Patient education: Rib fractures in adults (The Basics)

What is a rib fracture? — A "fracture" is another word for a broken bone. A rib fracture is when a person breaks a rib bone (figure 1).

There are different types of fractures, depending on how the bone breaks. When a bone breaks, it might crack, break all of the way through, or shatter.

Most rib fractures happen after an injury to the chest. If the injury is severe, it can also damage organs in the chest or belly.

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

What are the symptoms of a rib fracture? — Symptoms depend on which bone breaks and the type of break it is. Common symptoms can include:

●Pain, swelling, or bruising over the area

●Pain taking a breath or moving the upper body or arms

●The area looking abnormal, bent, or not the usual shape

●Not being able to take a deep breath

●Numbness in the area of the broken bone

A stress fracture also causes pain, but the pain usually starts slowly and gets worse over a few weeks or months.

Is there a test for a rib fracture? — Yes. If your doctor or nurse thinks that you have a rib fracture, they will ask about your symptoms, do an exam, and order a chest X-ray or other imaging test. Imaging tests create pictures of the inside of the body.

An X-ray will check for rib fractures and make sure that you do not have a collapsed lung (called a "pneumothorax"). Some people need other imaging tests to check for rib fractures, such as a CT, MRI, or ultrasound. These tests can also be used to look for other injuries.

How are rib fractures treated? — Treatment depends, in part, on the number of fractured ribs, the type of fracture, and how serious it is. The goal is to make sure that you can breathe deeply enough to get enough oxygen into your body and carbon dioxide out of your body. People with many broken ribs or other serious injuries usually need treatment in the hospital. Older adults might need to be in the hospital, too, even for less serious injuries.

In very serious cases, the doctor might need to do surgery to put the bones back in the correct position and put plates across them. This is called "rib stabilization." You might need this if:

●The ends of the broken ribs are not in line with each other.

●You have many broken ribs.

●The broken ribs are preventing you from breathing deeply.

People who do not need treatment in the hospital are treated with pain-relieving medicines. This 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. This raises the chances of getting a lung infection, called "pneumonia."

To treat your pain:

●Take an over-the-counter pain medicine. These include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve).

●Your doctor might prescribe a stronger pain medicine to take for a short time. Follow the instructions for taking these medicines.

●If you are in the hospital, you might get other treatments to help with pain. Examples include a shot called a "nerve block" or medicines given through an "epidural." An epidural is a small tube (catheter) that goes into your back, near the nerves in your spine.

Your doctor will probably also recommend a treatment to help prevent your small airways from closing off. It involves breathing deeply into a handheld device several times each day. The device is called an "incentive spirometer."

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.

How long do rib fractures take to heal? — Most rib fractures take weeks to months to heal. The doctor or nurse will talk to you about when to return to things like work, sports, or other activities.

Healing time also depends on the person. Healthy children usually heal much more quickly than older adults or adults with other medical problems.

How can I care for myself at home? — To care for yourself at home:

●Use your incentive spirometer or take 10 to 15 deep breaths at least 4 times each day.

●Hold a pillow to your chest to ease the pain when you take deep breaths, sneeze, cough, or laugh.

●Increase your activity slowly when you no longer have pain while resting. Avoid heavy lifting and sports for at least 3 weeks. (Your doctor or nurse will tell you exactly how long to avoid these or other activities.)

●Ice can help with pain and swelling:

•Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and the skin.

•Use the ice (or other cold object) for at least 6 hours after the injury. Some people find it helpful to ice longer, even up to 2 days after their injury.

●Eat a healthy diet that includes getting enough calcium, vitamin D, and protein (figure 2).

●If you smoke, try to stop. Broken bones take longer to heal if you smoke.

When should I call the doctor? — Call for advice if:

●It is getting harder and harder to breathe.

●You are so short of breath that you cannot talk in a full sentence.

●You develop severe pain in your chest, back, or neck.

●You start to cough up blood or yellow or green mucus.

●You have a fever of 100.4°F (38°C) or higher or chills.

●You are very weak or lightheaded, or feel like you might pass out.

●You have very bad pain that is not helped by your medicines.

More on this topic

Patient education: Fractures (The Basics)
Patient education: Pneumonia in adults (The Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (The Basics)
Patient education: Calcium and vitamin D for bone health (The Basics)
Patient education: Quitting smoking (The Basics)
Patient education: How to use an incentive spirometer (The Basics)
Patient education: Deep breathing and coughing after surgery (The Basics)

Patient education: Pneumonia in adults (Beyond the Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (Beyond the Basics)
Patient education: Quitting smoking (Beyond the Basics)
Patient education: Calcium and vitamin D for bone health (Beyond the Basics)