The ribs are the cage-like bones in the chest cavity that protect the lungs and heart. Several layers of muscle connect the ribs to each other.
The severity of broken ribs can vary. Although painful, a hairline fracture in one of these bones is not usually anything to worry about and will often heal without treatment.
However, it is not uncommon for people to have more than one broken rib at the same time. Blunt trauma, such as from an automobile accident, is the most common cause of serious rib fractures.
In this article, learn about the symptoms of a broken rib, as well as how doctors diagnose and treat them. We also discuss the recovery process.
A simple broken rib usually means that a person has a hairline fracture in one of the rib bones in the chest.
In more complex fractures, the edges of the broken bone can be pushed out of place.
A serious rib fracture can damage the nearby internal organs, nerves, or blood vessels.
The sharp end of a displaced broken rib may puncture the lung, for example. This complication is called pneumothorax.
Sometimes, part of the rib can break off completely and “float,” or move independently in the chest.
When someone breaks three or more ribs in two or more places, it can lead to a serious condition called flail chest. People with flail chest will find it hard to breathe and need immediate medical attention.
Blunt trauma is the most common cause of a broken rib. Causes of blunt trauma include:
- an automobile or bicycle accident
- falling from a height
- a physical attack
Around 10% of people who go to the hospital for blunt chest trauma will have one or more broken ribs.
Severe coughing can also cause a rib fracture. These stress fractures tend to occur in the upper or middle ribs.
Some people are more susceptible to broken ribs, including older adults and those with health conditions that affect the bones, such as osteoporosis or osteopenia.
The main symptoms of a broken rib include:
- pain in the chest wall that gets worse when breathing, moving, or coughing
- bruising or swelling around the ribs
- shortness of breath
- difficulty taking a deep breath
To diagnose a rib fracture, a doctor will usually look for signs of bleeding or bruising during a physical examination. They may ask the person about their pain levels and if it is difficult to breathe.
The next step is usually a chest X-ray with rib detail. A simple hairline fracture will show as a crack or jagged edge on the bone. The doctor will easily be able to see any segments of floating bone on an X-ray.
Anyone who suspects that they have a broken rib should speak to a doctor.
If the person has trouble breathing or severe chest pain, they should call 911 or the local emergency number immediately.
Immediate medical attention may also be necessary if the pain does not get better after treatment or if the person develops a fever or cough.
Simple fractures will usually heal by themselves. Doctors may recommend resting to facilitate this.
People should avoid activities that involve pulling, pushing, or lifting, as they might make the pain worse or cause more damage to the ribs.
If a person has more than one fractured rib, severe damage, or flail chest, they may need surgery. During the operation, a surgeon will use plates and screws to fasten the broken ribs together.
Surgery will also repair any damage to internal organs, nerves, or blood vessels.
Doctors previously thought that the pain and other symptoms of broken ribs lasted no more than 6–8 weeks, but research suggests that many people experience pain for longer than this.
People with simple rib fractures can usually recover at home. In more serious cases, the person may need to stay in the hospital.
During the healing process, clinicians usually recommend pain medications. These may include drugs such as acetaminophen or a nonsteroidal anti-inflammatory drug such as ibuprofen.
People with severe pain may need to take prescription pain medications such as opioids. Alternately, a doctor may recommend an intercostal nerve block, which is an injection.
Ice may decrease swelling and pain and help prevent tissue damage. People should cover an ice pack or bag of crushed ice with a towel before placing it on the injured area.
Sometimes, rib fractures can lead to lung infections. A doctor may recommend trying deep breathing exercises to help prevent this.
These might involve taking a deep breath and holding it for as long as possible, before letting out the air and coughing strongly. If it hurts, the person can try supporting the rib area with their hands, a towel, or pillow while performing the exercise.
No one with a broken rib should attempt to take part in contact sports for at least 6 weeks, or for as long as their doctor recommends.
The severity of broken ribs can vary. A simple fracture will heal by itself with rest. It may take up to several weeks for the pain to fully subside.
More severe cases, however, can lead to serious health conditions. These will usually need hospital treatment and may require an operation.