Bone Bruises (Bone Contusions)
Introduction
A bone bruise, also called a bone contusion, is an injury to the bone that is less severe than a fracture. It happens when the bone sustains a strong impact that damages the internal structure of the bone but does not break it completely -a microscopic injury to the bone. This type of injury often occurs after a fall, a sports injury, or a direct blow to the body. Commonly affected areas include the knee, ankle, hip, and wrist. Symptoms can include pain, swelling, stiffness, and tenderness over the injured area.
Why Bone Bruises Cause Symptoms
A bone bruise occurs when when an injury causes microscopic damage to the bone itself, but no obvious fracture. The injury causes tiny blood vessels inside the bone to break leading to bleeding and swelling within the bone itself. This can make the area painful and sensitive, and sometimes the joint around the bone feels stiff or sore. Bone bruises can also be slow to heal because bones have less blood supply than soft tissues. The severity of symptoms may range from mild discomfort to significant pain that limits walking, exercise, or sports activity.
Diagnosis of Bone Bruises
To diagnose a bone bruise, a doctor will ask about how the injury happened and what symptoms are present. They will examine the affected area for swelling, tenderness, and range of motion. While X-rays are often used to rule out fractures, they cannot show bone bruises. An MRI is the best imaging test for detecting a bone bruise, as it can show the bleeding and swelling inside the bone. In some cases, a bone bruise is suspected based on symptoms and mechanism of injury, even without advanced imaging.
Treatment of Bone Bruises
Most bone bruises heal with conservative, non-surgical care. Treatment focuses on rest and protecting the injured area. Patients are often advised to limit weight-bearing activities, use crutches or a brace if necessary, and apply ice to reduce pain and swelling. Over-the-counter pain relievers like acetaminophen or anti-inflammatory medications (ex. ibuprofen) may also help. Physical therapy is sometimes recommended to restore strength, flexibility, and normal joint function once the pain improves.
When Surgery Might Be Needed
Surgery is rarely required for a bone bruise itself. However, if the bone bruise is associated with other injuries—such as severe ligament tears, cartilage damage, or a nearby fracture—surgery may be needed to address those problems. In those cases, surgery is not for the bruise directly but to stabilize the joint and repair other damaged structures, which allows the bone to heal properly.
Prognosis and Long-Term Outlook
The outlook for a bone bruise is usually very good, but healing can take time—often several weeks to a few months, depending on the severity of the injury. Most people fully recover without long-term issues. However, in more severe cases, a large bone bruise can increase the risk of developing arthritis in the affected joint later in life. Proper care, rest, and follow-up with a doctor help ensure the best outcome.
Edited by Stephen Pinney MD, October 1st 2026.