Hematoma: Causes, Symptoms and Treatment Options

Have you ever noticed a painful, swollen bruise after a fall or injury that takes days or even weeks to fade? It could be a sign of a hematoma. It is a common condition where blood collects outside a blood vessel due to injury, trauma, or underlying medical factors. 

It can occur under the skin, within muscles, or even inside organs, depending on the cause and severity. In this blog, we will explain what a hematoma is, its common causes, key symptoms to watch for, available treatment options, and when you should seek medical care.

What is a Hematoma?

A hematoma is a collection of blood that forms outside of blood vessels, due to injury or trauma. It is also known as a contusion (bruise). When blood vessels are damaged, blood leaks into the surrounding tissues, creating a swollen, often painful lump. Unlike simple bruising, a hematoma can feel firm and may increase in size depending on the severity of the bleed. It can appear anywhere on the body, including under the skin, within muscles, or around organs, and the symptoms can vary based on the location and size.

It can be classified into different types depending on where they occur:

• Subcutaneous: Forms just under the skin, often appearing as a dark, firm bruise. Common after minor bumps or falls.
• Intramuscular: Occurs within the muscle tissue, causing swelling, stiffness, and sometimes limited movement.
• Subdural: Develops between the brain and its outer covering (dura mater), usually after a head injury. This type can be serious and requires immediate medical attention.
• Epidural: Forms between the skull and the outer layer of the brain, often caused by trauma, and may lead to neurological symptoms.

Understanding the type of bruise is important because it determines the appropriate treatment and monitoring required. While some hematomas resolve on their own, others may need medical intervention to prevent complications.

Causes of Hematoma

Hematomas can occur due to various reasons, ranging from minor injuries to underlying medical conditions. Understanding the cause helps in timely management and prevention.

Physical Trauma or Injury

Most hematomas are caused by a direct impact, such as a fall, bump, or accident. When blood vessels break due to the force, blood leaks into the surrounding tissues. Sports injuries, car accidents, or even minor household incidents can lead to visible bruising, often accompanied by pain, swelling, and discolouration.

Surgical or Medical Procedures

Hematomas may develop after surgeries or medical interventions. Procedures like biopsies, injections, or blood draws can inadvertently damage blood vessels. Post-surgical swelling or bruising sometimes indicates a bruising-forming, especially if proper pressure is not applied or if the patient has clotting issues.

Blood Clotting Disorders

Individuals with clotting disorders, such as haemophilia or low platelet count, are more prone to this disease. Even minor injuries can cause excessive bleeding under the skin or in muscles. Medications that thin blood, like anticoagulants, can also increase the risk of bruise formation.

Ageing and Fragile Blood Vessels

As people age, blood vessels become more fragile and susceptible to rupture. Minor bumps or strains can easily lead to hematomas in elderly individuals. The skin also becomes thinner with age, making bruises more noticeable and slower to heal.

Certain Medical Conditions

Underlying conditions such as liver disease, vitamin K deficiency, or vascular disorders can predispose a person to bruises. These conditions affect blood clotting or vessel integrity, making it easier for blood to leak into tissues after minor trauma or spontaneously.

Symptoms of Hematoma

Recognising hematoma symptoms early can help prevent complications. They vary depending on the location, severity, and cause of the blood accumulation.

Visible Swelling

One of the most common signs of a bruise is noticeable swelling in the affected area. The swelling occurs as blood collects beneath the skin or within tissues. It may appear immediately after injury or develop gradually, often accompanied by tenderness and discomfort when touched.

Discolouration of the Skin

Bruises often cause the skin to turn red, purple, or blue. Over time, the colour may change to green, yellow, or brown as the body breaks down the trapped blood. The discolouration is a key visual indicator and can help track healing progress.

Pain and Tenderness

Pain at the site is typical, ranging from mild soreness to severe discomfort. Tenderness occurs because the surrounding tissue is stretched and irritated by the pooled blood. Pain intensity may increase with movement or pressure on the area.

Warmth Around the Area

Affected areas often feel warmer than surrounding tissue due to inflammation and increased blood flow. This localised heat can indicate that the body is responding to the injury, but if persistent, it may signal infection or complication.

Restricted Mobility

Hematomas near joints or muscles can limit movement. The swelling and pain make it difficult to bend or extend the affected area, impacting daily activities. Severe bruises may require medical attention to restore normal function.

Formation of a Lump

Sometimes, bruises form a palpable lump under the skin or within deeper tissue. The lump is firm and can be tender. Its size may vary, and it may take weeks to shrink as the body gradually absorbs the blood.

Headache or Dizziness (for Head Bruises)

Bruises in the head or brain can cause headaches, dizziness, nausea, or visual disturbances. These symptoms require immediate medical evaluation as they can indicate increased pressure inside the skull.

Treatment Options for Hematoma

Hematoma treatment depends on its size, location, and severity. Mild cases may heal on their own, while more severe cases require medical intervention. Early care can reduce discomfort and prevent complications.

Rest and Protection

For minor bruises, resting the affected area and avoiding further trauma is crucial. Protecting the area prevents the bruises from worsening. Elevating limbs or using supportive bandages can help reduce pressure and swelling.

Cold Compress

Applying a cold compress or ice pack to the affected area can reduce swelling and numb pain. It is most effective within the first 24–48 hours after injury. Cold therapy slows blood flow and minimises tissue damage.

Pain Relief Medications

Over-the-counter painkillers like acetaminophen or ibuprofen can help manage discomfort. These medications also reduce inflammation. It is important to follow recommended dosages and avoid blood-thinning medications unless prescribed by a doctor.

Compression Therapy

Compression with bandages or elastic wraps helps limit swelling and provides support to the affected tissue. This method can be combined with rest and cold therapy for effective symptom relief.

Medical Drainage or Surgery

Large or deep hematomas may require medical procedures to remove accumulated blood. Drainage or surgical intervention is necessary when bruises press on nerves, organs, or joints, or if there is a risk of infection.

Physical Therapy

After a hematoma starts healing, gentle exercises and physical therapy may help restore mobility and strength in the affected area. Rehabilitation prevents stiffness and improves overall recovery.

Monitoring for Complications

Regular check-ups are essential, especially for bruises in sensitive areas like the brain or internal organs. Monitoring ensures early detection of complications such as infection, nerve damage, or prolonged pressure effects.

Preventive Measures

Using protective gear during sports, practising safe work habits, and managing underlying conditions like blood disorders can reduce the risk of bruising formation in the future.

When to Seek Medical Care

Many bruises heal on their own, but certain signs indicate the need for medical attention. Timely evaluation ensures faster recovery.

• Severe Pain or Swelling: If swelling or pain worsens suddenly, it may indicate internal bleeding. Consult a doctor promptly to prevent complications.
• Persistent or Spreading Bruising: Bruises that enlarge, darken, or fail to improve over days may signal a serious bruise. Seek medical assessment.
• Numbness or Tingling: Pressure from a bruise on nerves can cause tingling, numbness, or weakness. Immediate medical evaluation is required.
• Signs of Infection: Redness, warmth, pus, or fever around a bruise may indicate infection. Prompt medical care prevents serious complications.
• Head or Internal Hematomas: Severe headaches, dizziness, or vomiting after trauma may indicate an internal bruise. Emergency medical attention is critical in such cases.
• Difficulty Moving the Affected Area: Pain or swelling preventing normal movement could damage muscles or joints. Professional evaluation ensures proper care and recovery.
• Pre-existing Medical Conditions: Those with clotting disorders or on blood thinners should consult a doctor for even minor bruises.
• Recurrent or Unexplained Bruises: Frequent or sudden bruises without a reason may indicate underlying conditions. Early medical evaluation helps identify causes and treat them effectively.

Final Thoughts

Hematomas can sometimes signal underlying issues that need attention. Timely care, observation, and proper treatment help prevent complications and support faster recovery. Staying informed about symptoms and when to seek medical advice ensures you respond appropriately.

At Niva Bupa Health Insurance, we provide comprehensive coverage that helps you access quality healthcare without worrying about unexpected costs. With the right health plan, you can focus on recovery and well-being while managing medical expenses.

FAQs

1. How is a hematoma treated?

Treatment depends on size and location, including rest, ice, compression, elevation, drainage, or surgical intervention in severe cases.

2. When should I see a doctor for a hematoma?

Seek medical care if there is severe pain, rapid swelling, difficulty moving, signs of infection, or if it affects internal organs.

3. Can hematomas cause complications?

Yes, complications can include infection, pressure on tissues, nerve damage, or prolonged pain if not monitored or treated properly.

4. Are some people more prone to hematomas?

People on blood-thinning medication, with clotting disorders, the elderly, or those with fragile blood vessels are more susceptible to hematomas.

5. Can health insurance cover hematoma treatment?

Yes, health plans like Niva Bupa Health Insurance cover diagnosis, treatment, hospitalisation, and procedures related to hematomas, ensuring financial protection.