Chest pain originating from bruised ribs is an extremely disabling pain. Several cause influences bruised rib pain, which results in chest wall pain. Bruised rib is observed in young as well as elderly individuals. Bruised rib pain or chest pain in younger patient is caused by muscle spasm or direct impact to chest wall or ribs. In this article, we will discuss about bruised rib pain that is caused as a result of a chest injury or diseases. We will discuss about its causes, symptoms, and some of the do's and don'ts in the event of bruised ribs.
How Do We Define Pain Due To Bruised Ribs?
Vital organs like heart and lungs are enclosed and protected by chest wall. Chest wall is formed by sternum (breast bone) in front, 12 ribs on each (right and left) side and vertebral column on backside. Twenty-four ribs with sternum in front and vertebral column on backside forms a rigid bony cage, which protects vital organs. Ribs move inward and outward during expiration (breathing out) and inspiration (breathing in). Bruised ribs causes severe intractable pain with movement of the ribs and thus with breathing.
The upper seven ribs form a direct joint with breastbone or sternum. Lower five ribs are linked to cartilage and cartilage is connected to lower portion of breastbone. Direct blow or impact causes bruised or fractured ribs resulting separation or dislocation from breastbone. Bruised ribs result in excruciating pain but the most important fact about Bruised Ribs is that they completely heal on their own.
Rib Bruises are commonly known as sportsmen's chest pain. Sport injuries of ribs are observed during contact sports. Contact sports like wrestling, football, basketball and ice-skating causes chest wall impact resulting in bruised ribs. Immediately following injury, patient feels severe intractable chest pain. Pain restricts routine activities and patient becomes disabled for few days. Activities like breathing, coughing or sneezing may be extremely painful.
Causes of Bruised Ribs or Sportsmen's Chest Pain
Skeletal bruise or contusion can occur in various parts of the body, thus bruise can also occur in the ribs.
- Direct impact- Direct blow to the rib can cause the rib to push against the muscles and soft tissue surrounding the ribs, which results in a bruising of the ribs.
- Sports Injury- Bruised Rib is quite common in sportsmen who are involved in contact sports like hockey, football, wrestling, rugby etc.
- Automobile Accident- Motor vehicle accidents can also impact the chest and result in a Bruised Rib.
- Work Accident- Fall or collision with a heavy object can cause bruises of the ribs which results in rib contusion.
- Domestic injury- Minor incidences like playing with the child and the child falling on the chest may result in a bruised rib.
Medical Conditions Causing Bruised Ribs or Sportsmen's Chest Pain
Severe bouts of cough- Frequent coughing for few days can results in bruising of the ribs. Severe coughing is often observed in patients suffering with pneumonia, whooping cough and bronchitis
Osteoporosis- Patient suffering with osteoporosis develops rib contusion and bruising with cough and minor injuries.
Risk Factors for Bruised Ribs or Sportsmen's Chest Pain
The risk factors are as follows-
- Contact sports
- Prolonged coughing
Symptoms Of Bruised Ribs or Sportsmen's Chest Pain
The symptoms and signs of bruised ribs are as follows:
- Chest wall pain over the bruised rib
- Tender rib on touch and palpation
- Severe pain with inspiration (inhalation of air) and expiration (exhalation of air).
Shortness of Breath2-
- Shortness of breath or history of dyspnea
- Feeling of shortness of breath during inspiration.
Restricted Chest Wall Movements-
- Increased intensity of pain with any chest wall movement.
- Sharp and severe pain on affected part of rib
Contusion and Skin Discoloration-
- Development of erythema at the site of injury
- Purple discoloration of skin secondary to subcutaneous bleeding
Unable to Sleep-
- Difficulty with lying on the side that is injured
Complication Associated With Bruised Ribs or Sportsmen's Chest Pain
- Fractured ribs
Treatment for Bruised Ribs or Sportsmen's Chest Pain
Conservative Treatment3 for Bruised Ribs or Sportsmen's Chest Pain
- Complete rest for 1 to 3 weeks.
- Cessation of strenuous activities.
- Breathing exercise to prevent complications like pneumonia.
- Local ice applications.
- One should take deep breaths quite often so that the normal expansion of the lungs is not affected.
Medications for Bruised Ribs or Sportsmen's Chest Pain
Pain Medications and Anti-Inflammatories for Bruised Ribs or Sportsmen's Chest Pain
- Non-steroidal anti-inflammatory medications prescribed for pain and inflammations.
- Medications prescribed are Ibuprofen (motrin), Naproxen, Daypro and Celebrex.
Opioids for Bruised Ribs or Sportsmen's Chest Pain
- Short acting opioids are prescribed for 2 to 4 weeks for pain.
- Opioids are discontinued once pain intensity is tolerable.
- Most common medications prescribed are hydrocodone and oxycodone. Applying ice to the affected area is quite helpful for relief of pain.
Muscle Relaxants for Bruised Ribs or Sportsmen's Chest Pain
- Muscle relaxants are prescribed if pain is associated with intercostal muscle spasm.
- Most common muscle relaxants prescribed are Skelaxin, Robaxin and Flexeril.
Precautions for Bruised Ribs or Sportsmen's Chest Pain
- Avoid wrapping of chest wall
- Wrapping or restricting movement of chest to reduce pain may result in development of pneumonia.
- It is imperative to avoid contact sports for some time till the rib heals.
- Avoid re-injuring the ribs.
- Generally, it takes about four weeks for a bruised rib to completely heal, although if the injury is pretty severe it may take a bit longer to heal.
- One needs to consult a physician in case if an individual experiences symptoms of a bruised rib.
- One needs to wear protective equipment when involved in contact sports, although in some sports it may not be possible but one should try and avoid a direct blow to the chest.
What Are Some of the Do's And Don'ts For Rib Bruises?
- Take some time off from work in case if the job involves manual work.
- Take frequent pain medications as prescribed. Pain restricts inspiration and shallow inspiration results in retention of lung secretions resulting in pneumonia.
- Pain medications need to be taken religiously to help with the pain.
- Continue physical therapy to encourage intermittent coughing. Try and cough once in a while during the day to avoid retention of secretions in lung, which promotes infections
- Application of ice packs at the site of the injury helps with swelling and pain
- Avoid wrapping of the chest with bandage.
- Discontinue smoking during treatment and also following treatment to prevent recurrence of another episode of similar rib contusion or bruising.
- Avoid sudden movements of the chest area
When Should One See A Health Care Provider For Bruised Ribs?
One needs to consult a physician immediately if an individual experiences the following symptoms:
- Shortness of breath
- Progressive chest pain
- Shoulder or mid back pain
- Fever secondary to lung infection often seen when patient is unable to cough. Retention of secretions in lung because of difficulties in coughing causes pneumonia and lung infection.
Exercises For Bruised Ribs or Sportsmen's Chest Pain
There are some exercises suggested in case of a Bruised Rib:
Deep Breathing Exercises for Bruised Ribs or Sportsmen's Chest Pain
Deep breathing exercises helps to prevent blockade of alveoli. Blockade of alveoli causes retention of lung secretions.
- Sit or stand with back straight.
- Take deep breath slow and continuous while negotiating the intensity of pain.
- Hold the air for 3 to 5 seconds or count up to 5.
- Exhale slowly and at the end of expiration hold the breathing for 3 to 5 seconds or count up to to 5.
- Continue breathing exercise for 10 to 15 minutes. Repeat similar exercise 2 or 3 times a day.
Shoulder Blade Squeeze Exercise for Bruised Ribs or Sportsmen's Chest Pain
This exercise helps strengthen the ribs and increases its flexibility.
- Stand or sit with the back maintained in a straight position with shoulders completely relaxed.
- Now, push the shoulder blades and arm back so both the shoulder blades are brought closer to each other.
- The shoulder blades need to be squeezed as close together as possible without increasing pain.
- Breathe normal while holding the final positions of the shoulder blade. Hold the positions for about half a minute and then the shoulder blades needs to be relaxed.
- This exercise needs to be repeated about 8-10 times.