Acute Pain: Rib fractures

Overview

A broken rib is a common injury that occurs when one of the bones in your rib cage breaks or cracks. The most common cause is chest trauma, such as from a fall, motor vehicle accident or impact during contact sports.

Many broken ribs are merely cracked. While still painful, cracked ribs aren’t as potentially dangerous as ribs that have been broken into separate pieces. A jagged edge of the broken bone can damage major blood vessels or internal organs, such as the lung.

Symptoms

The pain associated with a broken rib usually occurs or worsens when you:

• Take a deep breath
• Press on the injured area
• Bend or twist your body

When to see a doctor

See your doctor if you have a very tender spot in your rib area that occurs after a trauma or if you have difficulty breathing or pain with deep breathing.

Seek medical attention immediately if you feel pressure, fullness or a squeezing pain in the center of your chest that lasts for more than a few minutes or pain that extends beyond your chest to your shoulder or arm. These symptoms can indicate a heart attack.

Causes

Broken ribs are most commonly caused by direct impacts — such as those from motor vehicle accidents, falls, child abuse or contact sports. Ribs also can be fractured by repetitive trauma from sports like golf and rowing or from severe and prolonged coughing.

Risk factors

The following factors can increase your risk of breaking a rib:

• Osteoporosis. Having this disease in which your bones lose their density makes you more susceptible to a bone fracture.
• Sports participation. Playing contact sports, such as hockey or football, increases your risk of trauma to your chest.
• Cancerous lesion in a rib. A cancerous lesion can weaken the bone, making it more susceptible to breaks.

Complications

A broken rib can injure blood vessels and internal organs. The risk increases with the number of broken ribs. Complications vary depending on which ribs break. Possible complications include:

• Torn or punctured aorta. A sharp end of a break in one of the first three ribs at the top of your rib cage could rupture your aorta or another major blood vessel.
• Punctured lung. The jagged end of a broken middle rib can puncture a lung and cause it to collapse.
• Lacerated spleen, liver or kidneys. The bottom two ribs rarely fracture because they have more flexibility than do the upper and middle ribs, which are anchored to the breastbone. But if you break a lower rib, the broken ends can cause serious damage to your spleen, liver or a kidney.

Prevention

The following measures may help you prevent a broken rib:

• Protect yourself from athletic injuries. Wear protective equipment when playing contact sports.
• Reduce the risk of household falls. Remove clutter from your floors and clean spills promptly, use a rubber mat in the shower, keep your home well-lit, and put skidproof backing on carpets and area rugs.
• Strengthen your bones. Getting enough calcium and vitamin D in your diet is important for maintaining strong bones. Aim for about 1,200 milligrams of calcium and 600 International Units of vitamin D daily from food and supplements.