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:
FallsSports-related injuries (e. g. , football or skiing)Car accidentsAssaultSevere 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 cavityVascular injury to the blood vessels in the chestIntra-abdominal injuryPulmonary contusionInjury 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 Opioids NSAIDs (drugs like Advil)
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.
You should avoid wrapping anything tight around your rib cage and talk to your doctor if you have any difficulty breathing.
When you have a broken rib, it is common to breathe lightly avoid fully filling the lungs with air. This can lead to atelectasis. Breathing exercises can help to prevent this from happening.
