Bruising: Information & doctors for the treatment of bruises

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

A bruise is usually caused by falls or impacts. Athletes have a particularly high risk of such injuries. The injury is usually harmless. Under certain circumstances, however, a doctor should check the extent of the injury in order to avoid complications.

Here you will find further information and selected doctors who treat all types of bruises.

ICD codes for this diseases: T14.05

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Article overview

What exactly is a contusion?

A contusion (ICD code T14.05) is a blunt injury without an open wound.

It is usually caused by a fall, a blow or the impact of a falling object. A bruise can also occur when a finger is caught. This bruises the tissue consisting of skin, muscle and fat.

A contusion is an injury that is generally harmless. Although it is accompanied by pain and tissue damage, it is not permanent. A bruise usually heals on its own.

Bluterguss Hämatom
A bruise is a common symptom of a contusion © frenta / Fotolia

Sports enthusiasts in particular have an increased risk of bruising. This applies in particular to contact sports such as soccer and ice hockey. In principle, however, a bruise can occur in any sport.

Whether due to a fall while cycling or a ball flying into the eye while playing tennis, bruising is one of the most common sports injuries of all. Athletes should therefore protect themselves well. Depending on the sport, there are different types of protective clothing, such as

  • helmets
  • back protectors or
  • shin guards

What are the typical symptoms of a bruise?

A bruise is typically accompanied by varying degrees of pain. The pain varies depending on the area of the body affected:

  • Joint contusions lead to movement-dependent pain.
  • Bruises to the back can lead to pain when walking and sitting.
  • Contusions of the coccyx make sitting particularly difficult.
  • Contusions of the skull can also cause headaches, but can also lead to serious symptoms such as unconsciousness and epileptic seizures. Medical treatment should then be sought immediately.
  • Bruising of the eyeball can impair vision.
  • If the ribs or thorax are bruised, those affected often suffer from pain when inhaling and coughing.

How does a bruise manifest itself externally?

Joint contusions often result in a bruise in the joint capsule. This can be seen externally by

  • swelling of the joint,
  • pronounced pressure pain and
  • a bruise

recognizable. The area where the greatest force was applied is also sometimes visible, as the skin here is sometimes reddened and swollen. Doctors also refer to this skin change as a bruise mark. However, the typical feature of the bruise mark is that the skin is externally intact. If, on the other hand, there is an open skin injury, it is referred to as a bruise.

Which parts of the body can be affected by a bruise?

Almost any part of the body can be affected by a bruise, although the superficial parts of the body are most frequently affected. However, internal organs can also be bruised, although a much stronger force is usually required here. Examples of organ contusions are

  • Bruising of the liver or spleen from blows to the abdomen (e.g. when falling onto the handlebars of a bicycle) or
  • bruised lungs after a fall onto the chest.

What are the most common bruises?

Areas of the body and especially bones that are only covered by a thin layer of skin are particularly at risk of bruising. The most common forms of contusion are therefore

  • bruised ribs
  • knee contusion
  • Skull contusion
  • shoulder contusion
  • Elbow contusion
  • Bruised foot

Is medical treatment always necessary for a bruise?

If you only have a simple bruise with minor pain, you do not need to see a doctor. In these cases, the bruise usually heals on its own within a few days.

However, if the pain is severe and persistent, does not improve significantly within a few days and may be accompanied by other symptoms, you should definitely seek medical help. There is a risk here that it is not a simple bruise, but that there are more serious injuries. For example, a broken bone, torn tendons or ligaments are conceivable.

If the skull is affected, there may also be brain damage, in particular a concussion (commotio), and you should generally have a medical examination.

What examinations are carried out to diagnose a contusion?

First of all, it is particularly important to find out how the accident happened, also known as the accident history. Here you will first be asked how the injury occurred and what specific symptoms occurred. Questions about previous illnesses and the intake of special medication are also part of the medical history.

In the case of skull injuries in particular, it is very important to know if you are taking blood-thinning medication, as this can cause bleeding inside the skull that is not visible from the outside. These bleedings can cause serious complications and be fatal, especially but not only in older patients.

After taking the patient's medical history, a physical examination is carried out. Ideally, this should start slightly away from the injury zone, as the bruised areas of the body are often very painful.

Specifically, it is checked whether

  • Swelling is present,
  • there is an accumulation of fluid, for example joint effusions,
  • the injured area is sensitive to pressure and
  • the patient's mobility is restricted.

An ultrasound examination (sonography) helps if joint effusions or injuries to the muscles and their bony attachments (tendons) are suspected and can be carried out quickly and without significant side effects.

If a bone fracture is suspected, an X-ray is taken. Further imaging procedures can be used to rule out injuries to the ligaments or if a brain contusion is suspected. These include a CT(computer tomography) or an MRI(magnetic resonance imaging).

What treatment options are there for a contusion?

Contusions rarely require invasive (= surgical) treatment; the measures used are generally symptomatic, which means they relieve pain and support healing. The so-called PECH rule has proved its worth here:

  • P - rest
  • E - Ice
  • C - Compression
  • H - elevation

Taking a break, especially from sporting activities, is natural and self-explanatory, as special movements and physical activities intensify the pain symptoms and are voluntarily avoided. Sport should initially be taboo after a bruise. You can only become active again once the bruise has healed completely.

Cooling the affected area is also advisable as it relieves pain and reduces swelling. This can be done, for example, with

  • a cooling pad
  • a cold washcloth or
  • ice cubes wrapped in a cloth

can be used.

If the extremities are bruised, you should apply an elastic pressure bandage for compression. Then elevate the arm, foot or leg, as this will reduce swelling and pain.

Pain-relieving ointments containing ibuprofen or the herbal active ingredient arnica can help relieve the pain. If the pain is very severe, a painkiller in tablet form can also be taken.

When is inpatient treatment in hospital necessary?

Medical treatment depends on the type and extent of the bruise. If, for example, the eyeball has been affected, special medication may be required which can only be administered under inpatient supervision. They lower the intraocular pressure. If the retina has detached, surgery is usually unavoidable.

In the event of a concussion (commotio), the patient is usually admitted to hospital for a few days. This ensures that staff can act quickly in the event of severe symptoms and deterioration. In particular, the use of blood-thinning medication should lead to rapid and very generous inpatient monitoring being arranged.

How long does it take for a bruise to heal?

This question cannot be answered in general terms, but depends on the severity of the bruise and the injured areas of the body. As a rule, a bruise heals completely within two to three weeks without serious consequences or complications. Severe bruises can sometimes take more than a month to heal. Minor bruises no longer cause any discomfort after just a few days.

Almost everyone suffers a bruise or two in the course of their life. As with most other injuries, the same applies here: Take it easy on the affected body region and pay attention to your body's signals (pain!). Then the bruise will heal quickly and without consequences.

You can then return to active sports and take part in everyday life without restrictions.

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