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This survival-medicine website provides general information, not individual advice. Most scenarios assume the victim cannot get expert medical help. Please see the disclaimer.

The Broken Rib Don’t (Formerly a Do)

by James Hubbard, MD, MPH

I heard a pro football player being interviewed on television say that of all the multiple injuries he had suffered through, a broken rib was the most painful. I can see why. It hurts anytime you move your arms, bend—it even hurts to breathe. And it can hurt for weeks. So what can you do to help it heal and relieve the pain?

One thing you shouldn’t do for a broken rib is wrap it. I know, that’s what we always used to do, and it can ease the pain considerably, but whether you wrap the ribs with a rib belt, elastic bandages, or anything else, you’re not going to be able to breath as deeply, and that puts you at risk for pneumonia.

But since pain is the main problem with most rib fractures, what can you do?

  1. Take it easy. The rib is going to heal. It’s going to take six to eight weeks. You might as well mentally deal with it and physically not overdo it by, say chopping wood, or doing something that’s going to injure the tissue around the break and make it tenderer.
  2. Take over-the-counter pain meds like ibuprofen (Advil), naproxen (Aleve), or acetaminophen (Tylenol) to relieve the pain and inflammation.
  3. Apply ice packs covered with cloth for ten minutes on, ten minutes off to relieve the pain and swelling.
  4. Make sure you take good, deep breaths to keep your lungs expanded. If it hurts too much, press the area around the pain with your hand or up against something hard for support. Do the same if it hurts too bad to sneeze or cough. Yes, I know this is doing essentially the same as an elastic binder, but you’re only doing it for a few seconds.
What About a Chest-Wall Strain?

You really can’t tell the difference between a strain and a rib fracture without an X-ray. And even then, some rib fractures are missed. But it doesn’t matter a whole lot because you’re going to treat them the same. The X-ray is to make sure the injury hasn’t punctured a lung or caused bleeding in the chest cavity. Also, if you see a fracture, you can predict it’s probably going to take longer for the pain to go away.

Complications of Rib Fractures

While broken ribs usually aren’t an immediate threat to life by themselves, the following complications can be dangerous. You may need to get professional medical help if they happen.

1. Bleeding into the chest wall.
The sharp, fractured bone can move out of place during the initial injury and damage a blood vessel that can leak blood into the chest wall. The blood between the chest wall and lung puts pressure on the lung and squeezes it into a smaller space. Besides pain, you’re going to get really short of breath.

2. Punctured lung.
The sharp fracture can puncture the lung. Just like the blood, air leaks out into the area between the chest wall and lung, putting pressure back on the lung. It’s really impossible in the field to know the difference between this and the bleeding.

3. Pneumonia.
This is the one you have the best chance to prevent by heeding the four steps above.

Treatment of Complications

A small amount of blood or air caught between the lung and chest wall will go away on its own. Usually there’s more pain and shortness of breath but not extreme. Larger amounts can cause quite a bit of shortness of breath and may need to be drained for relief as soon as possible. That’s for another post.

I already have a post on pneumonia, but antibiotics are key.

 

Have any of you ever had a chest injury? What did you do for it? How long did it take for the pain to go away?

 

Photo by Kordite on Flickr.

  • tina

    i did not know that about wrapping the ribs. my husband has a cracked or possibly bruised rib and we have been wrapping it and leaving the wrap on for about fifteen to thirty minutes at a time about three times a day and he leaves it off when he is sleeping. no problems with deep breaths but the area is still tender and causes pain when coughing and sometimes laughing.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Tina, Please be kind and don’t tell him jokes.

  • Tammi

    This is awesome information at just the right time. My husband just broke 3 ribs in a fall and I have been scouring everything I can read about this.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Thanks, Tammi. Three ribs. That sounds painful.

  • jamie

    I broke 2 ribs years ago from coughing due to bronchitis. To this day it seems as though one of the ribs shifts and then stabs me. I have to push in the area a couple of times to move the rib back into position. Needless to say, this was not a fun fracture to deal with.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Jamie, no, it doesn’t sound like fun. Thanks for sharing, though.

  • Linda

    Despite the current raging controversy regarding comefrey’s safe use, comfrey poultices have been used for eons by many cultures to help heal broken bones. One of comfrey’s active constituents is allantoin; which has cell-proliferant properties – allowing the herb to helps heal skin and bones. Comfrey contains the hepatotoxin (toxic to liver) pyrrolizidine alkaloids; so the recommendation to not use it on broken skin or for long periods of time seems prudent until we know differently.

    John and Kimberly Gallagher over at LearningHerbs.com offer a very nice tutorial in pdf format on making and using this remedy: http://www.learningherbs.com/support-files/comfreypoulticelowres.pdf

    Comfrey is another on of those easy-to-grow, nice-to-have-on-hand herbs.

    Hope this helps ~Linda (Barefoot Yankee Gal)

    • http://www.TheSurvivalDoctor.com James Hubbard, M.D., M.P.H.

      Thanks Linda

  • Jim

    Got two broken ribs during a kick boxing event. Wasn’t much fun, but the worst part was all the friends who couldn’t stop making me laugh about it.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Jim, smiling on the outside, crying on the inside.

  • Valerie H

    I am currently recovering from 4 broken ribs and a collapsed lung. I got some serious air time when my horse threw me. I also got some good bruising on my spine when a hoof caught me.

    When I landed, I did NOT bounce and was in indescribable pain. I spent 2 nights in the hospital. It’s been 2 months, and I’m nowhere near my usual activity level.

    I went through a period of being short of breath, but that’s improving.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Valerie, I’m so sorry for you. I guess all you can do now is give it more time.

    • Wendi K

      In 2009 I got thrown from my horse. Landed hard and felt the air get forced from my right lung. I took one big gasp of air and my lungs felt normal again. I had had bruised ribs before, so I thought I just badly bruised myself on my right side. Next day I went to work, left early, went to urgent care, then to the ER.
      Turns out I broke 4 ribs, one or two of them in 2 places. Punctured my right lung slightly at the bottom – which re-inflated itself after the fall, bruised my liver and slightly cracked 2 fingers. Took about 2-3 months to recover. Had shortness of breath for weeks, and trying to drive over a speed bump, even at 3 miles an hour was EXCRUCIATING! They did not keep me in the hospital. I wish they would have for pain management. Oh well! I survived it! Took 2 days off and returned to work.

      • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

        Wendi, you sound pretty tough. Glad you’re okay.

        • Wendi K

          Thank you Dr. Hubbard!

  • debbie

    I broke a rib from coughing of all things, man it is worse than having a broken leg or anything. cant breath laugh sneeze hiccup or anything.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Thanks, Debbie

  • Chuck

    Broke a few ribs sledding doubles some years ago. Didn’t wrap it, but the pain is just as described – breathing, bending over, raising arms. It took probably 4 months for me to be pain free. I was surprised at how much it hurt. But boy, the air we got on the sled was totally awesome!!

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Chuck, hope it was worth it. :)

  • Tom Ambrose

    Tylenol relieves inflammation?

    • Just Another Poster

      Don’t drink, at all, when using Tylenol. Tylenol and even a small amount of alcohol can cause permanent damage to your liver.

      Anyway, what I wanted to add is that if you sleep on your side, sleep on the side with the broken or bruised rib. It will offer some compression at the cost of some initial discomfort and will not hinder your breathing. Ask me how I know :)

      • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

        Thank, Just

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Tom, sorry for the confusion in the post.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Tom, no. But can relieve pain. It’s especially good in someone who can’t take the nsaids because of stomach irritation or other medical reasons.

  • GoneWithTheWind

    Some years back I had a lobectomy, no easy scopic surgery for me. The doctor said he had to break 4 ribs each in two places. I asked how big the “hole” was and he replied big enough to throw his desk telephone through. When people see my scar (13 inches) I explain I was in a machette fight and took second place. But the recovery was pure pain. The worst thing in the world was a sneeze. Eight years later if something bumps that side of my chest it will drop me to my knees with pain. I’m not sure it will ever be right.

    • http://www.thesurvivaldoctor.com James Hubbard, M.D., M.P.H.

      Gone, you’ve been through it. I hope you continue to improve.