Most broken ribs—including in children—come from vehicle accidents, but they’re also common from falling off horses, sports injuries, and falls. In some cases, lots of forceful coughing—like from a bout of pneumonia—can cause rib fractures. The elderly can get broken ribs easier than younger adults. Kids have more flexible bones.
Types of Broken Ribs
Most of the time, the rib is only broken in one place, and is an “incomplete fracture,” meaning not all the way through the bone.
Displaced and Nondisplaced Rib Fractures
Completely broken ribs may or may not move out of place. If they do move, they’re called displaced rib fractures and are more likely to puncture lungs or damage other tissues and organs. Ribs that stay in place—usually ribs that are not completely broken in half—are called nondisplaced rib fractures.
Flail Chest
Rarely, a section of the ribcage breaks away from the surrounding bone and muscle. This area loses its stable structure (imagine a short rack of baby-backs connected to the rest of the ribcage only by muscle) and moves fairly easily as the patient breathes. This section is known as a flail segment and is much more dangerous than simply broken ribs.
Broken Rib Symptoms
After an injury to the chest—or particularly forceful coughing—consider the possibility of a broken rib if the patient has any of the following:
Extreme pain when taking a breathTenderness over an area of ribs in the chest or back Crepitus—a “crunchy” feeling under the skin
Causes
One of the best ways to identify a broken rib is the mechanism of injury. Getting hit in the chest, falling on something and hitting the chest or smashing the chest into a steering wheel or dashboard during a car accident could certainly lead to broken ribs. Forceful coughing can also be a mechanism for breaking ribs.
Diagnosis
Any force hard enough to break a rib is powerful enough to cause other, more life-threatening injuries. It’s also possible to break more than one rib at a time. More than three broken ribs at one time are potentially life-threatening. Since the only way to know for sure is to get an X-ray, it’s important to go to the emergency department anytime you suspect a broken rib.
It’s especially dangerous if the patient has any of the following signs or symptoms:
Severe shortness of breath Coughing blood Confusion or dizziness General weakness Blood in the urine
Treatment
There’s good news and bad news about treating a simple broken rib. The good news is that it will heal on its own and probably not develop any additional problems. The bad news is it hurts a lot and there’s really very little you can do for it.
In the past, treatment for broken ribs included wrapping the chest with a wide band often called a rib belt. A study in 1990 found no benefit from wrapping patients. Displaced rib fractures caused more problems in this study when they were treated with the belt than when they were not. Most emergency physicians today don’t wrap broken ribs.
The best broken rib treatment is simple pain medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen are best. If you go to the ER for your broken rib, the doctor is likely to give you a prescription pain medication as well as a NSAID.
Complications
The most common complication of broken ribs is not being able to take a deep breath because it hurts. If you don’t breathe deeply enough, mucous and moisture can build up in the lungs and lead to an infection such as pneumonia.
Coping
It’s important to keep your lungs healthy. As you heal, practice taking deep breaths. It’s important not to be afraid of taking the pain medication as prescribed because keeping the pain under control is important for taking strong, deep breaths.
If you go to the ER, the doctor may send you home with a tool to encourage deep breathing. The tool is called an incentive spirometer. It measures lung capacity so patients can see how well their lungs are recovering as the broken rib heals.
A Word From Verywell
Although broken ribs are painful, simple rib fractures usually do not require surgery. In most cases, broken ribs usually heal on their own. Time, rest, and physical therapy can help you with the healing process, exercise, and maintaining your range of motion. Healing can take at least six weeks, so it is important to also exercise patience. It is important to talk to your doctor about adequate pain control, physical therapy, and breathing exercises so that you can continue to breathe deeply, move around, and avoid lung complications, such as pneumonia.
Trouble breathing (dyspnea) that gets increasingly worseDifficulty taking deep breathsCoughing, including an unusual cough or a cough that brings up blood or mucusFeverDizzinessWeaknessAbdominal pain
