Are broken ribs dangerous?
First of all, cracked ribs hurt. Every breath. Every movement. Even trying to sleep is a chore. However, the internal organs (heart, lungs and aorta) below the ribs are key.
For example, broken ribs may be seen with a life-threatening collapsed lung. Cracked ribs may be associated with a ruptured aorta. Broken ribs could be seen with a bruised heart.
Although they hurt, broken ribs are not nearly as important as the vital structures below the bones. Again, fractured ribs alone are not dangerous.
Quickcare or ER
Red Flags that will send you to the ER:
- Severe pain
- Shortness of Breath
- Loss of consciousness
- Signs of a Collapsed Lung such air at the skin (Pneumothorax)
What will a doctor ask?
Your doctor will want to know your symptoms. Remember, a symptom is your description of your condition to your doctor. It is your story.
Answering the following questions will help your doctor understand:
- When did the pain start?
- Is it sharp or dull?
- Do you have any shortness of breath?
- Do you have any other injury?
- What makes the pain better?
- What was the mechanism of injury? That is, how did the chest trauma happen?
In my experience, the vast majority of the patients who have rib injuries are in severe pain. They come in holding their chest; Not wanting to take a deep breath.
What will the doctor look for?
Your doctor will look for a sign. Remember, a sign is an objective finding that a doctor sees on exam
After a chest wall trauma, the key point is breathing. How are you breathing? Are you only able to take shallow breaths? Can you take deep breaths? Are you able to speak in full sentences? Upon examination with a stethoscope, your doctor will listen for equal breath sounds. That is, if both lungs are filling up with air properly, the breath sounds should have a nice clear flow of air. If a lung has been punctured and collapses, lungs sounds may be diminished.
Your doctor will assess the rib cage for pain and swelling. If there is crunchy, “rice crispy” air under the skin, it suggests that there is a punctured lung passing air into the skin. Also, your doctor will look for an uneven chest rise. That is, one side will go up with a deep breath and one side will not. This unevenness suggests a condition called “flail chest.”As mentioned, your doctor will consider the more life-threatening ailments such as a collapse lung (pneumothorax). Subcutaneous air (air under the skin) is a clue to a collapsed lung complication. This is not good. A patient with a collapsed lung should go to the ER. immediately.
To better diagnose the chest pain from rib fractures, a chest X-ray is fundamental. With rib details, your doctor may determine if there are multiple rib fractures. Furthermore, the X-ray allows the doctor to see the lungs for the possibility of a pneumothorax. Your doctor can easily check the oxygen level with pulse oximeter which is conveniently placed on the finger.
Also, depending on the location of the injury, your doctor will look for injuries in the abdomen. Nothing has substituted for a doctor’s hands-on examination of the belly.
What is the doctor thinking?
Your doctor will want to formulate possible reasons for the chest pain. The list of possibilities is called a differential diagnosis.
In the forefront of your doctor’s thinking is that he actual ribs broken is actually secondary to the more important concern of a pneumothorax. Your doctor must consider it and rule it out. Shortness of breath could mean that a lung was popped. A popped lung (pnuemothorax) can be very dangerous. Air can rush into the chest and cause the big vessels such as the aorta to collapse.
Rib cage pain could be simply mean bruised ribs.
It is possible that both the ribs are not broken and the lung only bruised. It doesn’t take away the pain. But, it is great to know that nothing major is present.
Your doctor will need to consider injury on other parts of the body. Liver and spleen are subject to injury in chest trauma cases.
What is the treatment for cracked ribs?
Medical attention is limited to the basics. Time. Patience. Pain medications with pills like Naproxen or Motrin help. Ideally broken bones should be splinted. Of course, ribs cannot be immobilized. So some persons use Ace wraps and wrap themselves tightly. You may get fitted for a back brace if broken vertebrae are present.
I prescribe my patients a narcotic such as Vicodin. I tell them to take at night only.
Every once in a while, a pain specialist will need to inject numbing medicine into the broken ribs’s surrounding nerves. This nerve block deadens the pain for an extended period of time.
Prevention of a secondary lung infection is key. Take deep breaths. Even if it hurts. Make sure air goes down deep into the lung fields. Deep breaths help prevent infection in the lungs.
How long is the treatment?
Rib pain takes so long to heal. It can be very very frustrating.
The problem is the constant movement of our chests when we breath. Every time a breath is taken, the ribs move. Constantly. 24/7.
How can something heal when it is constantly moving? That is what we are expecting from the rib…to heal while moving.
In general, the rib fracture pain lasts at least 4-6 weeks.
Let me tell you a story
Juan grew up near the local motorcross park. His friends rode. His dad rode. Even his aunt Connie hit the trails on the weekends. So how could he resist the openness of the trail, the oak studded scenery? He wanted to do just one more jump with the whole familiawatching? Carpe Diem! Seize the day!
His speed picked up. The ramp did not look that bad. Whoosh! Off into the air. Pilots say that taking off is easy. The landing is what kills you.
Go Juan Go!! Somehow the handle bar left his hand and, upon decent, poked his chest when he crash landed
“Dude, you allright,?” they all asked.
“Yeah, I’m ok.” said Juan holding his left chest. Maybe a little smile eked out but underneath was a whole lot of pain.
In Juan’s case, the pain is local, sharp, constant and got worse with movement such as breathing. Juan has no associated shortness of breath. Bruised rib symptoms are very similar to broken rib symptoms.
After going home, a quick shower and sleep quickly led to the magic hour of 2 am. All the stimuli of the world are gone except for the pain in the chest. Over and over, the pain keep building upon itself. Pain is unique. No one can feel your pain except you. It may blend in with anxiety which then snowballs into worry.
OMG! “Maybe it’s my heart? Lungs ok?” The darkness plays tricks on the mind. What was a Cool Jump has become a Foolish Folly.
He came to my ER in the middle of the night. He was holding his chest but speaking in full sentences. His exam demonstrated clear lungs sounds. The rib details upon X-ray demonstrated three broken ribs but his lungs were spared.
I hope this helps