Rib Pain- Generally an individual feels pain in different joints of the body such as the ankles, knees, hips etc. Sometimes as a result of a medical condition or trauma, an individual may also experience chest pain. There are certain factors, which may cause chest wall pain or rib pain. One of the common medical conditions which may cause Rib Pain is Osteochondritis of rib at costo-sternal joint or costo-spinal joint. Rib or chest wall pain is also by chest wall injury following direct impact or an accident damaging the ribcage. In this article, we are going to discuss about such cases in which there is damage to the ribcage causing rib pain, especially Rib Fracture. We will be discussing about the causes, symptoms, and treatment of Rib Fracture.
How Do We Define Rib Fracture or Broken Rib?
A Rib Fracture is a type of crack or break in bones of ribcage. Any form of a break in the cartilage, which connects the ribs to breastbone can also be termed as Rib Fracture even though the bone itself is not fractured. The ribs have the following function and any fracture of the ribs impairs these functions
- Protect organs in the chest.
- Help in breathing.
Causes of Rib Fracture or Broken Rib
A direct blow to the chest wall often results in Rib Fracture. Fractured rib causes severe chest wall pain during breathing in (inspiration) and breathing out (expiration). Breathing causes chest wall movement resulting in intense pain. Traumatic rib fractures is observed following motor vehicle accidents and spontaneous rib fracture is seen in patients suffering with osteoporosis. Fragile and weak ribs caused by osteoporosis fractures during coughing or minor bump.
Patient suffering with sudden chest wall with history of osteoporosis or chest wall injury must see physician or go to emergency room for further check up. Fractured rib if not treated soon, then loose sharp end of the rib can damage and cause penetrating wound of lungs, spleen, or blood vessels. A medical condition called Pneumothorax (air pocket around lungs) is quite common following Rib Fractures. In case, there is a fracture of more than one rib at more than one place then it can lead to a potentially serious condition called as "Flail Chest."
Symptoms of Rib Fracture or Broken Rib
The Following Are The Symptoms Of A Rib Fracture or Broken Rib:
- Moderate to excruciating pain in the ribs
- Pain with breathing
- Pain with palpation of the chest/ribs
Due To Breathing Difficulties As A Result Of A Rib Fracture or Broken Rib, An Individual May Experience The Following Symptoms:
- Shortness of breath
- Anxiety or panic attacks
- Dizziness or lightheadedness
Diagnosis of Rib Fracture or Broken Rib
While Diagnosing A Rib Fracture or Broken Rib, The Physician May Do The Following:
- Gently palpate the injured part of chest to localize the area of pain
- Observe the breathing pattern and making sure that air is moving in and out of the lungs in a normal fashion.
- Check the condition of the heart
- Check other important parts of the body like the head neck, spine etc. to look for other potential injuries
Following initial physical examination, the physician may also advise chest x-ray and other imaging studies such as CT scan and MRI. Hairline or stable Rib Fractures may not show up on x-rays. Negative X-Ray finding is always followed by MRI, CT scans or ultrasound study of ribs.
Treatment for Rib Fracture or Broken Rib
Rib fracture is treated with conservative approach or surgery. Non-displaced rib fracture heals on their own with time. Most of the Rib Fractures are generally treated as out patient treatment. Pain is treated with analgesics. Analgesics prescribed are either non-steroidal anti-inflammatory medications (NSAIDs) or opioids. Adequate pain relief is the most important segment of the treatment so patients can breath normal. Rib Fracture takes 6-8 weeks to completely heal. While Rib Fracture is in the healing process, one might do the following to manage the severe rib pain that is caused due to Rib Fracture:
- Application of ice on the injured part
- Get as much rest as possible
- Pain medications like Tylenol or ibuprofen (NSAIDs) may be helpful to relieve pain. If NSAIDs are not controlling the pain, then opioid medications may be prescribed by the physician
- Another aspect of healing of Rib Fracture is to take a deep breath or cough at least once every hour in order to clear the lungs and prevent diseases like pneumonia.
- It may seem odd but the best position to lie down in cases of Rib Fracture is to lie on the injured side. Patients can breathe better when lying on injured side. Injured patients feel less painful when lying on injured side and thus is able to breathe deeper. Normal oxygenation like deep breathing and prevention of complications like pneumonia by frequent coughing helps the healing of fracture.
- In the past following fracture, ribs chest wall were wrapped with ace bandage and tape for 4 to 6 week to prevent pain with breathing. Later research has suggested restriction of chest wall movement reduces pain but also causes retention of secretions in lung resulting in pneumonia.