Symptoms
A fractured rib manifests as acute pain, most commonly with breathing, coughing, and pressure, and may be accompanied by a crunching sound. Possible complications and associated conditions include internal injury, pneumothorax, pneumonia, pulmonary contusion, respiratory failure, respiratory insufficiency, and hemorrhage. One or more ribs may be involved, and a rib may be broken more than once. It is called a serial rib fracture when more than three ribs are involved.
Causes
The injury usually occurs because of mechanical force, such as during sports, a car accident, a collision, or after a fall. Repetitive overuse and severe coughing can also lead to torn or broken ribs. Risk factors include:
- Sports, especially contact sports
- Cancer, metastases
- Osteoporosis, old age
Diagnosis
Diagnosis is made in medical treatment based on the patient’s history, physical examination, and with imaging techniques (e.g., X-ray, CT scan, ultrasound). Concomitant injuries must be excluded or treated separately.
Nonpharmacologic treatment
Single ribs usually heal on their own within one to two months. Treatment of a serial fracture is done as an inpatient.
- Physiotherapy
- Breathing technique: avoid gentle breathing, breathe normally.
- Possibly tape bandage, provided that breathing is not restricted. Rib bandages are hardly ever used.
Other non-drug options are presented under the article Acute pain.
Drug treatment
For drug treatment, analgesics such as acetaminophen (e.g., dafalgan) are used to relieve pain and prevent breathing problems. If acetaminophen is not effective, NSAIDs with gastric protection or opioids may also be administered. Topically administered medicines such as gels and ointments like a diclofenac gel (Voltaren, generics) are cooling, analgesic, and anti-inflammatory. They are usually well tolerated.
