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What You Need to Know About a Bone Bruise

author image Sharon Brock
Sharon Brock, MS, is a content editor for LIVESTRONG.COM with a focus on health. Brock was previously the lead editor for two medical publications at USC medical center. She was pre-med as an undergraduate and earned a master's degree in journalism from Columbia University. You can find Brock's work in several publications, including Yoga Journal, 7x7, New You and
What You Need to Know About a Bone Bruise
Bone bruise on the knee. Photo Credit: IpekMorel/iStock/Getty Images

A bone bruise is a lot more painful and the pain lasts longer than the giant swelling of a bruise on the skin or in the muscle. It is one step before a fracture. The bone has a cortex with interconnected fibers and calcium fills the spaces between the fibers. When the bone strikes something, those fibers break and leak out the contents held between them. If enough fibers break then the result is a fracture of the bone. A bone bruise occurs when only a few of the fibers break.

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What is a Bone Bruise?

Bones are composed of a network of fibers that help retain calcium, a mineral in the body that keeps bones healthy and strong. If a bone is damaged, a small number of these tiny fibers can break apart, resulting in a deep bone bruise. This condition, which is also called a periosteal hematoma, occurs when the outer layer of a bone, called the cortex, sustains small breaks following injury or trauma. If enough fibers break, the result is a fracture of the bone. A bone bruise occurs when only a few of the fibers break. If you are taking medication that thins your blood, you may be at greater risk for bone bruises.

Deep Bone Bruise Symptoms

Bone bruises are a lot more painful and last longer than a bruise on the skin or in the muscle. Deep bone bruises can cause severe pain for several weeks or even months. There is also swelling and discoloration with bone bruises since the muscle and tissue surrounding the affected bone are also damaged. The skin around the injured bone can appear enlarged and puffy, tender to the touch and can appear blue or purple due to pooled blood beneath the skin. As the bone bruise begins to heal, the injured skin may appear green or yellow in color, until it is completely healed and regains its normal coloring.

What are the Best Treatments for Bone Bruises?

Immediately after injury, apply an ice pack to the area 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 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 (heat pack or hot water bottle) to reduce the risk of burns.

More Treatments for Bone Bruises

Other important treatments are to rest and elevate the injured area as much as possible, as well as take an over the counter anti-inflammatory pain medication such as ibuprofen (Advil, Motrin) or naproxen (Aleve). Resting allows the body to generate new bone tissue without stressing the injured area. Depending on the severity, patients may continue light activity wearing a splint, elastic bandage or athletic tape, while more severe cases may need crutches or a sling to prevent any more damage and allow for healing.

When Should I go to a Doctor for a Bone Bruise?

Patients who experience severe pain from a bone bruise should contact a doctor immediately after the injury to find out if they have a bone fracture, which is diagnosed with an X-ray. Some scientists are linking bone bruises with other more serious conditions such as ACL injuries and arthritis, therefore you should see a doctor immediately if your pain is moderate but you also have one of the following symptoms: - You don’t see improvement, or if swelling increases, after 3 or 4 days of icing, resting and anti-inflammatory pain medication. - If you have pain while stretching or bearing weight in either leg. - If the skin is pale and cool below the injury.

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