A broken rib isn’t quite like any other broken bone. The rib cage encircles the lungs, so a rib fracture can hurt with every breath. Any other broken bone can be immobilized, but ribs move with every breath we take. The pain can be severe, especially when coughing or taking a deep breath. Even a hairline fracture causes a dull pain when breathing or twisting the body. Like any other broken bone, touching or pressing the injured area hurts. Because of the pain, there is a danger that people won’t breathe adequately. The most common complication of a broken rib is pneumonia due to reduced breathing.
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A broken rib is a common health condition that can affect anyone regardless of age, sex, race, or ethnicity.
Early signs of a broken rib include localized pain and tenderness.
Serious symptoms of a broken rib, such as difficulty breathing, shortness of breath, severe pain, worsening pain, progressively worsening cough, weakness, fever, or pale skin, may require immediate medical attention.
A broken rib is caused by trauma or repeated stress. You may be at risk for developing broken rib symptoms if you are an athlete, an older adult, play contact sports, or have cancer or osteoporosis.
A broken rib usually requires a medical diagnosis.
A broken rib generally requires treatment. In six to eight weeks, broken rib symptoms typically resolve with treatment, but severe or complicated fractures may take longer to heal.
Treatment of a broken rib may include rest, pain relievers, limitations on activity, ice packs, nerve blocks, or surgery.
Rib fracture complications vary depending on the severity of the break. An untreated broken rib could result in complications like reduced breathing, inadequate oxygen intake, inability to breathe, pneumonia, lung injuries, collapsed lung, bleeding, liver injury, heart injury, and spleen injury.
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The early signs of a broken rib will depend on the cause. If it’s due to blunt force trauma, the earliest signs of a broken rib may include:
Immediate, localized pain
Tenderness around the fracture
Worse pain when breathing deeply, coughing, or sneezing
Stress fractures progress more slowly, so the earliest sign may be a dull pain where the hairline crack is located. The pain may worsen when coughing or taking a deep breath. As the bone is repeatedly stressed, the pain will gradually worsen.
Symptoms of rib fractures due to injury typically include:
Localized pain
Worsen pain when breathing
Pain or tenderness when the injured area is touched or pushed
Bruising around the break
Inability to take deep breaths
A grating sound when breathing
Stress fractures (or hairline fractures) are tiny cracks in the rib bone caused by repeated pressure or stress on the bone. Severe and persistent coughing is one cause. Athletic activities like throwing or rowing are another common cause. Symptoms of a stress fracture on a rib include:
Dull pain at the site of the fracture
Worse pain over time
Bruising around the fracture
Swelling around the fracture
A bruised rib is easy to mistake for a broken rib. Like a rib fracture, a bruised rib is usually caused by a sudden impact, like a hit or a fall. However, the impact doesn’t break the rib but damages blood vessels, causing bleeding in the soft tissues around the rib. The bruise may be too deep to see, so people may think their rib is broken. Like a rib fracture, the rib will hurt in a specific spot. It will be tender or painful to touch. The pain will worsen when taking a deep breath, coughing, or sneezing. In other words, a bruised rib often feels the same as a broken rib, particularly a stress fracture. Fortunately, a bruised rib is treated like the average broken rib: over-the-counter pain relievers, rest, and (initially) ice packs. A bruised rib may also take several weeks to heal.
Ribs can be broken because of an acute injury or repeated stress.
Trauma fractures result from a forceful impact on the chest, such as a blow, a car accident, or a fall. At the moment of the injury, the bone may audibly crack. The pain will be immediate, sharp, and could be severe. The pain will get sharper when breathing. Coughing or deep breaths may be excruciating. Other symptoms may be bruising or swelling in the injured area.
Sometimes, a rib will break for no good reason, such as rolling over in bed. These, too, are trauma fractures resulting from the weakening of the rib bone. The most common causes are cancer and osteoporosis.
Healthcare providers distinguish between two types of rib fractures:
A non-displaced rib fracture is a crack in the bone, but the bone remains in place on either side of the crack. These fractures usually heal without surgery.
A displaced fracture is a bone break where the bone on either side of the break doesn’t line up with the other side. A displaced fracture usually requires surgery to get the two sides back into alignment.
Stress fractures or hairline fractures are due to repeated pressure on the bone. Chronic or severe coughing can do it. So can many athletic activities. Even so, stress fractures are more common in people with osteoporosis. The pain is usually not as sharp as a trauma-induced rib fracture. Stress fractures require treatments such as pain management and limiting movement, or the crack will worsen.
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See a healthcare professional if experiencing any signs or symptoms of a broken rib. If the break is due to an injury, the clinician can ensure that there are no additional injuries that need treatment. The clinician can also determine if there’s any risk of serious complications.
Sometimes, emergency treatment is necessary. Get immediate medical care if there are other injuries or several broken ribs. Serious symptoms of fractured rib complications, such as trouble breathing, severe pain, worsening pain, worsening cough, weakness, fever, or pale skin, also require emergency medical care.
An isolated and uncomplicated broken rib is usually diagnosed with a medical history and a physical examination. However, the clinician may also order a chest X-ray to check for other injuries or complications.
A chest X-ray is often the first imaging test used to spot a rib fracture and other injuries. However, sometimes a fracture isn’t seen on a chest X-ray. The clinician may need more information, or a patient may be at greater risk if they have an undiagnosed fracture. In those situations, making a diagnosis may involve a CT scan, separate rib X-rays, a bedside ultrasound, a bone scan, or an MRI.
An isolated broken rib usually heals in a few weeks without causing complications. However, there’s always a risk. The rib cage surrounds some of the most important internal organs in the body. Most importantly, the pain from a broken rib makes breathing difficult, so the most worrisome complications of a fractured rib are:
Insufficient breathing (respiratory splinting)
Low oxygen (hypoxia)
Pneumonia
Lung injury
Collapsed lung (pneumothorax)
Bleeding in the chest cavity
Injury to the heart
Spleen injury
Liver injury
Kidney injury
Depending on the severity of the fracture and other injuries, healthcare professionals will either treat people and have them return home, hospitalize them, or admit them to an ICU if there is a concern for damage to other organs. They are more likely to hospitalize older adults and those with extensive injuries because of the risk of complications.
Healthcare professionals start treatment with pain relievers. This allows for easier breathing, which helps to prevent lung complications. Most people will take over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Opioids are rarely used. A doctor may inject nerve blocks to treat pain for severe or multiple rib fractures.
At-home treatment will consist of pain relievers, ice packs, rest, and refraining from any activity that stresses the chest wall. Because the rib cage must expand with each breath, putting a cast on the chest is impractical, and taping or splinting the ribs is no longer routinely recommended. Some people will be sent home with an incentive spirometer. This device helps people exercise their lungs by allowing them to measure the volume of each breath. The clinician may also advise other breathing exercises. These exercises help people breathe normally, preventing complications such as pneumonia. The rib should heal completely in six to eight weeks with these conservative treatments.
People usually get follow-up care about eight weeks after a rib fracture. Follow-up care aims to check pain levels, lung function, and oxygenation.
Surgery may be necessary for displaced fractures to re-align the parts of the rib bone.
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Most broken ribs heal in six to eight weeks. The fracture will hurt for a few weeks, but the pain will gradually improve. You can resume some simple activities if the rib doesn’t hurt when you’re at rest. When the bone is healed, all activities can be resumed. Athletes with a stress fracture can return to their sports when they are advised to do so by a healthcare professional.
Don’t try to guess why your rib hurts. The impact or accident that caused the bone break could have caused more serious injuries. More importantly, an untreated rib fracture might worsen and cause serious complications like pneumonia. Only a doctor can accurately diagnose a rib fracture, identify other injuries, assess the risk for complications, and provide the most appropriate treatment to ensure healing.
An untreated broken rib may get better. Or it may not. If the fracture worsens, the broken bone could cause serious complications or life-threatening injuries to the internal organs in the upper body.
The standard treatment for an isolated broken rib is pain relief, rest, and ice.
Some broken ribs are more painful than others. However, it has little to do with what rib is broken and more about where it’s broken. Rib bones start at the spine, travel across the back, sweep around the side of the body, and then travel across the upper body. People report more pain during breathing when ribs are broken on the side of the body rather than the front or back. Why? Every time a person breathes, the chest cavity expands to make room for that air. That puts pressure on the injured area. Most of that pressure is on the side of the chest wall, making a fracture there particularly hard to bear.
Initial evaluation and management of rib fractures, UpToDate
Rib fracture, StatPearls
Incentive spirometer, Cleveland Clinic
Rib fracture, StatPearls
Cough-induced rib fractures, Mayo Clinic Proceedings
Bruised rib: care instructions, Kaiser Permanente
Osteoporosis treatments and medications, SingleCare
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