Contusions In Adults
What is a contusion?
A contusion is a bruise that appears on your skin after an injury. A bruise happens when small blood vessels tear but skin does not. When blood vessels tear, blood leaks into nearby tissue, such as soft tissue or muscle.
What causes a contusion?
A hard object or a strained muscle can leave a bruise on your skin. A twisted knee or ankle can cause a bone bruise. You may get a bruise near an area where you have had blood taken for medical tests.
What increases my risk of contusion?
- Illness: Bleeding disorders make you more likely to bleed, which increases your risk of bruising. Other illnesses, such as kidney and liver diseases or infections, can also increase your risk of bruises. Tell your caregiver if you or someone in your family bleeds easily.
- Medicines: Some medicines, such as blood thinners, will make you more likely to bleed and bruise. Some over-the-counter (OTC) medicines and herbal medicines may also make you bleed more easily. Tell your caregiver if you are taking any OTC, prescription, or herbal medicines.
- Other conditions: You have a greater risk of bruises if your skin and muscles are weakened. This may include people who are elderly or those with poor nutrition.
What are the signs and symptoms of a contusion?
Signs and symptoms may appear right away, or they may not appear until 24 to 48 hours after your injury. You may have any of the following:
- Pain that increases when you touch the bruise, walk, or use the area around the bruise
- Swelling or a lump at the site of the bruise or near it
- Red, blue, or black skin that may change to green or yellow after a few days
- Stiffness or problems moving the bruised area of your body
How are contusions diagnosed?
Your caregiver may ask about any injuries, infections, or bleeding problems you had in the past. He will check the skin over the injured area. He may touch it to see where it hurts. He may ask you to point to where it hurts the most. He may also check for problems you may have when you move your bruised area. You may need any of the following tests:
- Blood tests: Your blood may be checked for blood disorders or to see how long it takes for your blood to clot.
- Ultrasound: An ultrasound uses sound waves to show pictures on a monitor. An ultrasound may be done to see the bruise and how deep it is. An ultrasound can also show if any of your organs, such as your liver, are injured.
- X-ray: An x-ray will show any broken bones near the bruise.
- MRI: This scan uses powerful magnets and a computer to take pictures that may show if a hematoma (pooling of blood) has started to form. You may be given dye to help the pictures show up better. Tell the caregiver if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body.
How are contusions treated?
Your bruise may heal without any treatment. Treatment depends on the part of your body that is injured, and how serious your injury is. You may need any of the following:
- NSAIDs: These medicines decrease swelling, pain, and fever. NSAIDs are available without a doctor's order. Ask your caregiver which medicine is right for you. Ask how much to take and when to take it. Take these medicines as directed. NSAIDs can cause stomach bleeding and kidney problems if not taken correctly.
- Pain medicine: You may be given prescription medicine to decrease or take away pain. Do not wait until the pain is severe before you take your medicine.
- Aspiration: Pooled blood in your muscle is drained to help prevent increased pressure in the muscle.
- Surgery: This may be done to repair a tear in the muscle or relieve pressure in the muscle caused by swelling.
What can I do to help my contusion heal?
- Rest: You may need to rest the injured area or use it less than usual. If you bruised your leg or foot, you may need crutches or a cane to help you walk. This will help you keep weight off your injured body part. Use crutches or a cane as directed.
- Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel and place it on your bruise for 15 to 20 minutes every hour or as directed.
- Compression: An elastic bandage may be wrapped around a bruised muscle to support the area and decrease swelling. Make sure the bandage is not too tight. You should be able to fit 1 finger between the bandage and your skin.
- Elevation: Elevate (raise) your injured body part above the level of your heart to help decrease pain and swelling. Use pillows, blankets, or rolled towels to elevate the area as often as you can.
- Do not massage or use heat: Heat and massage may slow healing of the area.
- Do not drink alcohol: Alcohol may slow healing of your injury.
- Do not stretch injured muscles: Ask your caregiver when and how you may safely stretch after your injury.
What are the risks of contusions?
- Some bruises may scar your muscles. Scar tissue may make you more likely to get bruises in the future. Bone bruises may lead to osteoarthritis. Osteoarthritis can cause stiffness and pain in joints, such as the knees and shoulders. You may have a hematoma (swelling filled with blood) that does not get smaller, and need surgery to drain it. You may get a hernia if you get a tear in the thin layer of tissue that covers the muscle. A hernia happens when muscle and fatty tissue push through the tear.
- Bony deposits may form within your muscles. You may also develop compartment syndrome. Compartment syndrome occurs when a hematoma or swelling at the injured site presses on nearby tissue. Muscles and blood vessels may be damaged. You may need surgery to relieve the pressure caused by swelling. If you do not get treatment for your contusion, it may not heal as quickly or as well.
How can I prevent contusions?
- Stretch and warm up before you play sports or exercise.
- Wear protective gear when you play sports. Examples are shin guards and padding.
- If you begin a new physical activity, start slowly to give your body a chance to adjust.
When should I contact my caregiver?
Contact your caregiver if:
- You find a new lump in the injured area.
- Your symptoms do not improve with treatment after 4 to 5 days.
- You have questions or concerns about your condition or care.
When should I seek immediate care?
Seek care immediately or call 911 if:
- You have new trouble moving your injured area.
- You have tingling or numbness in or near the injured area.
- Your hand or foot below the bruise gets cold or turns pale.
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.