A bruise appears on the skin out of the blue, and you have a hard time trying to figure out what caused it. You ignore it, as it seems innocuous or try some home remedies. Often, the story ends there, with the bruise healing over time. But if the swelling and pain get worse, you should get it checked, as it could be a muscle hematoma, which can have serious repercussions if left untreated.
Bruises occur when there is extravasation (leakage of blood, lymph or other fluids) in the connective tissue of the skin or layers of tissue deep under the skin. However, a muscle hematoma is starkly different, where immediate medical attention is required. In certain cases, surgical intervention is also needed.
What is muscle hematoma?
Muscle hematoma or bleeding within muscles, leads to the accumulation of blood inside the tissues, causing pain and swelling. It is further classified into traumatic and spontaneous muscle hematoma.
“Traumatic muscle hematoma is caused by an injury that produces blood within the muscle and soft tissue,” says Dr Gokulraj Dhanarajan, head, orthopedics and knee replacement surgery, Fortis Hospital, Vadapalani, Chennai. “This can cause pain and swelling in an individual. Spontaneous muscle hematoma is seen in the elderly who are on anti-coagulant drug therapy. These medicines, when taken for a long time, cause spontaneous rupture of blood vessels, resulting in hematomas in and around the abdomen or sometimes around the buttocks.”
Symptoms and treatment of muscle hematoma
Just after the initial rupture of blood vessels within a muscle, swelling will set in, accompanied by pain. Over time, the swelling will increase, and people with a light skin tone will notice a bluish discolouration in the region.
“An individual with muscle hematoma can intermittently apply an ice pack for the first five to six hours. The ice should not be in direct contact with the skin and should not be applied beyond five minutes at a stretch,” says Dr Dhanarajan. “Initially, ice will have a soothing effect and constrict the blood vessels. However, icing the area beyond six hours is detrimental, as it will cause muscle damage and hamper the healing process.”
Hot packs can also be used. It will relieve muscle spasms and decrease the viscosity of the hematoma.
While these are immediate first aid interventions, it is important to consult a doctor. In mild cases, compression dressing is mostly done with a crepe bandage. Depending upon the severity, muscle hematoma can take anywhere between two to 10 weeks to heal, and rest is essential throughout the course of recovery. Massaging the muscles should be avoided, as it may lead to a condition called myositis ossificans (formation of bone tissue inside a muscle).
Adverse consequences of muscle hematoma
Arterial bleeding in the abdominal wall (in case of spontaneous hematoma) sometimes causes compression of other blood vessels.
“Compartments [a group of muscles, nerves and blood vessels] present in the legs and forearms are tightly packed, and there is no place for a muscle to expand,” says Dr Dhanarajan. “If a hematoma has occurred, it will affect the blood vessels, thereby resulting in increased swelling and blister formation due to increased intra-compartmental pressure. This leads to a condition called compartment syndrome. In such cases, surgical intervention is required.”
Takeaways
- Muscle hematoma, which refers to bleeding inside the muscles, is caused either by a traumatic injury or prolonged usage of anti-coagulant drugs.
- An ice pack can be applied during the first five to six hours to reduce pain and soothe the region. However, doing so beyond that time can cause muscle damage and hamper the healing process.
- A compression dressing with a crepe bandage is applied for mild cases of muscle hematoma. However, severe cases may require surgical intervention.
