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Bruises: Causes, Symptoms and Treatment

A bruise (contusion) is a soft tissue injury caused by blunt force without breaking the skin. Common signs include pain, swelling, and discoloration of the skin.

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Things worth knowing about "Bruises"

A bruise (contusion) is a soft tissue injury caused by blunt force without breaking the skin. Common signs include pain, swelling, and discoloration of the skin.

What are Bruises?

A bruise, medically referred to as a contusion, is an injury to the soft tissues beneath the skin caused by blunt force trauma. The impact damages small blood vessels, causing blood to leak into the surrounding tissue. This results in the characteristic discoloration, swelling, and tenderness associated with bruises. Bruises are among the most common injuries in everyday life and sports.

Causes

Bruises occur when the body receives a direct blow or impact from a blunt object. Common causes include:

Falls onto hard surfaces
Sports injuries, especially in contact sports such as football, basketball, or martial arts
Bumping into furniture or hard objects
Road traffic accidents
Workplace injuries

Muscles, bones (without fracture), joints, and internal organs can all be affected. In cases of severe impact, bone bruising or organ contusion (e.g., pulmonary contusion, kidney contusion) may occur.

Symptoms

The symptoms of a bruise depend on the severity of the injury and the area of the body affected. Typical symptoms include:

Pain at the site of injury, especially when touched or moved
Swelling due to bleeding into the tissue and the inflammatory response
Skin discoloration (hematoma): The skin turns bluish-purple shortly after the injury, then gradually changes to green and yellow as the bruise heals
Limited range of motion, particularly with joint or muscle contusions
Warmth and tenderness over the affected area

Diagnosis

Most bruises can be diagnosed through a physical examination. A healthcare provider will ask about the circumstances of the injury and examine the affected area. If a more serious injury such as a fracture or organ damage is suspected, imaging tests may be used:

X-ray: to rule out bone fractures
Ultrasound: to assess soft tissue damage and hematomas
MRI (Magnetic Resonance Imaging): for suspected ligament, tendon, or internal organ injuries

Treatment

Treatment depends on the severity of the bruise. Mild to moderate bruises can typically be managed at home using the RICE method:

Rest: Avoid putting weight or strain on the injured area
Ice: Apply a cold pack or ice wrapped in a cloth (never directly on the skin) for 15-20 minutes to reduce swelling
Compression: Use a bandage to help reduce swelling
Elevation: Raise the injured body part above heart level to reduce blood flow to the area

Over-the-counter pain relievers such as ibuprofen or paracetamol can help relieve pain. Topical anti-inflammatory gels containing diclofenac may also be applied to the affected area. Heparin creams can help speed up the reabsorption of the hematoma.

Severe bruises, particularly organ contusions or large hematomas, require medical attention. In rare cases, a large hematoma may need to be surgically drained.

When to See a Doctor

Medical evaluation is recommended in the following situations:

Severe or persistent pain
Significant swelling or a very large bruise
Suspected fracture or joint injury
Bruising on the head, abdomen, chest, or back
Loss of consciousness or confusion following an impact
Symptoms such as shortness of breath, blood in the urine, or severe abdominal pain after an accident

Prognosis

Simple bruises typically heal completely within a few days to two weeks. The discoloration follows a typical pattern, changing from blue-purple to green and then yellow before disappearing entirely. Severe contusions or organ injuries may take several weeks to heal. Early and consistent treatment helps speed up recovery and prevents complications.

References

Pschyrembel Clinical Dictionary. De Gruyter, Berlin. (current edition)
American Academy of Orthopaedic Surgeons (AAOS) - Muscle Contusion (Bruise). https://www.orthoinfo.aaos.org
World Health Organization (WHO) - ICD-11: Injuries and related conditions. https://www.who.int

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