Therapy of injuries to the costal arch | Ribbed Arch

Therapy of injuries to the costal arch

As varied as the causes of pain in the costal arch area can be, so different is the therapy. Injuries after an accident are very painful in most cases, regardless of the cause. For example, a contusion of the ribs can cause similarly severe pain as a rib fracture.

After excluding serious consequences, such as major bleeding, nerve injury or injury to the lungs caused by a rib fracture, rib fractures and contusions are treated similarly. First and foremost, adequate pain therapy is of utmost importance, which is started with classic painkillers such as ibuprofen and diclofenac (Voltaren). Depending on the intensity of the pain, the dosage and also the medication must be weighed.

Adequate pain medication is particularly important because the pain when breathing automatically keeps the depth of breath lower. This also carries the risk of developing pneumonia. Particularly in older people and people with other previous illnesses that increase the risk of pneumonia, additional respiratory gymnastics or respiratory therapy can be useful.

In these exercises, the person concerned learns to breathe with as little pain as possible while at the same time having sufficient depth of breath with a physiotherapist. In general, after injuries in the region of the costal arch, a break from sports and physical rest should be taken. If pain is caused by so-called intercostal neuralgia, a triggering cause should first be sought and, if possible, eliminated.

For example, shingles can be prevented from progressing severely by appropriate therapy with Aciclovir. When a nerve is pinched by a broken rib, the pressure must be removed from the nerve. In addition, muscle-relaxing drugs (so-called muscle relaxants) are used. If exactly one nerve is affected and/or there is a clear trigger point, injection of a local anesthetic into the nerve and its root can help to improve the pain. Physiotherapy, classical massages and electrotherapy are also used here.

Diagnosis of an injury to the costal arch

In order to determine the cause of pain in the costal arch region, it is first necessary to obtain a detailed medical history. In general, there are a large number of possible differential diagnoses for chest pain, which must first be excluded (for example a heart attack and other diseases of the heart and vascular system, lung diseases, diseases of the esophagus such as reflux and the stomach). In the following, we will discuss the diagnosis of pain caused by the costal arch.

In the medical history, a distinction must be made between pain after an accident (for example, a collision during sports or a fall on the ribcage) and pain that has occurred without an identifiable cause. The medical history should then be supplemented by an examination of the costal arch and the entire upper body. Particular attention is paid to bruising marks, incorrect posture but also to other skin changes (e.g. blisters in the case of shingles).

By scanning the costal arch, painful regions can be identified and possible trigger points can be found. Listening to the lungs and, if necessary, the heart can provide clues to other causes of pain in the region of the ribcage and indicate complications in the event of a rib fracture. If a rib fracture is suspected, X-ray diagnostics can help, although this is not generally necessary, since the treatment of a contusion and a simple fracture is no different.It can be particularly important in cases of suspected lung injuries as a result of a puncture, although there are usually already clinical indications of this.

Rib fractures can also occasionally be visualized using ultrasound. Trigger points are often seen in the case of so-called intercostal neuralgia. These should be found during the examination and can be a starting point for therapy.