If you break one or more ribs in an accident, you will experience very severe pain. Rib fractures are among the most painful bone fractures of all, because the fracture cannot be immobilized by a cast or splint and the movement of the chest cavity while breathing causes constant pain. If the fracture is in a favourable position, there is no or only slight pain, but in most cases a rib fracture is extremely painful.
Complicated fractures can also lead to other injuries such as bleeding into the chest cavity (hematothorax). This makes breathing more difficult and can lead to a blood loss shock. When the lung is injured, air can enter the pleural space (which is normally filled with a fluid) and accumulate in the chest cavity, resulting in a pneumothorax.
These injuries also cause severe pain and must be treated immediately. Without an X-ray examination, it is often difficult to distinguish between a rib contusion and a rib fracture, as the contusion is accompanied by similarly strong pain, sometimes even stronger pain. Often, complete healing of a rib contusion also takes a little longer than with a fracture. However, since it makes no difference in therapy whether one suffers from a rib fracture or a rib contusion, an X-ray is often unnecessary.
Pain when lying down
A broken rib causes pain in almost all positions, but many people feel the pain particularly clearly when lying down. One reason for this is that there is little distraction when lying down or sleeping and the pain is perceived more consciously. On the other hand, the two ends of the fracture can be pushed further apart depending on the lying position, which increases the pain. Under certain circumstances it can be useful and helpful to lie down actively on the side of the fracture at night. The load on the rib fracture causes the fracture ends to be pressed together and the sensitive new bone tissue is relieved by the lack of movement, which leads to an alleviation of the pain and enables a more painless sleep.
