Lloydspharmacy.com Health - Sprains and bruises

Reviewed by Dr Dan Rutherford, GP

What are sprains and bruises?

A sprain causes pain, swelling and discolouration (blue colouring). This happens because the small blood vessels and fibres in the flesh burst, causing blood to enter the surrounding tissue. This results in swelling and the blue colouring.

It is the same principle with a bruise: the skin is exposed to such a hard blow that the blood vessels break.

What should I do about a sprain?

If you have a sprain, you will also suffer pain. The injured area must be kept still or the bleeding in the tissue will continue more intensely. The most important treatment for a sprain is: rest, ice, compression, elevation (RICE).

Rest

Rest is important to ensure that healing occurs as quickly as possible. You should rest the injured area for at least one or two days, because the bleeding can continue for up to 24 hours.

If possible, the sprained area should be kept straight - an arm, for example, can be supported in a sling. Try to keep the injured area in the same position while you are sleeping, perhaps by placing a couple of pillows under your sprain.

Ice

Since blood enters the tissues when you have a sprain, the main thing is to limit the bleeding. This can be done by cooling. Try the following techniques.

Put ice cubes in a plastic bag, then place over the sprained area.
In an emergency, use frozen vegetables in a bag.
Use custom-made cooling-packets, which are bags containing a special jelly that can be chilled in your freezer.

In each case, wrap the cold bag in a towel before placing it on the sprain. Always put a piece of fabric between your skin and the coolant, otherwise your skin may get frostbite.

Stop the cooling long before your skin turns white or hard. Contact a doctor if your skin does not regain its usual colour after the process has stopped. It is a good idea to cool the skin for 15 minutes, stop for 15 minutes, then cool again, and so on.

Usually, the cooling is felt in different ways. This can range from cold to painful, burning and finally numbing.

Be careful if you are diabetic. To prevent damage to your blood circulation, do not cool an area without consulting your doctor.

Compression

You can also wrap bandages around the damaged area to prevent movement. Most people use a pressure bandage at first, followed by tape when the swelling has disappeared.

If you are wearing bandages, it is important to monitor the area surrounding them. If this becomes blue-coloured and the surrounding tissue seems cold, you should remove the bandages and contact a doctor.

Elevation

The injured area shouldn't point downwards, otherwise fluid build-up may occur. This prolongs the healing process and causes more pain.

How can I relieve the pain?

The most important treatment for a sprain is rest, ice, compression and elevation, as described above. However, the pain experienced following a sprain can also be relieved with over-the-counter painkillers, such as paracetamol (eg Panadol) or paracetamol and codeine (eg ).

Good advice

Ask a pharmacist for advice on which painkillers are suitable for you.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (eg Nurofen, Advil) used to be frequently recommended following a sprain, because they reduce the inflammation and swelling as well as relieving pain. However, inflammation is a necessary part of the healing process. It limits movement to prevent further damage to the joint and also initially helps to repair the damaged tissue. There is now some suggestion that reducing inflammation with this type of painkiller can actually slow down the healing process in the long-term. It may be best to avoid these types of painkillers in the first 24 to 48 hours after the injury.

When to consult a doctor

If the sprain is accompanied by severe pain and severe swelling.
If one of your joints gives way and is unable to carry your weight.
If the pain is still present after two days.
If the sprain has not improved after four days of self-treatment.

What should I do to prevent sprains?

Ask yourself what caused your accident and focus on the cause. Note that the following information is a very rough guide: if in doubt, consult a doctor.

Running too quickly?
Exercising without any warm-up or stretching exercises?
Running, working out or playing sport without the proper shoes?
Running on hard or uneven surfaces?
Are any of your muscles overcompensating for weakness in another - for instance, due to a bad knee?

Recovering from sprains

When the pain and the swelling have gone, start exercising the injured part of the body gently. After one or two days' rest, it is important to start moving again to reduce the amount of scarring formed in the damaged tissue.

As with any activity, warm up slowly and use stretching exercises to begin with. If it's possible to stay physically active without further injuring the sprained area, do so. Keep your other muscles functioning and maintain physical fitness.

How to treat bruises

Bruises and swellings are caused by bleeding under the skin. Again, bruises are best treated with cooling. To do this, follow the instructions given above for cooling treatment of sprains.

If several bruises surround a large one, and you have not had any other accidents, consult your doctor to find out whether your blood is clotting as it should.

Based on a text by Dr Hans Gad Johansen, specialist and Dr Ejnar Kuur, consultant

Last updated 23.06.2006