Does a rib fracture hurt?

Written by Lv Yao
Orthopedics
Updated on November 21, 2024
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Rib fractures are generally caused by trauma, resulting in localized pain and restricted respiratory movements. In severe cases, there may be blood or fluid accumulation inside the chest cavity, or even respiratory distress, presenting symptoms similar to flail chest. Therefore, when a rib fracture occurs, the pain is very severe because the ribs are an important part of the thoracic cage, which is a crucial structure during respiratory movements. Thus, during breathing, the pain from a rib fracture can be quite intense.

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What are the symptoms of a rib fracture?

Symptoms of rib fractures include, firstly, there is usually a clear history of trauma, either from direct impact or from falling and the ribs making contact with the ground, etc. Secondly, the main symptoms of a rib fracture include three points: The first is local deformity. If it is a single rib fracture, this deformity is generally not easy to detect. However, after multiple rib fractures, this deformity becomes readily apparent, and you can see that the chest cage is abnormal, with a caved-in appearance. Moreover, in cases like flail chest, breathing is also abnormal. Normally, when inhaling, the ribs should expand outward, but if flail chest occurs, the chest cage appears to expand inward during inhalation; therefore, such a condition often requires surgical treatment, otherwise the consequences are very serious. The second symptom is friction sound and bone rubbing sensation. Some people, after fracturing a rib, during deep breathing or activity, hear cracking sounds from within. This occurs because the continuity and integrity are disrupted by the fracture, and then during breathing or during movement, there is friction between the bones. The third point is abnormal movement, which occurs at locations without joints, resembling joint movements. Normally, a person has 12 ribs on each side. If the continuity and integrity of the ribs are not damaged, there should be no abnormal movement; that is, pressing on the ribs should not cause sensations similar to joint movements at places where there are no joints. Therefore, the symptoms of a rib fracture include three points: the first point being local deformity; the second, bone friction sounds and sensations; and the third, abnormal movement. If any of these three symptoms are present, it is generally indicative of a rib fracture.

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Common sites of rib fractures

The most common sites for rib fractures are the fourth to tenth ribs, as they are more prone to fractures. The first to third ribs are relatively short and are protected by the scapula and clavicle. Additionally, the 11th and 12th ribs are quite mobile, making them less likely to fracture when subjected to external forces. Among the fourth to tenth ribs, the fourth to seventh ribs are the most susceptible to fractures, because their internal cartilage is relatively short, making these ribs the most likely to break when impacted.

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Can someone with a rib fracture move?

Patients with rib fractures should rest during the acute injury phase. Premature activity can cause pain at the fracture site and is detrimental to the recovery of the fracture. After the condition stabilizes and symptoms such as pain have alleviated, patients can appropriately start mobilizing. Proper exercise can help prevent complications such as dependent pneumonia and bedsores. Rib fractures are generally treated non-surgically. A chest brace can be used for protection in conjunction with anti-inflammatory and analgesic medications, as well as Chinese medicines that promote blood circulation and remove blood stasis, which aid in the healing of the fracture. Recovery from a rib fracture generally takes about four to six weeks.

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Complications of rib fractures

Rib fracture complications. Structurally, each rib is located above the intercostal arteries, veins, and nerves. Therefore, the most critical issue with rib fractures is that they can cause severe pain for the patient. Thus, the main complication of a rib fracture is pain. This pain persists 24 hours a day, especially when the patient takes deep breaths, coughs, or turns over while sleeping during the night, which can awaken them due to the severe pain. Additionally, because of this pain, the patient is unable to cough effectively. Therefore, a large amount of phlegm, especially in smokers, accumulates in the lungs, leading to complications such as lung infections and pneumonia. Besides pain, another complication of rib fractures is the potential puncture of intercostal arteries or veins, which can cause hemothorax. This condition can result in a significant accumulation of blood in the pleural cavity, and a severe hemothorax can be life-threatening, especially a progressing hemothorax. Therefore, for patients with fractures of three or more ribs, it is recommended, according to the 2017 US guidelines for the treatment of internal fractures and the 2018 consensus from Chinese experts on internal fracture treatment, to actively proceed with surgical interventions. Studies have found that active surgical intervention for fractures of more than three ribs can significantly reduce the patient's pain, shorten hospital stays, and improve quality of life. In summary, the main complications of rib fractures include pneumothorax, hemothorax, pain, and resultant lung infections and pneumonia. These complications are crucial in the treatment of rib fractures and need to be actively addressed.

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How to care for a rib fracture

After a rib fracture, it is recommended to adhere to the following aspects in terms of care. Firstly, after a rib fracture, a chest bandage can be used to protect and stabilize the area, which generally requires about four to six weeks. Secondly, in terms of diet, it is important to enhance nutrition. Consume foods rich in high-quality proteins, calcium, and vitamins. These foods aid in recovery by providing nutrients and energy, helping to promote the healing of fractures. Additionally, symptomatic medication treatment, such as non-steroidal anti-inflammatory painkillers and traditional Chinese medicine that invigorates blood circulation and removes blood stasis, can be used to facilitate recovery. During the recovery period of the fracture, it is advised to start rehabilitation exercises as soon as possible and encourage activities such as coughing and expectorating to prevent complications such as dependent pneumonia and atelectasis. (Please consult a professional physician for specific medication usage and avoid self-medication.)