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To help prevent a collapsed lung or lung infection, do slow deep-breathing and gentle coughing exercises every 2 hours. Holding a pillow or blanket against your injured rib can make these less painful. You may need to take your pain medicine first. Your provider may tell you to use a device called a spirometer to help with the breathing exercises.
Table of Contents
- Symptoms
- When to See the Doctor
- Complications
Ribs are pretty hard to break. They are surrounded by strong muscles and usually can take a lot of abuse before they crack. Most broken ribs—including in children—come from vehicle accidents, but they're also common from falling off horses, sports injuries, and falls. In some cases, lots of forceful coughing—like from a bout of pneumonia—can cause rib fractures. The elderly can get broken ribs easier than younger adults. Kids have more flexible bones.
Symptoms
After an injury to the chest—or particularly forceful coughing—consider the possibility of a broken rib if the patient has any of the following:
- Extreme pain when taking a breath
- Tenderness to the chest or back over an area of ribs
- Crepitus—a 'crunchy' feeling under the skin
One of the best ways to identify a broken rib is the mechanism of injury. Getting hit in the chest, falling on something and hitting the chest or smashing the chest into a steering wheel or dashboard during a car accident could certainly lead to broken ribs. Forceful coughing can also be a mechanism for breaking ribs.
Types of Rib Fracture
Most of the time, the broken rib is only broken in one place, and is an 'incomplete fracture,' meaning not all the way through the bone.
Displaced and Nondisplaced Rib Fractures
Completely broken ribs may or may not move out of place. If they do move, they're called displaced rib fractures and are more likely to puncture lungs or damage other tissues and organs. Ribs that stay in place—usually ribs that are not completely broken in half—are called nondisplaced rib fractures.
Flail Chest
Rarely, a section of the ribcage breaks away from the surrounding bone and muscle. This area loses its stable structure (imagine a short rack of baby-backs connected to the rest of the ribcage only by muscle) and moves fairly easily as the patient breathes. This section is known as a flail segment and is much more dangerous than simply broken ribs.
When to See the Doctor
Any force hard enough to break a rib is powerful enough to cause other, more life-threatening injuries. It's also possible to break more than one rib at a time. More than three broken ribs at one time are potentially life-threatening. Since the only way to know for sure is to get an X-ray, it's important to go to the emergency department anytime you suspect a broken rib.
If you've been hit hard enough in the chest to make you think you may have broken a rib or two, go to the emergency department or call 911.
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It's especially dangerous if the patient has any of the following signs or symptoms:
- Severe shortness of breath
- Coughing blood
- Confusion or dizziness
- General weakness
- Blood in the urine
Treatment
There's good news and bad news about treating simple broken ribs. The good news is that it will heal on its own and probably not develop any additional problems. The bad news is it hurts a lot and there's really very little you can do for it.
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In the past, treatment for broken ribs included wrapping the chest with a wide band often called a rib belt. A study in 1990 found no benefit from wrapping patients. Displaced rib fractures caused more problems in this study when they were treated with the belt than when they were not. Most emergency physicians today don't wrap broken ribs.
The best broken rib treatment is simple pain medication.Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen are best. If you go to the ER for your broken rib, the doctor is likely to give you a prescription pain medication as well as a NSAID.
Complications
The most common complication of broken ribs is not being able to take a deep breath because it hurts. If you don't breathe deep enough, mucous and moisture can build up in the lungs and lead to an infection such as pneumonia.
Displaced rib fractures can damage other tissues or organs and sometimes lead to collapsed lungs (pneumothorax) or internal bleeding.
It's important to keep your lungs healthy. As you heal, practice taking deep breaths. It's important not to be afraid of taking the pain medication as prescribed because keeping the pain under control is important for taking strong, deep breaths.
If you go to the ER, the doctor may send you home with a tool to encourage deep breathing. The tool is called an incentive spirometer. It measures lung capacity so patients can see how well their lungs are recovering as the broken rib heals.
- May L, Hillerma C, Patil S. Rib fracture management. BJA Education. 2016;16:1. doi:10.1093/bjaceaccp/mkv011
- Talbot BS, Gange CP, Chaturvedi A, Klionsky N, Hobbs SK, Chaturvedi A. Traumatic Rib Injury: Patterns, Imaging Pitfalls, Complications, and Treatment. Radiographics. 2017;37(2):628-651. doi:10.1148/rg.2017160100
- Quick G. A randomized clinical trial of rib belts for simple fractures. Am J Emerg Med. 1990;8(4):277-81. doi:10.1016/0735-6757(90)90073-9
Additional Reading
- Quick, G. 'A randomized clinical trial of rib belts for simple fractures.' Am J Emerg Med. Jul 1990.
- Sirmali, M, et al.'A comprehensive analysis of traumatic rib fractures: morbidity, mortality, and management.' Eur J Cardiothorac Surg. Jul 2003.
Your ribs are thin bones, but they have an important job protecting your lungs, heart, and chest cavity. If you experience trauma to your chest, one or more ribs may be bruised, cracked, or fractured.
A bruised rib can take some time to heal, depending on the severity. It’s important to get your injury checked out by your doctor to rule out more serious injuries and learn about treatment options that can help your recovery.
The main symptom of bruised ribs is chest pain. This pain may feel worse when you inhale. It may also hurt when you laugh, cough, or sneeze. Bending over or moving into other positions may also cause sharp chest pain.
Other symptoms can include:
What To For A Cracked Rib
- tenderness in the area of the bruise
- swelling around the bruised rib
- a bruise that’s visible on the skin
- spasms or twitching in your chest muscles
The symptoms of a broken rib are similar. If a rib is broken, you may hear a cracking sound when it happens, but only imaging tests can confirm the diagnosis.
What To Do To Heal Cracked Ribs
The most typical cause of a bruised rib is a blow to your chest. This can happen in a car accident or during direct contact in a sport such as football. Falling from a ladder or other high place can bruise or break a rib, as can having something heavy fall on your chest.
Less common causes include excessive coughing or repetitive, strenuous activities, such as rowing or lifting heavy weights.
Diagnosing a bruised rib starts with a review of your symptoms and a physical exam. Your doctor will also listen to and watch your chest while you breathe to see if any lung function may have been affected. A bruised or broken rib may be accompanied by a bruise on your skin.
Whether a bruise is visible or not, your symptoms may require an X-ray. Your rib may have a slight fracture that isn’t detected with an X-ray. In these situations, a CT scan may help the doctor differentiate a break from a bruise.
Other diagnostic tools include a chest MRI. A rib bruise won’t show up on an X-ray, but it can often be detected with an MRI.
A bone scan can be particularly helpful in diagnosing a broken rib caused by repetitive action, such as excessive coughing or rowing, especially when it’s not visible on rib detail X-rays.
Rib injuries are difficult to treat. Unlike a broken arm, for example, that can be set in a cast, a rib injury can’t be wrapped. The practice of wrapping your rib cage is seldom used these days because it restricts you from breathing deeply. Too much shallow breathing places you at risk of developing pneumonia.
Resting and restricting your activities are the main treatment options for bruised ribs. Ice may help relieve some of your pain and swelling.
Since bruised ribs cause pain when you inhale — causing you to take more shallow breaths — your doctor may prescribe medication to help manage your pain. Long-lasting anesthetic injections near the site of the bruise may also help temporarily keep your nerves there from relaying pain signals to your brain.
Your doctor may also advise respiratory therapy. You’ll learn breathing techniques that can reduce some of the pain, while still allowing you to fill your lungs with air.
Bruised ribs usually heal within a month or so, but that process can take longer if one or more ribs are actually broken instead of bruised. If you’re initially diagnosed with bruised ribs but the pain isn’t easing after a couple of weeks, tell your doctor. More imaging or another evaluation may be necessary.
Don’t hesitate to see your doctor if you experience any of these symptoms:
- rib pain when breathing or coughing, especially if you notice bruising or swelling and tenderness around your ribs
- worsening pain in the days or weeks after an injury
- shortness of breath
Even though there isn’t much you can do to help with the healing of your injury, you should still have a thorough evaluation of your ribs and lungs. Ignoring your pain could raise your risk of damaging your lungs or developing pneumonia or other serious respiratory problems.
Bruised ribs can be a painful injury with the potential to affect your lung health. They generally require time to heal and patience to put up with the pain. But if you follow your doctor’s advice, you should be able to fully recover.
There are safe ways to manage your pain. If you’re prescribed opioids or other strong medications, be sure to take them only as prescribed.
To help prevent bruised ribs in the future, wear proper padding when engaging in contact sports. You may also want to explore other activities or exercises that pose less of a threat to this important set of bones.