Dealing With Rib Fractures

There is no specific treatment other than time and pain meds

In This Article

Rib fractures are the most common type of injury caused by chest trauma. Moreover, rib fractures are closely associated with overall health and risk of dying. In other words, a person who sustains a severe injury and has several broken ribs can be at a higher risk of death.

An older man clutching his ribs in pain
Colin Hawkins / Getty Images

Which Ribs Break Most Often

Typically, we all have 12 sets of ribs. The first three ribs are difficult to break and typically fracture only after high-energy trauma (e.g., a car crash).

The other nine ribs are easier to break and account for more fractures, with the middle ribs most often broken. Some more common causes of rib fractures are:

  • Falls
  • Sports-related injuries (e.g., football or skiing)
  • Car accidents
  • Assault
  • Severe coughing

Secondary Injuries Are Hard to Spot

Up to 25% of all rib fractures are detected not on X-ray but by physical examination.

Furthermore, damage to cartilage may be impossible to spot on an X-ray. Other diagnostic tools to visualize rib fractures, including fractures in cartilage, can include CT scans, MRI, and ultrasound. 

Finally, damage to cartilage may be impossible to spot on an X-ray. Ultrasound is emerging as a potential diagnostic tool to visualize rib fractures, including fractures in cartilage.

Link to More Serious Injuries

In and of itself, a rib fracture is painful but not life-threatening. However, rib fractures are often closely linked to other more serious injuries.

With rib fractures, doctors are more suspicious of the following:

  • Air and blood in the chest cavity
  • Vascular injury to the blood vessels in the chest
  • Intra-abdominal injury
  • Pulmonary contusion
  • Injury to the airway

Atelectasis (Collapsed Lung)

The pain of a rib fracture makes it harder to breathe and can contribute to atelectasis.

Atelectasis is defined as the partial or complete collapse of a lung when the airsacs do not expand with air. When you experience rib pain, it's common to breathe lightly, thus not filling the lungs with air; this hypoventilation can result in atelectasis.

Treatment Options

If you or a loved one suffers from an injury that results in rib fracture outside of a hospital setting, there's a good chance your physician may not be able to diagnose the fracture on X-ray. Instead, pain over the affected ribs may be the only sign of injury.

Outpatient treatment of a rib fracture typically consists of the application of ice packs and prescription of pain medications as well as breathing exercises.

The pain from rib fractures can be treated with a combination of:

Benzodiazepines and opioids have abuse potential. They should be used as prescribed and for no longer than the duration of the illness or injury.

People hospitalized with severe pain caused by rib fractures can receive a nerve block with a long-acting anesthetic like bupivacaine. Sometimes, an epidural can be given to help with the pain, especially in some cases of severe chest trauma.

It's important to stay active while recovering from a rib fracture. Recovery can take up to six weeks or more.

A Word From Verywell

Even though there's no specific treatment for a rib fracture, if you suspect that you've sustained one, it's a good idea to see a doctor. They can help with the pain and examine you for other trauma or injury.

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Additional Reading
  • Brunett PH, Yarris LM, Cevik A. Chapter 258. Pulmonary Trauma. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY: McGraw-Hill; 2011.