Although the term “bone bruise” seems to indicate a relatively mild injury, in actuality it is no less severe than a broken bone. Also referred to as a bone contusion or bone swelling, bone bruises result from an acute trauma or a repetitive stress injury, and should be treated professionally.
A bone bruise occurs when the inner structure of your bones becomes fractured. Bone is made up of two different types of tissue: compact “cortical” bone on the outside and “cancellous” or “spongy” bone on the inside. Cortical bone is strong and solid, whereas spongy bone, as its name suggests, is a more delicate meshwork of bone tissue that can more easily suffer many small fractures, resulting in a bone bruise.
An acute trauma or stress to a bone may not be sufficient to fracture the outer bone, but there may be enough force to cause the spongy inner bone to fracture, leading to bleeding in the injured area. Sports injuries may be one of the most common causes of bone bruises, when an athlete falls or bumps into another person with considerable force. Auto accidents, falls and twists, particularly to the knees and ankles, also frequently result in a bone bruise. Other areas likely to sustain a bone bruise are the wrist, foot and hip.
Symptoms of a bone bruise (which include pain, stiffness and swelling) can sometimes be mistaken for tendon or ligament damage, or even a muscle bruise. Intense pain that lasts more than a couple of days (and often for weeks or months) may be a sign of a bone bruise. Stiffness may occur if the bone bruise is located near a joint or is in part of the joint. However, swelling is the leading symptom of a bone bruise, and there will usually be no sign of bruising on the skin, as the bleeding occurs within the bone itself. If you think you may have a bone bruise, an MRI can determine whether it’s that or something else. X-rays and CT scans can only indicate a fracture of the outer bone.
A bone bruise usually takes several months to heal because the inner spongy bone takes longer to repair than the outer layer. Treatments typically involve rest to take any pressure off the bone, elevating the affected area to help reduce swelling, taking an anti-inflammatory pain reliever and using ice packs to relieve pain soon after the injury. A brace can be worn to provide support to the injured area and reduce healing time. Experts also recommend that people quit smoking if they want the bone to heal more quickly, since smoking constricts blood vessels, reducing the circulation necessary to bring healing.