Chest contusion

Synonyms

• Chest contusion
• medical: Commotio thoracis

introduction

A chest bruise results in an injury to the chest, which usually occurs as a result of blunt violence (e.g. falls on the chest), typically in household accidents or sports accidents.
The bony structures of the burst basket, i.e. the ribs, the sternum and the thoracic spine, remain unharmed. The organs that the chest protects (heart and lungs) are also not damaged by the force.

causes

By blunt force, such as with

• Traffic accidents,
• Household accidents,
• Sports accidents,
• and as a result of strong coughing in the event of a respiratory infection

chest bruises can occur.
A chest contusion can also be part of a multiple injury (multiple trauma), but it plays a subordinate role.

Symptoms

In the case of burst basket bruises, there are often no external injuries to be seen at the beginning, but bruise marks, i.e. visible injuries to the skin or the underlying soft tissue, such as bruises, can develop over time. A chest contusion is usually very painful. Patients often complain of tenderness in the affected area and pain with certain movements.

The pain persists especially when breathing. This can lead to the patient adopting a relieving posture, which means that breathing is relieved, whereby the lungs no longer develop properly. The pain therapy is enormously important, because long breathing with reduced breathing, too Hypoventilation called, bacteria can multiply in the lungs and thus more easily pneumonia (pneumonia) can arise.

The pain is described as very severe and since a chest bruise can take months to heal, the pain can last for months.

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Pain

As already mentioned above, a bruise in the chest usually causes severe pain and in a large number of cases also a typical difficulty in breathing, aggravated by pain, which is known as a severe bruise cyanosiswhich can cause blue discoloration of the skin and mucous membranes caused by a lack of oxygen.

Pain mainly occurs when breathing, coughing, laughing and sneezing, but can also occur when bending the upper body and moving the upper extremity.

Difficulty falling asleep and staying asleep caused by the painful chest compression that often occurs when lying down are also described as particularly stressful.

In the course of a chest contusion, painful muscle spasms in the intercostal muscles and back pain as a result of the painful posture of the upper body can also occur.

Due to the pronounced pain symptoms, you should not wait too long to go to the doctor. Adequate pain medication is indicated in most cases.

Further information is available under our topic: Chest pain

Duration of a chest contusion

Duration of pain

It can sometimes take several weeks for a chest contusion to be completely free of symptoms. The duration of the illness depends not only on the type and severity of the injury but also on the personal fitness and the level of training of the injured person. Athletes recover faster after a chest contusion than older people with a weak constitution.

The acute symptoms immediately after the injury usually last for about one to two weeks. During this time, a pronounced feeling of illness can prevail, but this can be alleviated with adequate pain therapy.

Even after surviving the acute phase, many sufferers still complain of pain. This condition can last for a few weeks, in exceptional cases months. As described above, the duration depends on the injury itself and the physical condition of the injured person.

Duration of illness and sick leave

The healing process of a chest contusion depends on various factors. These include the general health and fitness of the person affected, the type and severity of the bruise and compliance with the recommended therapeutic measures. In the optimal case, a chest contusion can then be healed after a few weeks (approx. 3-4 weeks).

The length of the sick leave should also be based on this period. The type of work involved should be taken into account individually. Physically demanding jobs may only be exercised at a later point in time compared to office work, since physical protection of the chest is an essential prerequisite for the healing process. Accordingly, it is at the discretion of the patient and the treating GP how long the exact length of the sick leave will be.

Duration of full recovery

Chest contusion can vary in extent depending on the patient and cause. The specific, anatomical characteristics of the respective patient also have a decisive influence on the duration of the healing of the chest contusion.

In addition, the time at which the diagnosis is made and the type and intensity of the treatment initiated are of enormous importance.

As a rule, trauma does not affect just a single rib, but several ribs at the same time. For this reason, the time it takes for a chest contusion to heal completely differs from case to case.

If the course is ideal, i.e. if a single rib is impaired, a prompt diagnosis and adequate immobilization of the affected ribs, the time taken to completely heal the chest contusion is approximately three to four weeks.

However, in the event of severe trauma and / or severe impairment of the affected rib, the healing process can take several months.

Especially in the case of a chest contusion that was triggered by a respiratory infection, i.e. by a strong cough, the healing time can be greatly extended. The reason for this is the fact that a real immobilization of the chest cannot be guaranteed by persistent coughing. In spite of the already existing chest contusion, the cartilage-bone apparatus continues to be overloaded and the pressure on the damaged ribs is too high.
Real healing can therefore only begin after the cough has subsided.

In addition, chest contusion caused by a strong cough is diagnosed very late in most cases. The reason for this is the fact that patients suffering from a respiratory tract infection and severe coughing do not see a doctor immediately if they experience cough-related pain.

Furthermore, many doctors attribute pain phenomena when coughing to an overload of the muscles and / or the diaphragm. A direct treatment of the chest contusion is usually initiated very late in these patients. For this reason, the time until healing is increased enormously.

Read more on the topic: Duration of a bruised rib.

Therapeutic measures for a chest contusion

The most important pillar of therapy is pain therapy, as a chest contusion usually heals on its own in due course without invasive interventions, so purely symptomatic treatment is sufficient.

If the pain in the acute stage of the injury is too great for the patient to stand upright and allow the lungs to fully unfold, it may be necessary to supply oxygen through the nose to ensure breathing.

Various pain relieving medications are available for further treatment. The pain should be reduced to such an extent that it does not come to breathing and posture and the lungs can develop properly at all times.

Physiotherapy exercises can also be helpful. Instructions for self-therapy with breathing exercises are also given here.

If, in spite of adequate pain therapy, a reliever posture and easy breathing occur, an antibiotic can be prescribed for prophylaxis of pneumonia.

Also read our article: Treatment and duration of a bruise.

Exercise with a chest contusion

After a chest contusion, you should refrain from exercising until you are free of symptoms.

In the acute phase, increased physical activity is hardly possible anyway due to the breathing-dependent pain and can even lead to circulatory collapse due to lack of oxygen due to pain-related flattened breaths.

Even later, in the recovery stage, physical exertion should be limited to support the healing process.

Resuming training too early can lead to an intensification of the pain symptoms as well as to an increase in the time required to restore complete freedom from pain under resting conditions. The return to physical activity should be slow and must be limited according to clinical signs (pain, shortness of breath).

Diagnosis

The diagnosis of chest contusion depends on the patient's condition and anamnesis.
The chest should be palpated routinely. If the injury resulted in broken bones in the chest area, this may be felt or heard through a crackling sound. Listening to the lungs and heart with a stethoscope is also important in order to rule out damage to the organs.

Further examinations may be necessary to rule out further, possibly worse diagnoses.

In order to safely rule out a fracture of a bony structure, such as the ribs, the doctor can order a chest x-ray (med. Chest x-ray).
The X-ray can also be helpful in getting an overview of the ventilation in the lungs.

Computed tomography can be helpful to examine all organs in the chest at the same time.

In some cases, however, an EKG can also be sufficient to rule out violations of the heart and the heart rhythm. If all other possible diseases are excluded, the doctor uses the clinical symptoms to make the diagnosis of burst basket contusion.

Read more on the topic: Chest x-ray (chest x-ray)

Breathing after a chest contusion

Breathing plays a relevant role in connection with chest contusion.
On the one hand, a strong cough as part of a respiratory infection can cause a chest contusion. On the other hand, breathing is impaired in various ways by an existing chest contusion. With every breath, the chest expands, which mainly results in breath-dependent pain. This breathing-dependent pain, in turn, promotes so-called “breathing easily”, whereby those affected breathe more shallowly in order to keep the chest expansion and the subsequent pain as low as possible. However, this increases the risk of pneumonia. In the therapy of chest bruises, it is therefore important to find a balancing act between breathing that is too shallow with the risk of pneumonia and moderate breathing work while ensuring that the chest is spared.

This topic could also be of interest to you: Breathing exercises

Bruised chest after a car accident

A chest bruise occurs when external forces act on the chest without breaking the ribs or the sternum, but damaging the surrounding tissue such as the muscles. Usually this is a blunt force.
A car accident is a typical course of injury: when a vehicle is driven or crashed, the occupants of a vehicle are pressed into the seat belt, which, depending on the speed, exerts enormous forces on the chest. As a result, there may be a bruise as well as swelling and reddening of the upper body, especially along the length of the seat belt, including a bruise of the chest.

personal injury compensation

The prerequisite for receiving compensation for pain and suffering in the context of a chest contusion is that there must have been external interference, i.e. that the force of a third party is responsible for the chest contusion.
The exact amount varies from person to person and is based on several aspects. This includes, among other things, the severity of the chest contusion, whether and for how long the affected person is unable to work, whether a hospital stay was necessary and whether the crime was negligent or willful. On the Internet you can find orientation tables with information on the amount of compensation for pain and suffering. The subject of compensation for pain and suffering is legally anchored in Section 253 of the German Civil Code (BGB).

Summary

A chest bruise is an injury to the bony chest, which is usually caused by a blunt trauma.

Such blunt trauma can be caused, for example, by car accidents, household accidents, sports injuries or forced coughing in the case of severe respiratory infections. The bony structures of the chest are not injured. The organs in it, the heart and lungs, are also not damaged by a chest contusion.

The symptoms of the patients usually complain of severe pain, whereby in 80% of the cases no external injury can be detected. Once the doctor has ruled out all other injuries, the clinic will make a diagnosis of chest contusion.

Painkillers are used symptomatically for therapy so that a relieving posture and breathing are avoided. It may be necessary to use antibiotics to prevent pneumonia.

Physiotherapy can also be helpful during the healing months.