by James Hubbard, MD, MPH

I heard a pro football player being interviewed on television say that of all the multiple injuries he had suffered through, a broken rib was the most painful. I can see why. It hurts anytime you move your arms, bend—it even hurts to breathe. And it can hurt for weeks. So what can you do to help it heal and relieve the pain?

One thing you shouldn’t do for a broken rib is wrap it. I know, that’s what we always used to do, and it can ease the pain considerably, but whether you wrap the ribs with a rib belt, elastic bandages, or anything else, you’re not going to be able to breath as deeply, and that puts you at risk for pneumonia.

But since pain is the main problem with most rib fractures, what can you do?

  1. Take it easy. The rib is going to heal. It’s going to take six to eight weeks. You might as well mentally deal with it and physically not overdo it by, say chopping wood, or doing something that’s going to injure the tissue around the break and make it tenderer.
  2. Take over-the-counter pain meds like ibuprofen (Advil), naproxen (Aleve), or acetaminophen (Tylenol) to relieve the pain and inflammation.
  3. Apply ice packs covered with cloth for ten minutes on, ten minutes off to relieve the pain and swelling.
  4. Make sure you take good, deep breaths to keep your lungs expanded. If it hurts too much, press the area around the pain with your hand or up against something hard for support. Do the same if it hurts too bad to sneeze or cough. Yes, I know this is doing essentially the same as an elastic binder, but you’re only doing it for a few seconds.
What About a Chest-Wall Strain?

You really can’t tell the difference between a strain and a rib fracture without an X-ray. And even then, some rib fractures are missed. But it doesn’t matter a whole lot because you’re going to treat them the same. The X-ray is to make sure the injury hasn’t punctured a lung or caused bleeding in the chest cavity. Also, if you see a fracture, you can predict it’s probably going to take longer for the pain to go away.

Complications of Rib Fractures

While broken ribs usually aren’t an immediate threat to life by themselves, the following complications can be dangerous. You may need to get professional medical help if they happen.

1. Bleeding into the chest wall.
The sharp, fractured bone can move out of place during the initial injury and damage a blood vessel that can leak blood into the chest wall. The blood between the chest wall and lung puts pressure on the lung and squeezes it into a smaller space. Besides pain, you’re going to get really short of breath.

2. Punctured lung.
The sharp fracture can puncture the lung. Just like the blood, air leaks out into the area between the chest wall and lung, putting pressure back on the lung. It’s really impossible in the field to know the difference between this and the bleeding.

3. Pneumonia.
This is the one you have the best chance to prevent by heeding the four steps above.

Treatment of Complications

A small amount of blood or air caught between the lung and chest wall will go away on its own. Usually there’s more pain and shortness of breath but not extreme. Larger amounts can cause quite a bit of shortness of breath and may need to be drained for relief as soon as possible. That’s for another post.

I already have a post on pneumonia, but antibiotics are key.


Have any of you ever had a chest injury? What did you do for it? How long did it take for the pain to go away?

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Photo by Kordite on Flickr.