Broken Ribs

A broken rib is either a crack or break in one of your rib bones, which occurs due to trauma to the chest, such as from a fall, motor vehicle accident or impact during contact sports.

Most commonly, the ribs in the middle portion of the chest break. A broken rib is very painful as ribs also move while breathing, coughing, and moving upper portion of your body.

Although painful, cracked ribs are not as dangerous as ribs that have been broken into many pieces. The sharp edge of a broken bone may damage major blood vessels or organs, such as the lung.

Broken ribs normally heal on their own within one or two months. Pain control should be adequate so that you can continue to breathe properly, and avoid complications such as pneumonia.

The main symptom of broken ribs is pain, especially when you breathe in, and worsen when you press on the injured area or bend or twist your body.

You may feel as if you are able to take only shallow breaths. There may be skin bruises, swelling or tenderness over your chest.

When to see a doctor

Consult your doctor if you have a painful area in your chest that occurs after trauma or if you have difficulty in breathing or pain associated with deep breathing.

Seek immediate medical attention if you feel pressure or a squeezing kind of pain in the central portion of your chest that lasts for more than a few minutes or pain that radiates to your shoulder or arm. These symptoms may be a sign of heart attack.

Broken ribs are a result of direct chest trauma caused by

• impacts from motor vehicle accidents,
• falls from a height,
• contact sports,
• child abuse.

Rib fracture may also occur due to repetitive trauma that occurs from playing sports such as golf and rowing, or from severe and prolonged coughing.

Making a diagnosis of broken ribs is done by performing several tests.

As most cases of broken ribs are caused by motor vehicle accidents, you may realize that you have a rib fracture in a hospital's emergency room.

If you get a broken rib because of repeated stress over a period of time, you may consult see primary care provider initially. Here is some information that helps you get ready for your appointment.

What you can do

You can make a list of the following information before you go to your doctor:

• Your symptoms, including those that seem unrelated to the reason you made the appointment
• Key personal information, including any recent accidents
• Medications, vitamins and supplements that you take, including the doses

Questions to ask your doctor

Ask a family member or friend to come along, if possible, to help you remember the information that you're given during the appointment. For broken ribs, some basic questions to ask your doctor include:

• For how long will the pain last?
• What kind of treatments are available, and which do you suggest?
• How can I best manage rib fracture with my other health conditions?
• Do I require any activity restrictions?

What to expect from your doctor

Your doctor may ask some questions such as:

• When did your symptoms start?
• Where is your pain located?
• Are your symptoms continuous or occasional?
• What is the severity of your pain?
• Do you know the cause for your pain?
• Is there anything that makes your pain better or worse?

During the physical examination, your doctor will gently put pressure on your ribs, listen to your breathing, and observe your rib cage move as you breathe. Your doctor may order one or more of the following imaging tests:

X-ray

Bones are visible on X-rays. But X-rays may have problems in revealing fresh rib fractures or if the bone has merely cracked. X-rays may be useful in diagnosing a collapsed lung.

CT scan

This scan reveals broken ribs that X-rays often miss out. Soft tissues injuries and blood vessel damage can be easily seen on CT scans.

MRI scan

This reveals any damage of the soft tissues and organs around the ribs. It also helps in the detection of more subtle rib fractures. An MRI makes use of a powerful magnet and radio waves to create cross-sectional images of internal organs.

Bone scan

This technique is good to determine stress fractures, where a bone gets cracked after repetitive trauma — such as prolonged bouts of coughing. During a bone scan, a small amount of radioactive material is injected into your blood circulation. It collects at the sites of bone, where healing takes place, and is detected by a scanner.

Most broken ribs take at least six weeks to heal on thier own and do not need specific treatment. Activity restriction and application of ice at the injured area regularly helps in normal healing and provides pain relief.

Application of an ice pack wrapped around a cloth should be done for 20 minutes every hour whenever you are awake for the initial 2 days of injury. Afterwards, ice pack can be applied for 10-20 minutes three times a day to reduce pain and swelling.

Medications

It is necessary to obtain adequate pain relief because if you avoid breathing deeply because of pain, you may develop pneumonia. If oral medications are not effective, your doctor might advise administration of injections of long-lasting anesthesia around the nerves that supply the ribs.

Therapy

Once your pain reduces, your doctor will teach certain breathing exercises that help you breathe deeply because shallow breathing can increase your risk of developing pneumonia.

Earlier, doctors would advise compression wraps — elastic bandages that are wrapped around your chest — to help splint and immobilize the area. Compression wraps are not used for broken ribs anymore as these could keep you from breathing deeply, which can lead to a lung infection or pneumonia.

Here are some measures that help you prevent a broken rib:

Protect yourself from getting injured during sports activities

Wear necessary protective equipments while engaging yourself in contact sports.

Reduce household falls

• Clean all the clutter from your floors and wipe the spills promptly,
• place a rubber mat in the shower,
• keep your home well-lit,
• put skidproof backing on carpets and area rugs to decrease your risk of household falls.

Make your bones strong

Include enough amount of calcium and vitamin D in your diet to maintain strong bones. About 1,200 milligrams of calcium and 600 International Units of vitamin D is required every day from diet and supplements.

There are different ways to adapt your lifestyle in coping with broken ribs.

Most of the times, broken ribs may be taken care at home. You can look after yourself by taking these precautions:

• Take over-the-counter pain medications such as paracetamol and ibuprofen for adequate pain relief

• Apply an ice pack to your chest during the first few days. This helps you reduce the pain and swelling.

• Take some time off work if you require, particularly, if your work causes physical strain or if your pain is severe.

• Be active in between periods of rest periods. Walk around and move your shoulders occasionally to help with your breathing and help clear off any mucus from your lungs.

• Hold a pillow against your chest while you cough.

• Do breathing exercises: Take in 10 slow, deep breaths every hour, let your lungs inflate fully each time, to help keep your lungs clear.

• Avoid wearing a bandage tightly around your chest, as this does not allow your lungs to expand properly.

• Avoid lying down or staying still for a long period.

• Sleepin in an upright position for the initial few nights.

• Avoid lifting heavy objects or straininh till you heal completely, as you may injure yourself again and this takes long time to recover.

• Stop smoking if you do so as it helps in your recovery.

Risk factors

The following factors may increase your risk of having a broken rib:

Osteoporosis

People with this disease are more susceptible to rib fractures as their bones lose their density.

Participation in certain sports activities

Playing contact sports such as hockey or football increases your risk of chest trauma and rib fracture.

Cancerous lesion in a rib

A cancerous lesion can make your bone weak, and more susceptible to rib fracture.

Complications

The sharp edge of a broken rib may damage blood vessels and internal organs. This risk increases with the number of broken ribs. Complications depend on which ribs break.

Potential complications of rib fracture include:

Torn or punctured aorta

If one of the first three ribs at the top of your rib cage break, their sharp edge could rupture your aorta or another major blood vessel.

Lung puncture

A broken middle rib can cause lung puncture and collapse.

Lacerations to the spleen, liver or kidneys

The two ribs in the bottom portion of the rib cage rarely fracture as they are more flexible than the upper and middle ribs that are anchored to the breastbone. In case a lower rib breaks, its broken ends may seriously damage your spleen, liver or a kidney.