A bruise is one of the most common household injuries.
Everyone has met bruises in their life, but not everyone knows how bruises differ from fractures. What is a bruise and how does it differ from a fracture?
A bruise is a traumatic tissue damage caused by a mechanical effect on a particular area.
The main difference between a bruise from fractures and other types of injuries is the absence of a violation of the anatomical integrity of the tissues.
Although bruises are widespread in medical practice, the variety of their types is so great that talking about the danger or safety of such an injury can only be based on the location of the damage. Fortunately, for the most part, bruises are not dangerous and are relatively easy to treat.
About a bruised back can only be conditionally. Officially, they do not make such a diagnosis, because it does not exist. From an anatomical point of view, the back is the back of the trunk, which originates in the region of the first cervical vertebra and ends in the lower back. It is clear that this is a huge anatomical area. In the back there is a huge amount of soft tissue. Based on this, the types of bruises on the back are diverse.
In most cases, we are talking about bruises of the back muscles. They are the least dangerous. In addition, in this area there are:
• Injuries to the spine. They, in turn, are divided into:
- bruises of the cervical spine;
- bruises of the thoracic spine;
- bruises of the lower back and sacrum.
• Injuries of the ribs (technically, it is impossible to hurt the bone, including the rib, the damage concerns the periosteum, which is rich in nerve endings).
There are more detailed classifications that take into account the presence or absence of damage to the vertebrae, spinal cord.
Back injury: causes
The causes of bruises on the back are manifold. Due to the fact that there are many muscles in the back, both the spinal column and the posterior ribs are relatively infrequently injured. Therefore, it is possible to isolate a number of specific causes, those that most often contribute to injury.
• Traffic accidents. Most often, as a result of an accident, bruises of the cervical and lumbar spine occur (when the head hits the steering wheel, etc.).
• Fight (in domestic conditions or during sparring).
• Blow into the back area with blunt objects. When striking along the spinal column, bruises of the spine and fractures of the posterior ribs are most often observed, while when striking across the spine, the picture is opposite. Similar effects are caused by the impact of the shock wave.
• Falls from a height. In this case, we can talk about falling from a small height to the back, and landing on his feet when jumping from a height (the so-called compression trauma of the spine). In the second case, the risk of serious damage is higher, because compression trauma requires a more thorough diagnosis. No less dangerous and falling on his back flat.
• Violation of the technique of performing sports exercises. In this case, not bruises, but sprains are more common.
• So-called bruises "diver". Occurs when the head hits the hard bottom surface of a shallow reservoir. It is accompanied by dangerous injuries, including bruises of the cervical spine of moderate and high severity, fractures and dislocations of the vertebrae.
In all cases, a back injury can be a single injury, or it can be a collateral damage.
At risk, according to medical statistics, are:
• Women of any age (due to the anatomical features of the structure of the skeleton).
• Athletes (contact, water, extreme sports are especially dangerous in terms of injuries).
• Drivers of cars.
• Persons whose professional activities are associated with a high level of physical activity.
Back injury: symptoms
Symptoms with bruises on the back are pronounced. The intensity, as well as the nature of the manifestations, depends on two factors:
• Localization of injury.
• Degrees of injury.
Nevertheless, symptoms can be distinguished that will be necessarily present in one way or another, regardless of the location and strength of the back injury. These manifestations include:
• Pain syndrome. The intensity of the pain syndrome depends not so much on the degree as on the location of the injury. The most painful injuries of the cervical spine, as well as ribs. In all other cases, the strength of the pain can be different. The pains are dull aching in nature. In some cases, they can be burning. Often pain radiates along the entire spinal column. If the ribs are damaged, the pain spreads to the sternum.
• Swelling of the injury site. Edema does not form immediately, but several hours after the injury (on average, from 2 to 12 hours pass). Swelling occurs due to accumulation of fluid in the area of damaged tissue.
• Hematoma. When a back injury occurs, the destruction of the surrounding blood vessels (capillaries) occurs. Blood from the vessels goes into the intercellular space of the skin layers.
In addition to the described symptoms, local manifestations are also observed. They play an important role in the diagnosis and contribute to the correct diagnosis.
With bruises of the cervical spine the picture of acquired neurological deficiency develops, motor activity of the upper and lower extremities decreases.
Among the symptoms are:
• Hum in the ears (tinnitus).
• Visual disturbances (flickering in the eyes of fly photopsies, an increase in the number of floating opacities, loss or reduction of visual fields).
• Lack of coordination, uncertain gait.
• Decreased motor activity of the arms and legs, up to the development of paresis or paralysis.
Somewhat less commonly observed:
• Respiratory problems.
• Violation of the reaction of the pupils to the light.
Most neurological symptoms are due to compression of the basilar and vertebral arteries that feed the brain (primarily the occipital lobe and cerebellum suffer).
A back injury in the thoracic spine is accompanied by:
• Violations of motor activity of the hands.
• Numbness of the upper limbs.
• Incontinence of feces and urine (rarely).
• Decreased sexual desire.
In case of damage to the lumbosacral spine, the following issues come to the fore:
• Violations of the excretory system.
• Decreased motor activity of the lower extremities.
In all three cases, this is an extremely dangerous injury.
With bruises of the posterior ribs, the main symptom is intense pain. In addition to the pain syndrome, breathing problems develop, which are also more often caused by pains that force the patient to restrain a normal breath.
Back injury: diagnosis
Diagnosing back injuries is not an easy task. The doctor faces several tasks at once:
First, to accurately determine the localization of the bruise (pain is an unreliable diagnostic sign, it can be located far from the site of the bruise).
Secondly, to exclude the presence of more serious injuries of the ribs and spine, as well as the lungs (with fractures of the ribs, bone fragments often damage lung tissue).
The standard diagnostic strategy consists of several stages.
1) First of all, the patient is interviewed (history taking). The doctor clarifies the points of interest to him regarding the patient’s condition, the circumstances of the injury, etc.
2) The doctor examines the site of damage. At this stage, it is important to determine the presence of deformations, the presence and size of edema and hematoma.
3) At the next stage, the specialist palpates the damaged area and conducts a number of functional tests (to assess tendon reflexes, the sensitivity of the skin over the site of the bruise).
After the initial diagnostic measures, the doctor can establish a preliminary diagnosis. The next steps are to confirm the findings of a specialist and to exclude more serious injuries.
4) X-ray of the spine, chest in two projections. Allows you to visually assess the condition of bone structures and exclude partial or complete fractures of the vertebrae and ribs.
5) Magnetic resonance imaging (MRI) - is intended for a thin assessment of soft tissues of the back, organs of the chest cavity, blood vessels. Especially important for the study of the state of intervertebral discs, spinal cord.
6) Computed tomography (CT) - is assigned as an alternative to x-ray or in combination with it. Designed for fine assessment of bone structures.
In rare cases, a lumbar puncture is prescribed (to exclude the presence of blood in the cerebrospinal fluid).
Back injuries, regardless of location and severity, are considered to be potentially dangerous injuries, therefore they are comprehensively used for diagnosis. The following are involved in the diagnosis and treatment of back injuries:
Surgeon (neurosurgeon).
Neurologist (neurologist).
Orthopedist.
In case of lung damage - a pulmonologist.
Back injury: treatment
The tactics for treating uncomplicated back contusion, as well as contusion of soft tissues of the back (muscles), is to relieve pain. For these purposes, non-steroidal anti-inflammatory drugs in the form of ointments (Ketorol, Diclofenac) and analgesics (Baralgin and others) are used. In addition, compliance with a sparing regime of physical activity is prescribed.
Much more complicated is the situation with complicated bruises and bruises of the spine and ribs. In this case, in addition to anti-inflammatory and painkillers, hormonal drugs are prescribed. All of them serve the purpose of relieving pain, swelling, and inflammation.
Also, "complex" bruises require a mandatory rehabilitation course. After drug treatment is completed, when the condition is stabilized, physiotherapy (magnet and electrophoresis) and exercise therapy are prescribed.
Thus, a back injury is a collective concept and exists only for convenience. In most cases, we are talking about relatively harmless muscle injuries, but more serious injuries cannot be ruled out until specialized diagnostic measures are taken. In all cases, it is impossible to make a diagnosis on your own, a visit to the doctor is mandatory.
