Broken or Cracked, Fractured Ribs Hurt

fractured-ribsWhether it’s a fracture or a clean break, anyone who’s cracked a rib can tell you that the pain is unforgettable. With a broken leg, immobilization helps control movement and pain. But doctors can’t immobilize the ribs, which must move as we breathe in and out. When every movement causes discomfort, healing takes time.

Our main focus in most patients with fractured ribs is to relieve the pain and assist with breathing so that other ailments, such as pneumonia, can’t take hold.

Most people recover from a fractured rib with conservative therapy and without lasting complications. If more than three ribs are injured, the condition is called a flail chest. In this case, there is not enough space for the lungs to expand.

Why You Need Those Rib Bones

Ribs do more than provide a nice frame for your muscles. They protect the organs in your chest, such as the lungs and heart. Ribs also allow us to breathe deeply by creating space within the chest cavity.

Many if not most rib injuries occur as a result of trauma— such as car accidents, violent tackles in football, or a fall from a ladder. People (especially young males) with rib pain may try to tough it out. Not a good idea. For starters, any blow that is hard enough to fracture a rib could also damage other parts of your body, such as the lungs, spleen or blood vessels. That’s why it’s important to have x-rays and other imaging tests as well as a physical exam.

Ribs can be injured by other less violent means as well. Patients with osteoporosis or cancer who have brittle bones have been known to fracture a rib just by coughing hard. One study showed that 40 percent of rib fractures had no identifiable trauma, and may have been caused by something as innocent as swinging a golf club.

Why We’re Careful About Broken Ribs

Fractured ribs, which may have only a hairline crack (but can still be painful) are less dangerous that a rib bone that has a total break. The jagged edge of bone on a broken rib can tear and injure internal organs, and the risk is increased if you have more than one broken rib.

knee-replacement-consultSome complications we’ve seen include:

  • a punctured lung, which collapses like a balloon that’s been pricked by a knife
  • torn aorta, when this major blood vessel is ruptured by a bony fragment
  • bruised or bleeding lung
  • lacerated (torn) spleen, kidneys or liver— less common because the lower ribs are more flexible and less prone to fracture. Still, it happens.

 How Can I Tell If It’s Broken

Patients with fractured ribs may be unsure what exactly hurts. Usually, you can tell if it’s a rib injury if it hurts (more) when you try to take a deep breath, or if you feel pain when someone presses on the injured area.

Not being able to breathe normally may lead to shortness of breath, headaches, dizziness, sleepiness or a feeling of panic or anxiety.

Any rib injury may set up the conditions for pneumonia. If the patient cannot breathe deeply, the lungs are vulnerable to inflammation. In fact, about one third of patients over the age of 65 who suffer a rib fracture end up with pneumonia— which is one of the leading killers of seniors.

Treatment for pneumonia consists of pain relief and breathing exercises. Our orthopedic staff will show you how to breathe deeply to avoid the fluid build-up that causes pneumonia. You will be given medication to relieve pain and help you sleep and breathe more comfortably.

Activities will probably need to be curtailed until you can move without pain. If the ribs are allowed to remain relatively stable, they typically heal within six weeks. However, it may take months for a patient to return to full-body engagement.