Post-Car Accident Pain Without Bruising: What Could It Be?

After the car accident, there are no bruises, but it hurts when pressure is applied?

A few days ago, I was in a car accident and only sustained abrasions on my legs, so I did not go to the hospital for an examination.
However, since the car slid out with me for about a meter and then fell on top of me, I experienced impacts in certain areas that are now painful.
The painful areas are on both sides of my pubic triangle.
There are no bruises, and I do not feel pain when walking or pressing on it, but I do feel pain when I laugh.
Based on my pain sensation, it feels like a bruising type of pain, but it has been decreasing over the days.
I have been busy with work and have not had time to see a doctor.
Could this be due to a ruptured ovary, or is it simply internal bruising causing the pain?

Baobao, 20~29 year old female. Ask Date: 2017/07/22

Dr. Chen Jiaming reply Surgery

The ovaries are located within the pelvic cavity in the lower abdomen and are not easily palpable.
Based on your description, there are two possibilities: the first is pain from a simple muscle or fascia strain due to an accident, and the second is swelling of the inguinal lymph nodes caused by an injury to the leg (a normal immune defense mechanism).
However, as long as the symptoms gradually diminish, there is generally no need for concern.
This is provided for your reference.

Reply Date: 2017/07/22

More Info

After a car accident, experiencing pain without visible bruising can be concerning, especially when the pain is localized in sensitive areas such as the pelvic region. Given your description, it’s important to consider several potential causes for your discomfort.

Firstly, even in the absence of bruising, internal injuries can occur. The impact from the accident could have caused soft tissue injuries, which may not always present with visible signs like bruising. These injuries can involve muscles, ligaments, or tendons, leading to pain that might feel similar to bruising. The fact that you experience pain when laughing or during certain movements suggests that there may be some strain or irritation in the affected area.

Another possibility is that the pain could be related to the pelvic region itself. The pelvis houses various structures, including the reproductive organs, and trauma can lead to conditions such as pelvic floor dysfunction or even irritation of the ovaries. While the concern about ovarian rupture is valid, it is relatively rare and typically accompanied by more severe symptoms such as significant abdominal pain, nausea, vomiting, or changes in menstrual cycles. If the pain is mild and only occurs with specific movements, it is less likely to be due to a serious condition like ovarian rupture.

Additionally, the pain you are experiencing could be due to referred pain from other areas of the body. For instance, injuries to the lower back or hips can sometimes manifest as pain in the pelvic region. Given that you mentioned the pain has been gradually decreasing, this could indicate that your body is healing from a minor soft tissue injury.

Despite the absence of severe symptoms, it is crucial to monitor your condition closely. If the pain persists, worsens, or if you begin to experience additional symptoms such as fever, abnormal discharge, or significant changes in your menstrual cycle, it would be advisable to seek medical attention promptly. A healthcare provider can perform a thorough examination, which may include imaging studies like an ultrasound or CT scan, to rule out any serious internal injuries.

In the meantime, consider the following self-care measures to help manage your pain:
1. Rest: Allow your body time to heal. Avoid activities that exacerbate the pain.

2. Ice Therapy: Applying ice to the painful area can help reduce inflammation and numb the pain.

3. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help alleviate pain and reduce inflammation.

4. Gentle Stretching: If comfortable, gentle stretching may help relieve tension in the surrounding muscles.

In conclusion, while your symptoms may not indicate a severe injury, it is essential to remain vigilant. If you have any doubts or if your condition changes, do not hesitate to consult a healthcare professional for a comprehensive evaluation. Your health and well-being should always be the priority, and timely medical intervention can prevent potential complications.

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