Suggest Treatment For Massive Painful Bruise On Lower Back After Injury

Posted on Wed, 5 Aug 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 5 Aug 2015 Answered on

Wed, 26 Aug 2015 Last reviewed on

Question : I fell off my mountain bike off road and hit a tree really hard with the side of my body, sort of my side of my lower back. I thought things were healing well but I do have a massive bruise that hurts and also
Burns now. Should I see my doctor?

Answered by Dr. T Chandrakant (43 minutes later)

Brief Answer:
Better to for clinical evaluation

Detailed Answer:
Hi.
Thanks for your query and picture.
Read and understood the history well.
Your picture is showing large hematoma. It is better to rule out fracture of the iliac bone by clinical evaluation by a Doctor and get X-rays of the iliac bone on the same side.
Since the hematoma is large it does cause pain as also the traumatized underlying muscles. The stretching and neuropraxia (partial injury to the nerves) can cause the burning or different sensations later during its healing stage.

Since you have not mentioned, I take that you do not have any other symptoms. If you have any other symptoms CT scan of the abdomen is a better choice to rule out any internal injury.

I hope this answers your query.
Please feel free to ask further relevant queries if you need to or if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (7 hours later)

Hi Dr. T,

Thanks for the answer, much appreciated.

I do not have any other symptoms than mentioned. I found the burning pain to be more intense than I expected last night which is why I reached out to this service yesterday, it got me worried that maybe more was going on.

I will follow your advice and see a doctor hopefully today. If they do find a fracture of the bone, what would they do with this information? I imagine it's likely something that has to heal on it's own, is that correct? Also, for the pain, how long should I be taking Advil? And is it helpful to still ice the area? It certainly seems to help when I do but am not sure if it's recommended, the accident happened on Saturday so 4 days ago.

Thank you very much!
XXXXXXX

Answered by Dr. T Chandrakant (1 hour later)

Brief Answer:
Thanks for appreciation.

Detailed Answer:
Thanks for your appreciation.

It is good to know that you have no other symptoms, this indicates that there is no internal injury that can be connected to the bruise.

If the burning pain is located at the bruise and below it, the reasons are the ones as I have already mentioned. This will settle with time as is seen in all the cases in which the burning pain is due to local (peripheral) nerve problems.

If the burning is on more areas than the the affected and as if coming from the spine, then only would have us to worry about it.

Since it is 4 days, icing will not help for the hematoma but may help for the burning pain. You may continue icing if it is helping to reduce this pain.

Since there is no local pain (not the burning) on movement it is less likely to have fracture of the iliac bone and since this bone is well covered on both the aspects by good muscle, no active treatment may be needed.

You are absolutely correct and goes on with your spirit of biking that the body only heals on its own and we just assist in the process for symptomatic relief and by reducing edema and pain.

You may please continue Advil till it is required for pain and/or edema to subside. Icing as said only if helps.

Take care, you will be fine very soon.

Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar