play sports, always wear protective gear to reduce your risk of contusions.

Most minor bruises (contusions) heal on their own in a few days. Larger contusions can take several weeks to fade. Most contusions do not require any specific medical treatment other than pain relief and a cold compress or ice pack along with rest, elevation, and compression. However, large contusions should be medically reviewed.


References:

  1. https://medlineplus.gov/bruises.html#
  2. https://orthoinfo.aaos.org/en/diseases--conditions/muscle-contusion-bruise/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4601975/