Bone bruises are painful and often make daily activities difficult. Bleeding inside a bone -- damage to the bone marrow or the innermost layer of a bone -- may be classified as a bone bruise. These injuries are typically caused by trauma and can take several weeks or even months to fully heal, depending on the area of the body affected. Treatments such as heat, cold, elevation and activity modification can decrease symptoms caused by the injury. Follow your doctor's specific instructions to help your bone bruise heal.
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Rest is often part of the initial treatment for a bone bruise. This allows the body to generate new bone tissue without stressing the injured area, as stress could cause the bone to break. Injuries to the leg or foot may require the use of crutches to reduce the amount of weight placed on the injured bone. A brace, cast or sling may be used to rest bone bruises in the upper extremity. In some cases, you may be able to continue athletic activities while wearing a splint or using athletic tape to support the injured area.
Cold and heat application may be used to decrease pain caused by a bone bruise. Cold may be applied immediately after injury to reduce pain and swelling. An ice pack can be applied over a wet towel for 10 to 15 minutes every 3 to 4 hours. Ice is typically used for 2 to 3 days after injury or until swelling has subsided. Thereafter, heat can be applied to decrease pain and promote healing. Heat can be applied in a variety of ways, including heat packs, microwavable pads, hot water bottles or a hot shower. Heat is typically applied for 15 to 20 minutes at a time for 3 to 4 days. Place a towel between your skin and the heat source to reduce risk of burns.
Inflammation and Swelling
Your doctor may instruct you to take nonsteroidal antiinflammatory medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve) to reduce inflammation and promote healing of your bone bruise. These medications may also reduce pain and swelling. If possible, elevate the affected area above the level of your heart as often as practical throughout the day to decrease swelling. Using an elastic wrap to secure the ice pack will also provide compression to reduce swelling.
As your bone bruise heals, your doctor may allow you to gradually return to your typical activities. You may see a physical therapist who will guide you through appropriate exercises at each stage of healing. Range of motion exercises are typically employed first to decrease stiffness and improve mobility. Strengthening exercises are prescribed when the injured bone has sufficient strength to withstand resistance. Gait training -- to help you walk and stand properly -- may also be included if your lower extremity is affected.
Contact your doctor if you experience an increase in pain, swelling or stiffness while your bone bruise is healing. These symptoms should generally decrease with time. Inactivity while you rest the injured area of your body can lead to blood pooling in the veins. In rare cases, a blood clot may develop due to this pooling. Symptoms include redness, pain, swelling and warm or hot skin. This can potentially be a life-threatening condition. Seek immediate medical attention if you experience any symptoms that may indicate a blood clot.
- Sports Health: Traumatic Bone Bruises in the Athlete's Knee
- BMJ Case Reports: Carpal Contusions in an Elite Platform Diver
- American Academy of Pediatrics: November 2012 Case Study
- European Radiology: Clinical Consequences of Bone Bruise Around the Knee
- Dr. Nicholas Rizzo, M.D.: When to Use Heat and Cold for Athletic Injuries