Is My Rib Broken?

Picture of a rib cage with a broken rib

The 24 rib bones that surround your chest have two important jobs. First, they shield the organs in your upper body, like your heart and lungs, from harm. Second, they connect to muscles and ligaments that move when you inhale or exhale and help you breathe.

Your ribs are flexible, and they curve. That makes them hard to crack or break. But sometimes, they do.

The most common way you can break a rib is direct impact. That is with a hard hit to the chest or rib cage.

This can happen if you:

• Have a bad fall
• Get injured while playing sports
• Are in a car accident
• Are a victim of abuse

A rib can also break if you keep doing the same action over and over, like swinging a golf club. Repeated, hard coughing can also break a rib.

You’re more likely to break a rib if you have a health problem, like osteoporosis, which weakens your bones. Older people are also more likely to break a rib since bones thin naturally with age.

If your rib is broken, you may notice:

• A cracking sound or feeling inside your chest
• Intense chest pain, especially when you take a deep breath 
• Swelling
• Soreness
• Bruising

If your doctor suspects that you have a broken rib, she’ll do a physical exam and ask how you hurt yourself. She may also want you to have an imaging test. An X-ray, CT scan, MRI, or bone scan can give more details about what’s going on inside your chest.

A cracked rib isn’t as likely to cause problems as a rib that’s broken in two. A jagged part of a broken rib can harm some of your blood vessels and organs and cause:

• Trauma to your heart or blood vessels: If you break one of your top three ribs, a sharp edge could puncture your aorta (your body’s main artery).
• Collapsed lung: A broken rib may tear your lung or chest wall, which can cause your lung to collapse. Signs that this has happened include trouble breathing, coughing up blood, and severe chest pain.
• Flail chest: If two or more of your ribs break into two or more pieces, you have a serious condition called “flail chest.” Your chest muscle and rib cage can start to move away from each other, rather than remain in sync, when you breathe.

Although rare, broken lower ribs can also cause damage to your liver, spleen, or kidneys.

Many times, a rib cracks (fractures) but doesn’t break in two. Either way, your doctor can’t put a cast on it like you would get for a broken arm or leg. Instead, you’ll likely need to let your rib heal on its own. This often takes about 3 to 6 weeks. In the meantime, your doctor will try to manage your pain and make sure that no other problems arise.

Your treatment will likely include:

• Over-the-counter pain relievers like NSAIDs (non-steroidal anti-inflammatory drugs)
• Prescription pain medicine
• Rest
• Ice packs to reduce the swelling

If you have flail chest, your doctor may want to do surgery. Fixing your ribs can help you breathe more easily and prevent a severe lung infection like pneumonia.

To help your broken rib heal, your doctor may also suggest that you:

• Sleep upright for the first few nights
• Move around throughout the day to keep your lungs healthy
• Don’t lift heavy objects or do any activity that makes your pain worse
• Take 10 slow, deep breaths every hour
• Don’t avoid coughing
• Hold a pillow against your chest to reduce the pain when you need to cough
• Quit smoking -- it may help your rib heal faster

If you’ve had an impact to your chest and now have symptoms of a broken rib, it’s a good idea to see a doctor.

If the doctor says it’s broken, let her know if:

• Your pain doesn’t go away within a few weeks
• You cough up green or yellow mucus
• You start to run a fever

Get help right away if:

• You feel pressure or squeezing in your chest that lasts more than a few minutes
• Chest pain extends to one or both shoulders or arms

These may seem like symptoms of broken ribs, but they are signs of a heart attack.