Broken ribs

Overview

A broken rib is a common injury that occurs when one of the bones in the rib cage breaks or cracks. The most common causes are hard impacts from falls, car accidents or contact sports.

Many broken ribs are simply cracked. Cracked ribs are painful. But they don't cause the problems that ribs that have broken into pieces can. The sharp edge of a broken bone can harm major blood vessels or lungs and other organs.

Usually, broken ribs heal on their own in about six weeks. Pain control is important for being able to breathe deeply and avoid lung issues, such as pneumonia.

Symptoms

The following can cause pain with a broken rib or make pain worse:

• A deep breath.
• Pressure on the injured area.
• A bend or a twist of the body.

When to see a doctor

See a health care provider if part of your rib area is tender after an accident or if you have trouble breathing or pain with deep breathing.

Seek medical help right away if you feel pressure, fullness or a squeezing pain in the center of your chest that lasts for more than a few minutes or pain that goes beyond your chest to your shoulder or arm. These symptoms can mean a heart attack.

Causes

Direct impact — such as from a car accident, a fall, child abuse or contact sports — is the most common cause of broken ribs. Ribs also can be broken by repeated impact from sports such as golf and rowing or from coughing hard and long.

Risk factors

The following can increase the risk of breaking a rib:

• Osteoporosis. This disease in which bones lose their bulk increases the risk of breaking a bone.
• Sports. Playing contact sports, such as hockey or football, increases the risk of injury to the chest.
• Cancer in a rib. Cancer can weaken the bone, making it more likely to break.

Complications

A broken rib can harm blood vessels and internal organs. Having more than one broken rib increases the risk.

Complications depend on which ribs break. Possible complications include:

• Tear in the main artery of the body, known as the aorta. A sharp end from a break in one of the first three ribs at the top of the rib cage could pierce a major blood vessel, including the aorta.
• Tear in a lung. The jagged end of a broken middle rib can punch a hole in a lung and cause it to cave in.
• Ripped spleen, liver or kidneys. The bottom two ribs rarely break because they can move more than the upper and middle ribs. But the ends of a broken lower rib can cause serious harm to the spleen, liver or a kidney.

Prevention

To help keep a rib from breaking:

• Protect from athletic injuries. Wear protective equipment when playing contact sports.
• Reduce the risk of falls in the house. Remove clutter from floors. Wipe up spills right away. Use a rubber mat in the shower. Keep your home well lit. Put backing on carpets and area rugs to keep them from sliding.
• Strengthen bones. Getting enough calcium and vitamin D in the diet is important for strong bones. Get about 1,200 milligrams of calcium and 600 international units of vitamin D daily from food and supplements.

Diagnosis

During the physical exam, a health care provider might press gently on the ribs, listen to your lungs and watch your rib cage move as you breathe.

One or more of the following imaging tests might help with the diagnosis:

• X-ray. Using low levels of radiation, X-rays allow the bones to be seen. But X-rays might not show a fresh break, especially if the bone is only cracked. X-rays also can help diagnose a lung that has caved in.
• CT scan. This often can find breaks that X-rays might miss. CT scans also make it easier to see injuries to soft tissues and blood vessels.
• MRI. This scan can look for harm to the soft tissues and organs around the ribs. It also can help find smaller breaks.
• Bone scan. This is good for viewing cracked bones, also called stress fractures. A bone can crack after repetitive trauma, such as long bouts of coughing. During a bone scan, a small amount of radioactive material is injected into your bloodstream. It collects in the bones, particularly in places where a bone is healing, and is detected by a scanner.

Treatment

Most broken ribs heal on their own within six weeks. Being less active and icing the area regularly can help with healing and pain relief.

Medicines

It's important to relieve pain. Not being able to breathe deeply because of pain can lead to pneumonia. If medicines taken by mouth don't help enough, shots can numb the nerves that lead to the ribs.

Therapy

Once pain is under control, certain exercises can help you breathe more deeply. Shallow breathing can lead to pneumonia.

Preparing for an appointment

Because car accidents often cause broken ribs, many people learn they have a broken rib in a hospital's emergency department. There's no time to prepare. But if you break a rib because of repeated stress over time, you might see your primary care provider.

Here's information to help you get ready for your appointment.

What you can do

Before you see your primary care provider, make a list of:

• Your symptoms, even those that seem unrelated to why you made the appointment, and when they began.
• Key personal information, including recent accidents.
• All medications, vitamins and supplements you take, including doses.
• Questions to ask your care provider.

Take a family member or friend along, if possible, to help you remember the information you're given.

For broken ribs, questions to ask your provider include:

• How long will I be in pain?
• What treatments are available, and which do you recommend?
• How can I best manage this with my other health conditions?
• Do I need to restrict my activities?

Don't hesitate to ask other questions.

What to expect from your doctor

Your care provider might ask:

• Where is your pain?
• Are your symptoms constant or do they come and go?
• How bad is your pain?
• Did anything happen to cause it?
• Does anything you do make the pain better or worse?