Rib injuries Wharanga rara

Rib injuries are most commonly caused by a direct impact to the chest such as from a:

• fall
• sports injury
• car accident.

Ribs also can be broken by repeated impact from sports such as golf and rowing or from coughing hard and long.

Rib fractures can happen at any age, but some conditions increase your risk of a fracture, such as:

• osteoporosis (thinning of bones)
• cancer in a rib — this can weaken the bone
• radiotherapy to the chest wall — this can also weaken the bone.

Rib injuries are painful and can cause your breathing to be shallower than normal. They can also make it difficult for you to cough or sneeze.

You may also notice:

• an ache in the ribs, especially at night or first thing in the morning (particularly in the first few days after injury)
• pain increases when lying on the injured side, or with pressure on the injured area
• pain during movements of your upper back or your arm (such as bending, twisting or lifting your arm overhead).

Often, broken ribs are only cracked. Cracked ribs are painful, but they do not cause the problems that ribs that have broken into pieces can.

• The sharp edge of a broken bone can harm major blood vessels or nerves, especially from the higher ribs.
• The jagged end of a broken middle rib can punch a hole in a lung and cause it to collapse.
• The ends of a broken lower rib can cause serious harm to the spleen, liver or a kidney.

The more rib fractures you have, the more likely you are to have associated injuries.

As rib fractures are quite painful, you may tend to take short shallow breaths, minimise movement and avoid clearing your chest with a cough. This can increase your chances of getting pneumonia (a chest infection).

Healthcare providers often do not need to do any tests to diagnose injured ribs. The treatment for bruised and broken ribs is the same so it is not usually necessary to get an x-ray to tell them apart.

Sometimes you may need an x-ray, CT scan or MRI to check for damage to other organs such as the lungs, liver, spleen or kidneys. 

Injuries where a broken rib has damaged organs such as your lungs, liver or spleen will need hospital treatment.

Other treatment depends on how bad your injury is. Often rib injuries are quite minor, although painful. These injuries will heal on their own without any specific treatment. This usually takes about 6 weeks.

It may be helpful to see a physiotherapist for advice on:

• breathing exercises to prevent lung complications
• exercises to improve your posture, flexibility and strength
• modifying activity
• planning a gradual return to activity including sport.

Self care for a rib injury

Rib injuries can increase your chance of getting pneumonia (chest infection) because it can be hard to cough.

There are things you can do to reduce your chance of getting pneumonia.

• Do regular breathing exercises — take 10 slow, deep breaths every hour while you are awake to let your lungs fully expand.
• Take regular pain relief so you can take deep breaths and cough easily. Your healthcare provider or pharmacist will be able to advise what is best for you.

Pain relief medications for adults

It is normal to still feel some discomfort even with regular pain relief. As your ribs heal, you can reduce the amount of pain relief.

You might find it less painful if you hold a cushion or pillow against your injured side when trying to cough or take deep breaths.

See your healthcare provider if:

• your pain is getting worse
• you are having trouble breathing
• you are coughing more
• you have a fever — a temperature over 38 degrees.

These are signs that you could be developing a chest infection.