Rib Fracture

A rib fracture occurs when you break a rib bone, the bone of the rib cage. Most rib fractures happen after a direct injury to the chest, often from a fall, or a car accident. Coughing hard can also cause rib fractures.

Learn about additional causes of rib fractures, what the symptoms are and your treatment options.

What is a rib fracture?

A “fracture” is another word for a broken (or cracked) bone; these all have the same meaning.

Injuries significant enough to break ribs can also cause damage to organs in the chest or belly, such as the lung, liver or spleen. One or more ribs may be broken on one or both sides of the chest (you have 12 ribs on each side).

Some rib fractures, called “stress fractures,” do not happen after an injury. Instead, they are caused by a severe cough or a motion people do over and over, like swinging a golf club.

Symptoms of a rib fracture:

  • Mild to severe pain in the area of injury. The most common symptom of a rib fracture is pain. Some people also have bruising over the injured area as well.
  • Pain when you breathe or cough
  • Feeling short of breath or unable to catch your breath
  • A stress fracture also causes pain, but the pain usually starts slowly and gets worse over time.

Rib fractures can cause other significant injuries to internal organs (lungs, liver, spleen). You should seek medical attention immediately if you have any of the following symptoms:

  • Moderate to severe pain
  • Difficulty breathing or feeling short of breath
  • Racing heart rate
  • Feeling dizzy or lightheaded
  • Abdominal pain

Testing for a rib fracture:

Your doctor or nurse will ask about your symptoms and do an exam. He or she might order a chest X-ray. Sometimes rib fractures are not visible on X-ray, and you may need other imaging tests, such as a CT scan, to look for other injuries or more subtle rib fractures. Imaging tests create pictures of the inside of the body to help determine if there are injuries in nearby organs.

Treatment for rib fractures:

Treatment depends on how many ribs you broke and your other injuries, as well as your overall health and presence of other medical conditions. People with 2 or more broken ribs or other serious injuries usually need treatment in the hospital.


Hospital Treatment:

You will be given adequate pain medications to keep you as comfortable as possible. This is very important to help prevent pneumonia, which is the most common complication after rib fractures. Because the ribs help with you expand your chest to breathe, when the ribs are broken it is very painful to breath and cough. This allows the far ends of the lungs to collapse, which makes a more susceptible to developing pneumonia. Many people that have rib fractures, also have bruising of the lung on the inside. This also puts the patient at even higher risk of developing pneumonia, because the lung itself is injured as well. It is very important that you take the pain medications as recommended by your doctor. Your pain level should be low enough that you are able to cough. Having good pain control is critical to your recovery and in preventing pneumonia.

Your doctor will also recommend a treatment to help prevent your small airways from closing off. This treatment, called “incentive spirometry,” involves breathing deeply into a hand-held device a number of times each day. You will be seen by a Respiratory Therapist, a specialist in the lungs and lung function, to help you with these exercises to help prevent pneumonia.

It is also very important that you do not stay in bed. Activity, such as walking, although it can be painful, is very important to keep good lung function and to prevent pneumonia. You should walk around your house several times per day, and increase your activity as you can tolerate.


Home Treatment

People who do not need treatment in the hospital are treated with pain-relieving medicines. Treating the pain is important, because when people have rib pain, they try to keep their ribs from moving too much. Then they don’t breathe in and out as deeply as they should. When people don’t breathe in and out as deeply as they should, some of the small airways in the lungs can close off. This raises the chances of getting pneumonia.

To treat your pain, your doctor can use:

  • Strong pain medicines, such as narcotics (Percocet, Vicodin, Norco, etc.)
  • Nonsteroidal anti-inflammatory drugs, also called “NSAIDs” – NSAIDS are a large group of medicines that includes ibuprofen (sample brand names: Advil®, Motrin®) and naproxen (sample brand names: Aleve®, Naprosyn®).

Treatment for a stress fracture involves avoiding the activity that caused your stress fracture for 4 to 6 weeks. Then you can slowly restart that activity.


Recovery from Rib Fractures:

Rib fractures can take weeks to months to heal, depending on how mild or serious the fracture is. In general, any broken bone will take 6-8 weeks to heal. The worst pain is usually the first 1-2 weeks and gets gradually better after that.

Healing time also depends on the person. Healthy children usually heal very quickly. Older adults or adults with other medical problems (especially those with osteoporosis) can take much longer to heal.

It’s important to follow all of your doctor’s instructions while your fracture is healing. He or she will probably recommend that you eat a healthy diet that includes getting enough calcium, vitamin D, and protein. He or she will also probably recommend that you:

  • Avoid doing certain activities that make the pain worse.
  • Avoid smoking. A fracture can take longer to heal if you smoke. It can also make your breathing more difficult and put you at increased risk of developing pneumonia.

When should I call my doctor or nurse?

After treatment, your doctor or nurse will tell you when to call him or her. In general, you should call him or her if:

  • You get a fever.
  • You have trouble breathing.
  • You have a cough that is getting worse.
  • You have severe pain that is not controlled with the pain medications that you were given.

Your skin looks more pale than usual, or you feel very weak.

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