It happens quickly: You don’t pay attention for a moment, fall and fall awkwardly or you bump yourself somewhere. Usually, the pain subsides quickly. But if you have persistent pain around the rib cage, you may have a rib contusion.
What is a rib contusion?
The support bandage is used as a first aid measure for bruises. Click to enlarge. A rib contusion is an externally inflicted blunt injury or impairment to the bony ribs. However, in a rib contusion, unlike a rib fracture, these forces do not act so strongly that the ribs break; instead, it remains on the borderline of a fracture. The tissue in front of the ribs is bruised in a rib contusion. This bruising causes swelling and irritation of the nerve endings in the periosteum area. Sufferers usually feel pain in the rib area when they have a rib contusion, which can cause them discomfort when breathing and performing everyday activities. They often then adopt a protective posture as a result of the pain.
Causes
Rib bruising is most common in people who put a lot of stress on their bodies. Martial artists such as boxers or athletes in team sports (e.g., handball or soccer) are particularly affected because they are in constant physical contact and blows with other teammates. Athletes in sports with an increased risk of falling, such as skiing or mountain biking, are also at risk for rib contusions. In older people, fractures occur more easily than rib contusions because of the reduced elasticity of bones due to age.
Symptoms, complaints, and signs
A bruise of the ribs is usually always associated with very clear and typical symptoms, which are perceived by the affected person as very painful. Even the smallest movements cause severe pain that persists even at rest. Often, affected individuals complain of shortness of breath, as breathing in and out with a rib contusion is extremely uncomfortable. If, in addition to the rib bruise, there is also a troublesome and dry cough, the pain can increase considerably. In most cases, the pain occurs not only directly in the area of the bruise, but the entire chest is affected. In this case, the affected person often assumes a tense malposition, so that it can even lead to severe back pain. Unfortunately, in the case of an existing rib contusion, medical or drug treatment is of only limited help. Commercially available painkillers can effectively alleviate the existing pain. However, this is also the only means of combating existing symptoms. Physical activities should be reduced, otherwise the pain can increase considerably. The more rest the body is allowed, the faster the healing process can progress for an existing rib bruise.
Diagnosis and course
A rib contusion with persistent discomfort in the rib area should always be thoroughly examined to determine if it is indeed a rib contusion or a rib fracture. The diagnosis of rib contusion is not at all easy and cannot be easily palpated by manual examination, even by an experienced physician. Even with an X-ray examination, it is not readily possible to accurately distinguish a rib contusion from a rib fracture. A rib fracture can result in internal injuries, such as a pneumothorax due to injury to the lung pleura, with sometimes life-threatening consequences. In pneumothorax, air from the lungs enters the pleural space, which is actually empty of air. As a result, the lungs cannot expand properly when breathing and gas exchange is impeded, which can lead to serious complications such as cardiopulmonary failure in tension pneumothorax. The course of a rib contusion depends on the extent of the injury. A rib contusion must be healed at rest to allow the tissue to recover. A healing process of about 3 to 4 weeks is the rule for a rib contusion. During this time, one must refrain from all activities that strain the thoracic region, such as heavy lifting, abrupt twisting motions, etc. Athletes in particular must adhere to this, but all too often and too quickly they start training again after a rib contusion.
Complications
If internal injuries are present due to rib contusion, life-threatening complications may occur. A typical concomitant of rib contusion is tension pneumothorax, as a result of which cardiopulmonary failure may occur. In less severe cases, a rib fracture leads to severe pain and restricted mobility. As a result of bed confinement, for example, circulatory problems, edema, sores and infections may develop. If the affected person moves abruptly during recovery, turns the upper body too far to the left or right, or lifts heavy loads, there is a risk of fracture or secondary fracture. Severe contusions sometimes also impair the ability to breathe, which can lead to aspiration and subsequently pneumonia. This can be fatal, especially in children, the elderly, and those who are ill. The treatment of a rib contusion usually proceeds without major problems. However, painkillers and decongestants can cause complications – often there is fatigue, headache, pain in the limbs and other side effects. If taken regularly, there is a risk of heart and liver damage. In individual cases, corresponding preparations cause allergic reactions. In addition, interactions can occur and promote further complications.
When should you go to the doctor?
After an accident, a violent impact or a fall, the skeletal system should be checked for mobility. If the affected person suffers from persistent pain or an increasing sensation of pain, he or she should see a doctor for clarification of the symptoms. With a rib contusion, the affected person experiences irregularities in the upper body. Locomotion or bending over can no longer be done without discomfort. Restrictions in mobility, habitual movements, or irregularities in any movement should be presented to a physician. Loss of respiratory activity is a cause for concern. If the affected person cannot take in enough oxygen, he or she needs a medical examination. A lack of oxygen can lead to an emergency situation. An ambulance should be alerted as soon as an acute shortage of breath or loss of consciousness occurs. At the same time, first aid measures are to be initiated by those present. A visit to the doctor is necessary if pressure pains, sensory disturbances or discoloration of the skin appear. It must be clarified whether internal injuries of the organs or bleeding of the vessels have occurred after the incident. In case of palpitations, nausea, vomiting or an internal tension, the symptoms should be examined by a doctor. Coughing or a sputum indicates impaired health. If there is bloody sputum, action is needed as soon as possible. A physician is needed so that medical care can be initiated.
Treatment and therapy
A rib contusion is usually treated conservatively, less commonly by surgery. Because of the acute pain of a rib contusion when breathing and moving, the doctor usually prescribes an analgesic. Cooling the affected area with cold packs is useful for a rib contusion, especially to prevent swelling. Sometimes decongestant medication is prescribed for a rib contusion. Rather rarely, an elastic support bandage is applied. The patient must keep the thoracic region still and avoid unnecessary strain in the event of a rib contusion. In addition, physiotherapeutic measures may be prescribed. Only in the case of a very severe rib contusion, respiratory therapy must also be performed to prevent pneumonia, for example, if the accumulated secretions cannot be coughed up properly due to severe respiratory obstruction.
Prevention
Although rib bruising cannot be completely avoided, there are effective measures of prevention. You can prevent a rib bruise from a fall by wearing appropriate footwear. In sports, a good warm-up workout that provides good blood flow to the thoracic area is especially helpful. A healthy amount of training should be done without overtaxing the body. Sensitive areas can be protected in sports by appropriate measures.
Aftercare
When a rib contusion occurs, there is usually a great deal of pain. However, the patient can help to alleviate the discomfort in everyday life after diagnosis of this injury with some measures himself. Sparing is the top priority here.The affected person must find a position in which he or she can lie optimally, especially at night. Side-sleeper pillows or other padding have proven extremely useful in this regard. Cooling compresses can also help to relieve the pain. Some patients, on the other hand, find warming compresses beneficial; this should be tried out on an individual basis. If tension occurs when coughing or laughing, this can unpleasantly increase the pain in the trunk area. Therefore, it is important to successfully treat a possible infection that triggers the cough. This is done with inhalations and herbal teas that have antispasmodic effects. Even though a rib bruise can often cause additional tension in the torso muscles, massages should be avoided. This could cause additional irritation to the rib area. Many patients find rubs with relaxing tinctures or warm baths with appropriate additives beneficial. Physical activities should be avoided as much as possible during rib bruising, since a deeper breathing activity associated with it can intensify the pain even more.
What you can do yourself
A rib bruise is a painful event, but its discomfort can also be alleviated quite efficiently with self-help in everyday life. First of all, sparing is important in order not to intensify the pain conditions that the rib bruise triggers. For this purpose, it is also important that the affected person finds a position in which he can lie optimally. This also applies to the night. Side-sleeper pillows or other padding often help to position oneself as painlessly as possible. Cooling compresses are often good for quickly relieving the pain. However, there are also patients for whom warmth is more effective. Individual trial and error is important here. Tension when coughing or laughing can make the rib bruise particularly unpleasant in terms of pain. Those who have a cough parallel to the bruise should also take care of the infection, for example by inhaling or drinking herbal tess. A rib contusion is often accompanied by tense muscles in the trunk area due to the pain. Massages are counterproductive, as they may further irritate the rib area. Rubs with relaxing and decongesting tinctures or, if heat is tolerated, baths with appropriate additives are better. Deep breathing can also cause pain in a rib bruise. Physical activity that greatly intensifies breathing is therefore also better avoided for the period of acute rib discomfort.
