What Is a Bone Bruise?

Medically reviewed by William Morrison, MD on April 15, 2016Written by Ann Pietrangelo

Bone bruise

When you think of a bruise, you probably picture a black-and-blue mark on your skin. That familiar discoloration is the result of blood leaking beneath the surface of your skin after you’ve injured a blood vessel.

A bone contusion, or bone bruise, happens when you have a small injury on the surface of a bone. The discoloration appears as blood and other fluids build up. A fracture, on the other hand, involves damage to a deeper area of bone.

It’s possible to bruise any bone, but it’s more likely to happen to bones that are close to your skin’s surface.

What are the symptoms of a bone bruise?

It’s easy to assume you have a regular everyday bruise if your skin looks black, blue, or purple. Your injury may run a little deeper, though. Symptoms that suggest you may have a bone bruise include:

  • stiffness
  • swelling of the joint
  • tenderness and pain lasting longer than a usual bruise
  • trouble using an injured joint

A bruise involving your knee can lead to a buildup of fluid on the knee, which can be painful. Depending on how the injury happened, you might also have damage to nearby ligaments.

Bone bruises can last anywhere from a few days to a few months.

What are the risk factors for bone bruises?

Bone bruises are fairly common. Anyone can get one. The bones that you’re most likely to bruise are the ones in your knees and heels.

A bone bruise is usually the result of a direct hit to the bone, which can occur during fall, accident, or bump during a sports event. You can also bruise your bone if you twist your ankle or wrist.

You might be more prone to bone bruises if one or more of the following applies to you:

  • You’re active in sports, especially high-impact sports.
  • You don’t wear proper protective equipment.
  • Your job is physically demanding.
  • You take part in an activity that’s physically demanding.

Osteoarthritis

If you have osteoarthritis, bone surfaces grinding against each other can lead to bruising. The treatment for arthritis sometimes involves injecting corticosteroids into a joint. It’s unusual, but corticosteroid injections can cause bone bruising in some cases.

When should you see your doctor?

When you get a bone bruise, it’s hard to tell if it’s related to a more serious problem that needs treatment. It’s always a good idea to get a doctor’s opinion.

Seek prompt medical attention if any of the following occurs:

  • The swelling won’t go down.
  • The swelling is getting worse.
  • The pain is increasing, and over-the-counter pain relievers aren’t helping.
  • Part of your body, such as your fingers or toes, are turning blue, cold, and numb.

Those symptoms may indicate a severe bone bruise. Sometimes, a bone bruise is only one part of the injury. You could also have a fracture or a break. A bone bruise on your knee could mean that you’ve ruptured a ligament.

A particularly severe bone bruise can interfere with blood flow. It’s not common, but this can cause part of the bone to die. If the bone dies, the damage that occurs is irreversible.

That’s why it’s important to talk to your doctor and report symptoms that won’t go away. Your doctor will probably be able to diagnose a bone bruise based on your symptoms and a physical exam.

If they suspect you have a bone injury, an X-ray can help determine if you have a bone fracture or break, but it can’t help your doctor detect a bone bruise. Getting an MRI scan is the only way to know for sure if you have a bone bruise. Those images can potentially show if the injury is greater than a bone bruise.

How are bone bruises treated?

For a minor bone bruise, your doctor may recommend rest, ice, and pain relievers. They may suggest that you take nonsteroidal anti-inflammatory drugs, such as Aleve or ibuprofen.

If the bone bruise is in your leg or foot, elevate your leg to help ease swelling. Apply ice for 15 to 20 minutes a few times per day. Don’t put ice directly on your skin. Use a towel or an ice pack.

You may also have to avoid certain physical activities and sports until you’re fully healed. Relatively minor bone bruises can start to get better within a few weeks. The more severe ones can take several months to heal.

Injury to a joint may require a brace to keep the joint still while it heals. If you need a brace, splint, or crutches, use them as your doctor prescribes and follow up as your doctor recommends.

Bone injuries can take longer to heal if you smoke. Depending on the extent of your injury, a physical therapist may be able to show you how to move your injured joint so that you don’t cause more damage.

You may need further diagnostic testing if your injury doesn’t heal.

What is the outlook?

You may have to rest for some amount of time, but it’s important to allow your bone to heal fully. Returning to your regular activities too soon can make things worse.

Although there’s a great variation in recovery time, it usually takes a few months to heal. Most of the time, there are no lasting problems. Complications are rare unless a more extensive injury occurred.

Tips for keeping your bones strong and healthy

Bone bruises aren’t always preventable. Certain lifestyle choices can help you’re your bones strong and healthy and improve their ability to heal. Follow these tips to keep your bones healthy:

  • Eat a well-balanced diet.
  • Get regular physical activity. Activity is good for your bone health, particularly weight-bearing exercise.
  • Always use the recommended protective equipment when playing sports.
  • Bones tend to weaken with age, so talk to your doctor about bone health at your annual physical.
  • Don’t smoke. It may weaken your bones.
  • Don’t have more than two drinks of alcohol per day. Drinking more than that may weaken your bones.

Make sure you get enough calcium

For good bone health, you need the right amount of calcium. Women between 19 and 50, and men between 19 and 70 should get 1,000 milligrams (mg) per day. The recommended amount increases to 1,200 mg per day for women after age 51 and men after age 71. Sources of calcium include dairy products, broccoli, and kale.

Make sure you get enough vitamin D

Your body also needs plenty of vitamin D to help absorb all that calcium. Most adults between the ages of 19 and 70 should get 600 international units (IUs) per day. At age 71, you should increase it to 800 IUs per day. Getting a little sunlight each day is a good way to absorb vitamin D. Egg yolks and fortified milk are also good sources of vitamin D.

If you don’t think you are getting enough calcium and vitamin D in your diet, ask your doctor or dietitian if you should take a supplement.

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