Recognize and treat broken ribs – this is how it works!

Recognize and treat broken ribs - this is how it works!

The ribs protect the underlying organs as part of the chest (thorax). But what happens when a rib is broken? The causes and symptoms of a broken rib can be very varied and challenging to identify. The correct and timely recognition of a rib fracture is essential for the shortest possible healing period. Here, you can find out how a broken rib manifests itself and how it can be treated.

What is a rib fracture?

A fracture of one of the 24 rib bones is called a broken rib or rib fracture. The rib bones are paired, so twelve rib bones are on each side. The pairs of ribs are numbered from top to bottom, whereby the number does not indicate on which side a rib is broken.

If more than three ribs are broken on one side of the chest, it is called a serial rib fracture. The ribs from the fourth to the ninth are most commonly affected by fractures.


What are the symptoms of a broken rib?

A broken rib often manifests through typical signs that can give the first indication of the presence of a fracture (fracture). The classic symptoms of a broken rib are:

  • Pain that gets worse, primarily when you breathe
  • instability of the chest
  • Bruising (hematoma) on the chest

Identify a broken rib.

Chest pain and bruising are very non-specific symptoms that are common without a broken rib being involved. For example, a wrong movement or position while sleeping can also cause breathing-related pain. However, these are usually caused by tense muscles in the spine or chest and are comparatively harmless.

Above all, severe pain that does not get better and causes difficulty breathing should be a reason to see a doctor. The doctor can test the stability of the chest by gently applying pressure to it. The doctor also takes an x-ray. Cracks can be detected on this.


Rib bruise or broken rib?

The symptoms of a rib bruise are no different from those of a broken rib. However, when the bruise occurs, only the surrounding tissue is damaged, and the rib is intact. In case of doubt, only a doctor can use an X-ray to tell whether a rib is broken.

In addition, pleurisy can also cause pain in the rib area, but it is usually accompanied by coughing, rattling breath or possibly fever.

Which doctor should you see?

Do you have rib pain, and are you worried a rib might be broken? Then the next question is which doctor you should see now. 

The family doctor is the first point of contact for most people. He can classify the symptoms and decide whether further investigation is necessary. As a rule, however, he cannot take an X-ray and has to send the patient on.

You are, therefore, better off in the emergency room of a hospital. Important: The emergency rooms are usually overcrowded, and the waiting times are correspondingly extended. Therefore, you should only go to the emergency room if it is an emergency. However, a suspicion of a fractured rib justifies a visit to the emergency room.

Orthopedists in private practice also usually admit patients with severe pain and usually also have the option of taking an X-ray. But it can also happen that the orthopedist sends you to a hospital for an X-ray.

Treating a broken rib properly

The treatment of a broken rib primarily involves the exclusion of more severe complications. The doctor takes an x-ray and examines the patient. If everything is fine apart from the broken rib, no special therapeutic measures must be taken. This means that, as a rule, neither an operation nor special measures for immobilization are carried out.

The person concerned receives painkillers and should rest physically in the following weeks. The treating doctor decides which painkillers are used for a rib fracture. Ibuprofen or Novalgin® are usually sufficient.

For a broken rib, sick leave is usually for two to three weeks. The sick leave can also be extended if you do heavy physical work.


Injuries as complications of a broken rib

A broken rib is painful but usually heals without consequences and is not dangerous. However, the possible accompanying injuries can be dangerous.

These include, in particular, accumulations of air or liquids in the so-called pleural space. The pleural space is the space between the chest wall and the lungs. Usually, the lungs lie directly on the inside of the chest wall.

However, a broken rib can cause a lung injury. The lung on the affected side collapses, it collapses. You can think of this as a balloon. If the balloon is whole, it is taut and expanded. If it has a hole, air will escape and collapse. Air may flow through the injured lung into the pleural space.

Air can also leak into the pleural space through a chest wall injury. In this case, the lung would not be injured but is compressed by the air in the pleural space.

Rib fracture: possible complications

As a result of the accompanying injuries mentioned, the following complications of a rib fracture are possible:

  • Pneumothorax: This is an accumulation of air between the chest wall and the lungs. Injury to the lungs or chest wall can allow air to enter the space. The collapsed lung loses its function, so those affected feel shortness of breath, pain, and usually also fear.
  • Haemothorax: If blood collects in the pleural space in addition to the air, this is called a haemothorax. The blood comes from blood vessels that were damaged in the rib fracture. The symptoms do not differ fundamentally from those of pneumothorax. However, the loss of blood can lead to circulatory problems.

In addition, the instability of the chest and the pain can cause the affected person to breathe very shallowly but quickly ( hyperventilation ).

What to do with a serial rib fracture?

A fracture of more than three ribs on one side (serial rib fracture) should be treated as an inpatient – ​​in contrast to a simple rib fracture. Careful pain therapy and breathing training can then be carried out. Breathing training can help prevent complications and reduce pain.


How long does it take to heal after a broken rib?

The healing process for a fractured rib is quite variable; therefore, how long the pain and healing takes varies incredibly. A healing period of four to six weeks can be assumed in most cases.

A shorter healing period is considered unlikely. However, individual cases may have delays so that healing may take a few weeks longer.

Physical rest without complete inactivity is decisive. This means you should move about generally in everyday life but avoid heavy lifting or activities that cause pain.

Assist in the healing of a broken rib.

Physiotherapy, bandages or kinesio tape are often used to support the treatment of a rib fracture. However, these accompanying measures are optional.

Physical rest without complete inactivity is most important for healing a fractured rib. The supportive measures usually cannot influence the healing time but often give the person concerned a good feeling. Physiotherapy can, for example, take away the patient’s fear of specific movements and improve mobility.

When is sport possible again after a rib fracture?

It would help to wait until the bone has completely healed before engaging in contact sports. This can take up to two or three months. It may be advisable to take another x-ray.

Depending on the pain, less stressful sports or physiotherapy can be started after about three to five weeks. If in doubt, you should consult your doctor.


How can you break a rib?

Classically, a rib fracture occurs as a result of direct force (blunt trauma) on the rib. This can have several causes, for example:

  • Contact sports: soccer, basketball, handball, martial arts
  • Fights: kicks, punches
  • traffic accidents
  • falls from great heights

If no force could have triggered the injury (adequate trauma), other diseases can be considered:

  • Osteoporosis (lack of bone mass)
  • malignant masses (cancerous tumours that take up space and thus affect the bones)

A fracture without previous trauma or due to only a slight trauma (inadequate trauma) is called a pathological fracture and must be clarified by a doctor in any case.

Broken rib from coughing or sneezing?

Even trivial things like coughing or sneezing can break ribs in individual cases. Coughing and sneezing create unusually high pressure in our bodies. In extreme cases, this can lead to ribs breaking.

However, this is instead the exception and occurs above all in people who cough or sneeze frequently and violently or are predisposed by the diseases mentioned above. Nevertheless, severe, persistent pain in the rib area after coughing or sneezing should be clarified by a doctor.

What types of rib fractures are there?

In addition to the already described simple rib fracture and the serial rib fracture, there are other types of rib fractures:

  • Displaced (displaced) rib fracture: If the two fragments are displaced from each other, the rib fracture is referred to as displaced. This shift can be seen in the X-ray image. Usually, however, rib fractures are not displaced. A displaced rib fracture may even necessitate surgery.
  • Consolidated (compacted) rib fracture is an old, healed rib fracture. The fracture was filled with new bone and has healed.
  • Spontaneous (pathologic) rib fracture: This is a broken rib without associated trauma (e.g., from sneezing, coughing, or light pushing).

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