Rib Fractures: Essentials of Management and Treatment Options

August 22, 2012

Rib fractures are the most common chest injury accounting for 10 to 15 percent of all traumatic injuries in the U.S. Nearly 300,000 people are seen each year for rib fractures and 7 percent of this population will require hospitalization for medical, pain, and/ or surgical management.

Rib fractures can cause serious complications including: bleeding in the chest (hemothorax), collapse of the lung (pneumothorax), or result in a fluid accumulation in the chest (pleural effusion), just to name a few. As well, rib fractures may contribute to the development of a lung infection or pneumonia. These problems are important to diagnose following chest trauma and even more importantly, when present, they need to be followed closely in the early post-traumatic period.

Pain is the most common symptom that people experience with rib fractures. It will often take the upwards of 6 weeks, sometimes 6 months for the fractures to heal and for patients to become entirely pain free. This pain results mostly from the movement of the broken ends and subsequently, with each motion or deep breath, the unstable ends move and pain ensues.

Pain control is a top priority in the care of patients with rib fractures. Poor pain control renders the patients unable to effectively breathe deeply, placing them at risk for collapse of the air sacs in their lungs (atelectasis) and at higher risk for infection in their lung (pneumonia). Additionally, when people are in pain they eat less, they cannot effectively sleep, and they are unable to move freely, or participate in their normal activities including work.

Rib fractures are most often uncomplicated which means that the fractured rib(s) are broken in one place. These uncomplicated fractures are usually not displaced allowing for realignment during the healing process and little movement with breathing and moving. These fractures can usually be managed conservatively with simple pain control and time.

However, at times, the fractures are considered complicated either because multiple breaks are present on each fractured rib causing the broken segments to be unstable, or when the broken ends are severely displaced. These complicated fractured ribs are often more unstable during activity and breathing and will likely take longer to heal; some may never heal normally.

3D reconstruction of fractured ribs before surgery

3D reconstruction of fractured ribs before surgery

Historically, good pain control and at times the use of a stabilizing elastic binder (to wrap around the chest) have been the only treatment options for most rib fractures. These treatment options continue to be utilized and are effective for many patients with uncomplicated rib fractures.

For the more complicated rib fractures we may also consider early surgical intervention to stabilize the unstable and/or displaced fractures. This is accomplished by screwing a small, customized, titanium plate across the fractured segment(s) of the rib thus achieving surgical fixation (stabilization); these plates realign the ribs and speed up the healing process.

After rib plating surgery

Images from after rib plating surgery

After rib plating surgery


Swedish Thoracic Surgery offers a specific clinic that is designed to care for patients with newly fractured ribs, both complicated and uncomplicated. We have a multidisciplinary team of care providers including thoracic surgeons, an interventional pulmonologist, and nurse practitioners who are available to evaluate the injury and make a clinical treatment plan that is individually tailored to each patient’s needs. This clinical plan would include consideration of the patient’s age, their underlying health, the severity of the fractures and the specific needs in their life. Our team is equipped to work closely with patients and caregivers to prevent potential and unnecessary post-traumatic complications and guide them to a quicker recovery and earlier return to productive and normal activities of daily living.

Topics: Services, Surgery


Iam 85 years old and have just had a fall onto mychest now have 3 broken ribs in agony taking 3 codapane forte every 6 hours no much relief any help availbe
Dear Hazel,Thank you for your inquiry. Given the intensity and duration of pain that are associated with rib fractures we have established a rib fracture clinic here just to take care of people like you. Good pain control is of utmost importance in the setting of rib fractures in order to optimize recovery and prevent conditions such as pneumonia. Unfortunately rib fractures hurt whether you are up moving around or even lying in bed. This is because the ribs are part of the chest wall that moves with any kind of action including just with breathing. Although you broke your ribs it is not necessary for you to be in agony. Some of our patients feel benefit with an elastic abdominal binder around the chest wall that provides some comfort and support. Some people only sleep with this because night time is often the toughest part of the day for people. Others like to wear it in the car to avoid unnecessary jarring of the chest wall while riding and others wear it during the day with activity; it can be pers...
I fell from a ladder and went to the emergency roon at our local hospital. They did a ex ray and I was told by the nurse it was one fractured rib. The hospital was very busy that night. Should I follow up with a Dr. ? Can I request the hospital to send my ex ray to my doctor?
Thank you for your response to our blog. When you have a fractured rib or ribs you can experience pain and disability for the upwards of 6 weeks, depending on how severely the fracture is displaced. It can be helpful to see your doctor for pain management during this time. If your ribs are more severely injured or displaced you may need to see a specialist. As a patient you have a right to transfer your medical records and radiographic films to another medical facility; this is common practice for patients. Usually you can sign a consent by the physician you intend to go see and they will request the records for you. Certainly if you are in the Seattle area we would be happy to see you in our Acute Rib Fracture Clinic. Wishing you a quick recovery!
My 70 year old brother in law fell a month ago and broke 5 ribs which we are told are displaced. Had a collapsed lung and fractured pelvic bone. After a month in the hospital he has continued to have complications trying to treat the lung and controlling the pain. The doctors at memorial in Modesto CA are baffled by his lack of improvement. He has required the use of a ventilator to assist with breathing as he has not been able to maintain adequate oxygen levels when breathing on his own. They just now did a tracheostomy to hopefully make him more comfortable but the pain levels continue to be unbareable. What are the signs that the ribs need to be repaired to insure that he can recover. I've been told that they have to get him breathing on his own before they could attempt surgery if it were feasible. How would we go about a consultation? Thanks for any help you may be able to offer.
Sorry to read about your brother�s ordeal. It may very well be that he would benefit from having his ribs plated , though other unrelated issues may here be at play. Though it is logistically impossible to see him in consultation, we would be happy to review his films if you were able to send us copies on DVD or CD. Ideally we would want to review a CT of the chest with 3-D shaded surface display of his rib cage, with and without the scapulae.
Dr. Vallieres, thank you so much for taking the time to respond to my questions. I have printed your response and contact information to pass along to his doctor and the treating physician. Initially we believed that some of his pre-existing health problems, arthritis and knees of which one after replacement had a staff infection. He has had surgery on his neck and shoulder blade. So he was already dealing with considerable pain and was taking Vicodin along with a nerve pill. They are now administering Morphine. While he is awake he becomes easily agitated when he feels any pain and frustrated that he cannot communicate other than to squeeze the hand and shake his head. The trauma physician has indicated that patients with worse injuries than his have been up and around in a few weeks. Needless to say both his family and the doctors are frustrated that we don't have any answers. My thoughts were that his ribs may just be too much for him to bear despite any medication. Hopefully, I can have his doctor co...
I was visiting Vancouver BC. 5 years ago and had an injury and went to the ER there. The ER doctor at the hospital I went to initially said there was nothing showing up on my x-ray. I was in such severe discomfort and could not take a breath without excruciating pain in my right upper stomach. The process of doing the x-ray in itself sent me screaming in pure agony. I am not a dramatic person but the simple act of lying on a table was too much. When doctor came back and said he found nothing on my x-ray... I asked him top please try to find out what was wrong with me. He left the exam room and looked at the x-ray again. He came back and said, "good to listen to the patient", it turns out that I had fractured rib(s). He said that there was nothing that could be done and that they didn't recommend wrapping ribs any more... He sent me home with pain meds that made me sick to my stomach, so I only took OTC acetaminophen. It took 3-4 months before I could move properly. I wish now that I had gotten a sec...
There are many causes for chronic pains after rib fractures. The most common etiology is some degree of nerve damage to the nerve that travels under each rib. This is usually treated by pain medications and at time physiotherapy may help. Less frequently, the chronic pains may be secondary to a lack of healing of the fracture (non-union). The best way to evaluate for this possibility is to get a CT chest with a special software reconstruction of the images to create a 3D shaded surface display of the rib cage. This is much more sensitive than plain rib views in assessing for such a process. If non-union is documented a surgical procedure where the non-healed fracture is repaired (plate and screws) is a possibility and could offer much relief.
On June 26th, 2013. I was in an automobile accident which caused an inferiorly displaced fracture of distal aspect of the RT 7th rib. I was advised to do no heavy lifting for 6 weeks and since I am a CT technologist on night shift in a hospital, I simply had to be put on medical leave. At about 5 weeks I went back to my physician for a recheck and to see if he would release me to go back to work the following week which would be 6 weeks post injury. He had no problem with that since my pain had greatly lessened, but he did not want to do it without another xray. Which I did. Here's where it gets complicated. In the days(yesterday) waiting for the report to come back, a gentleman ran a redlight a tboned me in the new car. I'm stubborn so I didn't go to the ER, but I called my doctor this morning and he wanted me to go back in and get examined in an ER. I went to the same facility where the last xrays had been done. MORE xrays and the ER physician told me that he can see the fracture on this xray, but not as we...
Thank you for your response to our blog. We are very sorry for your recent events. Although we can not provide medical diagnoses and advice without seeing you we can comment on the following. Rib fractures heal in varying amounts of time following injury and this is dependent on many factors including your overall health and ability to heal. Tincture of time heals most fractures, even the most complicated fractures, but the time it takes to heal varies person to person depending on the location of the injury and in your case a possible upset to that initial injury. Finally, in our clinic we rely nearly 100% on CT imaging with 3D reconstruction of those images to make firm diagnoses of rib fractures. It is the most accurate means for evaluating the bones to your chest wall. Wishing you the best in your recovery.
I fractured 2 ribs about 10 years ago, I had no idea at the time how it happened, and had xrays where the doctor said the fractures healed themselves. I saw a chiropractor a few times, but it didn't do much for the discomfort. All these years later, more often than not I feel discomfort on the left side of my back. I would describe it as like the feeling of an arm or leg you've had in one position for a while/leant on and need to stretch.I feel I need to stretch that side a lot, but to no relief. I feel better standing, will this ever go away?????
Hi, my spouse was just in a car accident on Friday, Nov 1,2013. He punctured both lungs, has 16 broken ribs, & a fractured sternum. He is in our local hospital in Palmer,AK, being treated by a trauma surgeon. I know it will be a long, painful recovery for him but am wondering if there might be more options & better treatments available at Swedish? I am not unhappy with the care so far, but am wondering what options you have for us? Thank you
Dear Stefanie,Thank you very much for your inquiry. First I would like to extend our concern for your husband; this is a traumatic event for all involved, you included. This is not a straight forward answer because each clinical case is specific to each patient. There are interventions that can be done to stabilize the sternum and ribs which can promote recovery for patients but whether or not this is realistic for the patient depends on many factors. You are very welcome to have the direct health care providers who are responsible for your husband�s care to call us and review the clinical case with one of our specialists. It is not uncommon for patients to airlifted from AK to our center if there is a clinical reason. Feel free to have them call me at 206-386-6800 and I can connect them ASAP to one of our docs. Warm regards,Joelle
HiI fell six months ago and bruised/cracked my upper ribs mainly in the area beneath my breast. I was on painkillers for a few weeks and was improving all the time, although I still found it difficult to lie on that side. Two weeks ago the pain suddenly came back again quite severely. It does't hurt to breathe but there is a constant ache in the area below my armpit and below my breast. Is it possible that I have somehow damaaged the ribs or torn muscles again? Or does the pain from cracked/bruised ribs continue for such a long time after the event?
Dear Chiela,I�m sorry for your injury. Rib fractures can take a very long time to heal. Although I can�t provide direct medical advice on this blog I can tell you that in general it would not be within the realm of healing to have such a significant relapse in your recovery including symptoms that suggest re-injury. I am unsure of your geographic location but I would recommend you follow up with your local practitioner or you�re welcome to call and make an appointment in our clinic at 206-215-6800.Wishing you the best of recovery.Warm regards,Joelle
I had a x-ray after bursting a fire door open with my shoulder I have 2 fractured ribs, this was 5 days ago, the local GP at hospital[ princess royal] gave me 10 days off work, I want to return now after 5 days but I have a chesty cough which as you can imagine is very painful as the ribs that are fractured are under my left arm and every time I cough my ribs kill, would I be better totally resting my body or doing light duties [if such a thing] at work ,is this coughing stopping my ribs from healing quick?, thank you from Gary Jones ,Telford.
Dear Gary,Thank you for your comment.Although I can�t provide direct medical advice in this forum I can tell you a typical and expected course of recovery for patients with uncomplicated rib fractures.When there�s a fracture in any bone there is a repair process that occurs. Your body�s cells understand that there�s been a break and recruit cells to the area to repair the bone. This repair takes a minimum of four weeks to fuse the bone(s) enough to provide stability in the ribs/chest wall. The challenge with rib fractures, unlike other bone fractures, is that you can�t splint them with a cast. The chest wall is always moving and this makes the healing process and time element to heal more difficult. Typically we advise patients to be on light duty, no heavy lifting over 10 pounds, for 4-6 weeks in order to optimize the healing process. It is very possible to disrupt those cells that are working hard to fuse the bones if lifting occurs. Meanwhile, the focus of treatment for patients is good pain control...
I broke two ribs about 6 months ago. I fell chest first onto a deck railing while trying to prune a tree branch. I still have a fair amount of pain but my big concern is that my left rib cage, is now deformed looking. Its hard to explain but it looks like my rib cage is much larger on the left side then my right side. Have you ever heard of something like this? The ribs I broke were 7 and 8 but the area that looks much larger is at the bottom of my rib cage. I had my ribs re-xrayed about 10 weeks after I broke them and they said they were healing normally and everything look good.
Dear Holly, Thank you for responding to our blog. I�m sorry for your injury. Given our experience in our rib fracture clinic, I can comment on your two concerns. Pain at the site of rib fractures is not uncommon even as late as 6 months following the injury. Typically the pain is not disabling or interfering with most activities for people but it�s present. It�s also not uncommon for this pain to be neuropathic pain. Each rib has nerves that run along it and when the rib is disrupted the nerve is inflamed and irritable. This condition can last at least six months following injury and if it�s interfering with activities you may want to visit with a medical professional to consider treatment with medication or even a nerve block. In regards to your chest wall deformity. When ribs are fractured they are either displaced or non-displaced. This means that either the bones are broken but in alignment or the fracture is more complex and the two broken ends are shifted out of place of one another. It is pos...
hiI was in an accident last year in September, I fell on my left shoulder and now I've got a bent collarbone, broke a rib just above my breast and bottom part of my rib cage on the left looks a bit bigger than the right.I don't feel any pain at all. is it a floating rib? and what should I do to bring it to it's original position?
Dear Catherine,Thank you for your mail.In order to answer your questions you�ll likely need a CT scan to accurately evaluate your anatomy following your injury. Our recommendation would be to follow up with a thoracic surgeon in your area to have this imaging and follow-up visit to discuss options. If you are in our area, you are welcome to make an appointment.Warm regards,Joelle
My name is hector and at the age of 17 I was jumped and one or maybe even two of my ribs were kicked in. I see a debt under my armpit. Well I kinda ignores the fact it happened for several years. I never experienced any pain so I ignored it. I have know started a new job carrying heat trays on my left hand and ribs we're injured on my left side. I'm know getting symptoms of small pain here and there . I'm kinda worried. I'm know 27 years of age. This was 10 years ago. Any advice. I don't have insurance and I'm considering on waiting a few months till I get insured. Any advice?
Dear Hector, Thank you for your message and for visiting our blog! Although we cannot provide direct medical advice in this forum, I do believe, given our experience in this area, that unless you experienced some recent trauma or forceful blow to the chest wall, your injury from 10 years ago is likely stable. Your pain and twinges are more likely related to muscles that you haven�t used in a while. Certainly if it gets worse and disabling seek medical care sooner. Best of luck to you! Warm regards, Joelle
I am 50 years old and have asthma which makes me cough a lot. I think I may have fractured a rib coughing. It is at the top of my right rib cage. It has been getting worse and worse for 5 days, and my lungs are suffering. Is this normal? Thanks
Dear Kate,Thank you for writing on our blog!I recommend that you seek immediate medical care with your primary care provider or a local urgent care. They should be able to make a definitive diagnosis and treat.Warm regards,Joelle
Hey how are you doing? I just had a quick question. I was in a bad car accident going on 5 years ago. I was told I didn't have any broken bones. I was put in a coma for maybe up to a couple of weeks. Every once in a blue moon I still get this sharp pain in my side right under my breast. The pain is so bad it hurts to breath. It lasts a few minutes. Should I be worried??
Dear Gabby,Your complaints are interesting so far out from your injury. It's not uncommon for patients to be told they don't have fractures by plain xray film but in fact, they do. Usually the ribs will heal back together. We do see people who had non-union or poor alignment of the broken bones in the healing process and this chronic poor alignment of the bones can trigger nerve pain. Nerves run along each rib and nerve pain can be sharp, stabbing, piercing, or even electrifying. The only way to fully appreciate if ribs have been broken is to have a CT scan with a 3-D reconstruction of the rib cage; this study would reveal if bones were injured and how they have healed back together. Before engaging in consideration of further imaging it's important to ask whether or not it would change the outcome and if there anything you can do for this. Usually people feel that they can tolerate the fleeting and intermittent nerve pain but if it's disrupting quality of life and functionality then it's important to c...
Hi, in July 2013 I fell from mountain bike and was admitted to Hospital A. Diagnose with a few broken ribs on my left chest and after a few day was discharged to go home with pain management.Few weeks later I had a haemothorax, then was rush to Hospital A again for emergency procedure to release the blood. Later to find more broken ribs on the same rib bone.Then was transferred to Hospital B due to Hospital A does not have expertise in thorax. In Hospital B, I was installed with MatrixRIB, plate and splint.3 months after the operation, an x-ray shows that a screw attached to the splint is sticking out from the rib. It is on the back of 5th rib between the scapula.Would like to know if I should remove it?
Dear John,Thank you very much for your inquiry.We have seen the screws work their way out. Our clinical approach is to leave it alone if they are not causing any discomfort. We would recommend that you follow-up with your surgeon who placed the system for further evaluation and discussion and long-term follow-up in case it becomes a problem for you.Warm regards,Joelle
I fell off of a ladder on Dec 19th, I have nine broken ribs on my left back side ribs 1 and 2 ribs have healed rib 3-6 are displaced fractured I had a CT reconstruction done Jan 29th and went to a Thoracic Surgeon on the same day I am schedules for surgery Feb 21st it will be 9 weeks since my fall and 3 weeks since the CT scan After learning about the rib plating surgery my concerns are that it is to late to have this surgery most cases have surgery 1-4 weeks after the initial breaks, are there any successful surgeries being preformed at 8- 9 weeks?
15months ago I fractured more than 10ribs.I,m having pain (shock)spikes threw out my body,Also I have body spasms,, will these stop? Are these Nerves trying to heal?I can,t sleep,when i do i wake up sweaty in chest area,I have a constant (3-7)pain in chest area,also numbness in chest area.and from this my mind is starting to go crazy. why won,t my chest heal? Please help
Dear Brenda,It is not too late to operate. However, your CT was a considerable amount of time ago and during this time considerable healing could have occurred. Our approach would include repeating the CT now to be sure the operation is necessary.Wishing you all the best in this process.Warm regards,Joelle
2 weeks ago a took a blow to my left shoulder. since then,i have pain in both armpits, both breasts top and bottom, left shoulder blade, and when breathing. i am a male 6 ft. 170 lbs, please advise.
I was in a motor roll over 3 months ago. I had a broken C1, fractured C2, T3, fractured 5th rib in my back and one on my left front side.I had x-rays taken 2 weeks, all the bones are healed and I was feeling fairly good.On the advice of my physio therapist I went for a massage last week. After the first massage I felt very good, but since the second one I am having severe pain in my back right side up under the shoulder blade.Could she have injured any of my previous injuries? I have another app't with her in 3 days and I am wondering if I should go.Thanks.
Dear Phyllis,Thank you for your mail. It takes many months to fully heal rib fractures. When there's been an injury to the chest wall there can be a lot of soft tissue disruption too. Unless your massage therapist was very aggressive with manual therapy, I suspect this is soft tissue responding to the massage with some local inflammation. Unfortunately, we can not provide direct medical advice in this forum, but I would recommend you see your general practitioner if this does not improve following the massage.Good luck in your recovery.Warm regards,Joelle
Dear Robert,Thank you for your comment. I regret that we can not provide medical advice in this forum. However, it would be advised that if your symptoms persist that you seek medical care ASAP.Best of health to you,Joelle
Dear Randy,Thank you for your mail.Although we can not provide direct medical advice in this forum I can provide a few thoughts.Nerve pain following a significant chest wall injury, such as yours, commonly disrupts nerves along the ribs. We frequently see patients like yourself in our clinic. Sometimes you can have a "non-union" of one or more of your ribs where they have not healed back together properly. There are surgical procedures that can be helpful in fixing these. We have had many patients who require long-term nerve pain medicines for that "neuropathic pain". Some folks even see pain specialists for nerve blocks to get relief.Certainly you could consider clinical follow-up with your primary care provider with serious consideration for referral to a thoracic surgeon, including CT scan with 3D reconstruction to get an accurate picture of exactly how your ribs have healed and proceed from there.If you're in the Seattle area you may want to see Dr. Eric Vallieres or Dr. Alex Farivar.All the best for...
About 2 1/2 weeks ago, I was doing bench press (205 lbs.) and the bar rolled of my palms and fell on my chest. Despite a fair amount of pain initially, the x-rays showed no broken ribs and I felt like things had been progressing well. Within the last two days, I have experienced a sudden increase in pain particularly on my left side under my arm and under my pectoral muscle. What symptoms generally necessitate a CT scan? I don't want to spend a lot of money trying to find the correct diagnosis if nothing is going to change in terms of care or treatment. I can't help but wonder with a blunt force such as that, would a CT scan show other possible complications that may require a different route of treatment than normal rib injuries?
Hi,I was in a motorcycle accident last week. Broke my collar bone and 4 ribs. Dr. said my ribs are stable and prescribed norgesic and voltaren every 8 hours and omeprazole bd. I'm still in a bit of pain.Anyway I just wanted to say thank you as reading all the posts and replies has made me more informed and is somewhat comforting.Thank you
Dear Wang,Thank you very much for reading our blog on rib fractures! Remember that it takes a minimum of 6 weeks for the bones to fuse back together and you can experience pain for the upwards of 6 months following an injury like this. Patience truly is a virtue in the healing process. Wishing you all the best in your recovery. Warm regards,Joelle
Dear David,You are likely about month out of your injury by now. If you in fact fractured your ribs, your pain should be improving now. If your chest wall seems unstable and the pain is not improving slow but progressively by now, it is time to consider further imaging and diagnosis of what has happened. When bones are fractured, including ribs, there are immature cells that congregate to the area of injury and build new bone to fix the break. It takes a solid six weeks for this repair to create enough stability in the break that you can be more active without significant pain. That six week mark tends to be the turn around point. There can be sharp stabbing pain with rib fractures that is associated with moving bones, nerve pain and muscle spasm and this can last intermittently for the upwards of 6 months following injury. It should start getting better by now though.I hope this is helpful information for you.Best of luck in your recovery.Warm regards,Joelle
I think I fractured a rib in January 2014, never had it evaluated. Seems 95% healed. Feel pressure in that spot while sneezing, and a little tightness in general. Can exercise without pain. Scheduled for cosmetic surgery today. Am I putting myself at risk for post op complications by not having this evaluated fully prior to my surgery? Thanks.
My wife had a fall she has 3 brokrn ribs on her left side, ribs number 9, 10, 11 please advise what should to do
Dear Mehra,I am sorry for your wife�s recent injury. Rib fractures can be very disruptive to comfort and routine for many weeks. Given this electronic forum and that I have not evaluated your wife I would recommend that she visit with her primary care provider for further evaluation, treatment, and monitoring. Thank you for your message.Warm regards,Joelle
Dear Ingrid,Although this is not a forum in which I can provide medical advice and given I don't have the benefit of evaluating you in person; I can tell you that likely the interval of time has allowed healing and stability of your injury rib/chest wall and should not pose a risk in your upcoming surgery.It's also not uncommon for some symptoms to take time to clear after a chest wall injury, even this far out from injury. However, if they persist and certainly if they worsen, you should seek further evaluation with your primary care provider.All the best to you in your recovery.Warm regards,Joelle
Hi About 3 years ago I had an injury, a blow to the front of my chest, which caused a fracture. Not long after I began to get wheezy, and despite many tests for asthma, this has been discounted. This developed into really bad breathing problems - breathlessness, bad breathing control, and chest pains when breathing. At first it appeared that the problem was breathing dysfunction but after having physio for that I am still getting problems - it feels like my chest will not expand properly, to its full extent, especially around the middle, which is where I got the injury. Is it possible my ribs did not heal properly and I have been having trouble ever since? If so, what should I ask my doctors to do? Thanks very much for any help you can give.
Dear Erik,Thank you for your message.It�s unclear to me if you had some imaging that diagnosed your rib fracture at the time of injury. There�s a complexity of structures including cartilage and bone that organize your chest wall; any of these structures can be disrupted and heal differently than their original orientation. A cat scan with 3-D reconstruction of the chest wall will very clearly demonstrate the orientation of your chest wall structures. In considering this study, you have to consider what difference it will make in the long-term outcome. If you decide to pursue this, it would be advisable to meet with a thoracic surgeon. They specialize in the thorax (chest and chest wall); they are also well equipped to clinically evaluate you as well as order and counsel you about the findings on a 3-D reconstruction. Given that you are 3 years out of your injury, this is really your only option to best understand exactly what is going on with the structures of your chest wall.Wishing you the best.Warm...
On June 20 I was thrown off my horse and hit the ground very hard n my left side the local hospital sent me north much larger hosp. The found I had broken 4 ribs but had a total of 11 fractures trauma surgeon told me about plating had the surgery went back 3 wheeks later for checkup doctor was very happy with my progress he did have to drain some fluid out on my back my breaks were on my back side I asked him if it was okay to start riding horses again he looked at me and said your kidding no riding or risky behavior for six months he told me if I was to fall I could die now I am wondering if I should ever ride again if my ribs with plating will be stronger or weaker as they heal should I give up my pation I have done most of my life
Dear Rob,Thank you for your comment. I appreciate your concerns and your interest in your health. Given that I don�t have specific information and films from your injury and this medium of interaction; I can�t give you medical advice but I can make some generalized comments about your concerns. It is possible to disrupt healing ribs within the first six months of healing, by direct or even indirect trauma, including bouncing on a horse. 3 months is too early to do a high impact activity, 6 months is a much more appropriate and reliable time to approach riding again. We recommend reintroduction of activities slowly and with caution until you�re certain that your body is tolerating it. We have had many people with injuries from being thrown from a horse with a successful return to their riding. I wish for you a successful and full recovery! Best regards, Joelle
i was in a car accident and punctured both lungs and 15 fractured ribs and fractured collar,how long before i feel better?i was in hospital for 15 days,i am at home now but in lots of pain.....
Aloha, four days ago i went for milk and eggs early in the morning for the kids. I took my scooter to save gas, being early morning the sun just broke over haleakala and was directly in my eyes. didnt see the car in front of me brake in timme and hit her rear end causing me to crack my rib cage into the back of her car and fly over onto pavement. went to maui medical, took x rays and was shown on x ray that my 6th rib was cracked 7th was broke in half and 8th was cracked. ive been icing and doing moderate moving around exept for going freediving yesterday at about 30 to 40 feet of water. since then im having pains in my chest like i think its my lung on the left side. ( same side as the break ) should i be worried and go doctor imediatly, or wait and see if it subsides. signed KOLOHE MAUI BOY!!!
im not too hip on the computer stuff. so does that meen after he reads it he will give me his opinion on what i should acctually do?
Hi Jeffrey, our providers are not able to provide medical advice online. If you have a specific question about your medical condition, please talk to your health care provider.
How old does a rib fracture have to be before it starts to heal and a dr can determine the age of the injury?
Dear Brian,When a bone is broken, including ribs, the body understands that there�s been a break. There are young cells that congregate to the area of damage to fix the break. These cells grow in numbers and build what is called a �callus�. This callus is initially soft and serves as a splint for the broken bone in stabilizing the bone but it also helps the bone repair itself and gather all the necessary tissue/minerals necessary to heal and strengthen it. You can see this �callus� on xray as early as four weeks following injury. It looks like a nob on a tree when you see it on film. This soft callus turns into a hard callus by 3-4 months and is usually present many years following a bone fracture. This is the hint that a fracture has occurred when someone views your xray film. A radiologist may be able to advise if the fracture is acute (occurred in the recent past) or if it occurred greater than 3 months ago but likely not much more detailed prediction past that.Best of luck to you.Warm regards,Joel...
Dear Luke,I�m sorry to hear about your significant accident and injuries! Given the current forum online and because you are not under my medical care, I cannot provide direct medical advice. I�m not sure of the extent of your injuries but likely you are under the care of medical professionals who will be able to guide you through your recovery. I would suspect it will take a minimum of six months to return to your usual activities and a pain-free state. Physical therapy and rehabilitation will be very important in a full recovery from such an injury.All the best to you in your recovery.Warm regards,Joelle
Twenty seven years ago the car I was driving was hit by a drunk driver. Among other injuries, I received crushed ribs resulting in a flail chest. I was on a ventilator, etc. Over the years a pain has developed on the right side of my back, about 6 inches below my shoulder blade. It developes upon any exertion--even standing or walking for an hour or so. For years I ignored the pain because I was grieving over the loss of my 12 and 23 year old sons in the accident. However, it has gotten to the point where I can no longer ignore it. It is stopping me from participating in many normal activities. The pain sees to lessen if I apply pressure to the spot with my hand. Can a doctor help me? What kind of doctor should I see? I once saw a physical therapist who told me she couldn't believe I was able to walk with the extent of muscle damage.Thank you
Dear Toni,Let me just begin by telling you that given my 30+ years of experience working in health care, life, and life as a parent; I believe there's not greater pain than losing children. I'm extending you my heartfelt condolences. I am terribly sorry for your loss!Technology and care for injuries like you suffered have advanced since your accident. Until you get more imaging, it's difficult to understand how your bones healed and how the layers of muscle are compensating. A cat scan without contrast plus 3D reconstruction of your chest is the imaging that would look at the bones of your thorax (chest). It would very clearly display where your injuries were and how the anatomy healed. That is the place to start. If you are in the Seattle or greater Seattle area or even Washington State, you are welcome to come see us. If you are at a distance, you would want to locate a thoracic surgeon to order this study and interpret the films with you.I think you may have already looked at my blog but in case y...
Hello,I was a passenger in a car that was hit head on by a drunk driver back in February. I was diagnosed with four mildly displaced fractures of ribs 3-6 on my right side from the seat belt. Back in July, I went to a walk-in clinic when pain that had always been present in my lower left rib area suddenly got much worse with activity. Also I had previously felt the bones in this area pop, and no injury had been diagnosed in this area despite my complaint of pain. The doctor at the walk-in told me that I probably had a costochondral separation initially with remaining costochondritis. The pain has improved, but is still present. What type of specialist do you normally recommend patients with this type of injury see if pain persists? I have called an Orthopaedic specialist but they don't treat ribs. Thank you!
Dear Kirsten,Given your injury history and ongoing symptoms, I would recommend you follow up with a Thoracic Surgeon. Thoracic Surgeons specialize in the organs, structures and mechanics of the chest, also known as the �thorax�. A 3-D reconstruction of a chest CT scan will very clearly display the injuries you�ve had and how they are healing. Wishing you all the best in your journey to health!Warm regards,Joelle
About six weeks ago I was pulling a branch out of a pile of wood and it suddenly released and hit the right side of my chest. There was considerable pain which I assumed was either a bruised, cracked or broken rib. A friend had been diagnosed with a cracked rib at another time and there was not a lot they could do but let it heal, so I did not bother to go to a doctor. Gradually the pain has decreased but a month or so after the accident I was feeling the rib to see if I could tell any difference from the other ribs. It seems to dive inward then there is a break and the other side of the break is level with my chest so that the two ends appear to not meet. Obviously if this is the case, the bone will not heal, and I am beginning to wonder what the chances are of having serious complications in the future. It has been about six weeks now and I can breath easily and only feel pain when I lie on my side or sometime pull upward on a heavy object. Thanks so much
Dear Adiyan,I understand your concern for complications from what we would call a non-union of your ribs following fracture or a break. Believe it or not, our bodies have some protective mechanisms and are built to last. Most of the ribs are anchored by other structures including muscles and even if they don�t heal back together following a break in them, they will continue to function for you and likely with no adverse repercussions. However, without actual imaging of your thorax (chest wall) we can only speculate on exactly what occurred when you sustained the injury and what you are feeling on inspection of your chest wall. If you are experiencing prolonged discomfort and feel that you haven�t made a full recovery you might want to visit your doctor for consideration of a chest xray to better understand the location of injury and how you have healed. If the xray doesn�t provide answers you can then progress to a cat scan with a 3D reconstruction to fully visualize the thoracic cage including all the r...
Dear Arshad,I�m sorry to hear about your injury and prolonged suffering. You could be experiencing muscular and/or neurologic symptoms related to this injury. Additional clinical considerations would be to visit physical therapy for further evaluation and treatment. A visit with a pain specialist might be worthwhile for consideration of a nerve block if their evaluation is consistent with residual nerve pain.All the best to you in your endeavor to find resolution in your symptoms.Joelle
4 weeks ago i injured my ribs due to a bad fall. The pain went away the first day so i started to walk, exercises clean vacuum and forgot about the pain. week latter pain came back worst i take Motrin for pain it seems to help a little. it goes like this for 3 days then i feel fine again.......so I stopped the Motrin hate to take medication ( another of my problems) finally after waking up one morning pain was really bad went to see DR he just just check me asked me a bunch of questions i had no visible bruises breathing was normal he order X-rays still waiting for results. I had another 3 days of feeling pretty good with the difference i cant stop the medication for 10 days..... its 2:00am the pain wake me up....it hurts when i take a deep breath but i had this before then went away.......the worse time is at night. mentally is getting to me and i dont like this feeling am very active, from tennis to the elliptico 5 days a week... bothers me not to be able to exercise... sometimes I w...
After my 5th spontaneous pneumothorax two doctors inserted two chest tubes (one each). One has no problems, but the other damaged the nerve under the rib. For over two years now I've had severe pain at the insertion site. I've tried steroid and electronic blocks without relief. I've been living on a Fentanyl patch (75mcg). Is there something that can be done to the nerve to remove the source of the pain? My last pain doc wants to try to uses his specially compounded ointment. I want to (surgically?) remove the cause of the pain. Any suggestions will be greatly appreciated.
Dear Alicia,Thank you very much for your comment.I�m sorry for your injury. Although I can�t give you formal medical advice in this online forum, I can give you some general information about rib fractures that maybe helpful.Rib fractures take a solid six weeks to stabilize therefore we recommend avoiding any lifting over 5 lbs and significant activity with the upper body until that time or later and only as tolerated. Until this time, your chest wall and ribs are mobile and will be irritated and usually much later than 6 weeks. Monitor your activity and proceed only as you tolerate. If it hurts, back off.Chest xrays can be helpful to see if there was an injury and if there are signs of healing but they don�t always pick up the broken bones. It can be more helpful to obtain a CT scan with 3D reconstruction to best view exactly what happened to your chest wall.There can be significant irritation of the nerve roots that run along each rib. The pain you're experiencing, especially at night, can be associate...
I broke 3 ribs on February 23,2014. I had a ct scan July15,2014. It showed they were still broke and dislocated. It is now the first week of January 2015 and still cannot do many things. Like shovel lift things sleep and it hurts badly if I do something like that. The pain is always there and it is making me crazy. Help me please!!!
Hi.First, let me say how impressed I am by the sincerity and individualism you have answered comments to your blog. Bravo.Here is my question:4.5 years ago I fell from a ladder onto a bannister breaking 7 ribs in 10 places. There was no damage to my lungs and a mild concussion. I was given pain meds and sent home where according to one account, my ribs shifted and were healing on top of each other. I was re admitted 10 days after returning home when tht was discovered in an exray. One doctor felt I should have them plated. The surgeon who would do that chose not to recommend it. Regardless of all that, the overall treatment was pain relief and.imsat in a chair. I am the mother of a young man who has multiple disabilities and often requires physical interaction. My pain continues, though not everyday. Recently I started walking again as my health requires some movement (I used to bike 200 miles a week, so this has been hard), even walking is causing flare pain now. I returned home today in tears after just 4...
Hi im a 55 yr old lady who in july 2014 aquired 2 lower back # ribs when hit by a surfboard. i was told recovery would be between 5 and 6 weeks, overall i am ok but my only problem is when i lie down, i wake in the night unable to move without pain, i find myself holding on to headboard to help me turn over. when upright and moving about there is a constant tenderness in that area. is this normal or should i seek further adivce? Pat
After having full hip relacement surgery at age 57at mayo clinic I was told by staff that my ribs may have been bruised as a result of being isolated in a device during the procedure. Recovery has been 5 months and left side middle back still has imflammation pain. Is this normal?
Hello, my husband fell about a year ago and broke 2 ribs..The doctor said they healed improperly...He recently had a cold with a bad cough, and now his side with the broke ribs is causing him a lot of pain...My guestion is can this be caused by the fx ribs and if so what can he do about the pain? Thanks for your time..
Dear Herve,I am SO sorry to hear about your suffering; this is very life altering!I work on a Thoracic Surgery service, we insert and remove chest tubes all the time. I reviewed this with one of our Thoracic Surgeons and our advice is that you consider contacting either a thoracic surgeon or a neurosurgeon for further evaluation and consideration of ablation or removal of that nerve.I can tell you that in our experience, pain medications like fentanyl are NOT so effective for pain that arises from a nerve. Medicines that are specific to the nerves are more effective. There are oral tablets and capsules and also topical transdermal patches that can target nerve pain. You should consider this conversation as well with your medical doctor or caring provider. If you are not already under the care of a pain clinic, you may want to consider this. Wishing you all the best in this endeavor.Warm regards,Joelle
Dear Joan,Thank you for your kind remarks; it�s a privilege to care for people and this forum is just another way to extend our ability to care for folks. Isn�t modern technology cool?!Your injury and story are interesting and similar to another person who wrote to me. Basically an old injury coming back to haunt you. These are my thoughts. You had an extensive and complex injury to your chest wall. Short of plating all those ribs, we wouldn�t expect them to heal in total alignment, especially if some of them were fractured in more than one place. When you have such an injury, you likely developed a new posture in order to accommodate the healing chest wall. You are structurally different on the side of injury AND on the non-injured side, as a result of this whole ordeal. Likely you have imbalance in your chest wall/cage and all the muscles that comprise these structures. Some of those muscles you rely more heavily on and I suspect you have developed significant weakness in many other muscles that ar...
Dear Sandy,I would recommend you consider further evaluation by a Thoracic Surgeon with a CT scan + 3-D reconstruction before you see the surgeon. There needs to be a thorough evaluation of exactly what is structurally happening with the chest wall before understanding what the underlying nature of your pain is and what your options are moving forward.All the luck to you!Warm regards,Joelle
I was told I fractured one of my ribs from hockey about 9 weeks ago. My limitations were up to me, although he recommended 2-3 weeks I went back after 1 and a half because I wanted to get back in the game so badly. With lots of ibuprofen, my injury had seemed to heal mostly but then a week ago I fell wrong and now it feels like I am back where I started, but much more popping and locking and it isn't as bad with breathing as it is with movement. Was my doctor right to let me go back so early?...I don't want more reinjuries like this. I have a reasonably high pain tolerance from what I have figured from other injuries, and I don't want to sit out but I don't want this to lead to other complications-is that a risk? Basically my main question after all this is what should I expect for the future and should I go back to a doctor or is this normal?
Dear Debbie,You bring up a good question and an interesting problem. In the traditional setting of a fracture (broken) bone, we are able to splint bones in casts so that they can be realigned with the best chances of healing as "properly" or as close to their usual position as possible. However, when ribs are broken, it's impossible to provide a splint or cast so these bones can heal in perfect position. Make things more challenging, it's impossible to immobilize the chest wall to provide alignment in the healing process because we require the chest wall to move in order to breath; the ribs are moving at least 16 times a minute.Given these considerations and the various mechanisms of injury when people break their ribs, it's not surprising that the old injury will haunt folks every now and then. I always tell people, that your body remembers injury and will remind you in certain settings.So, you have the bones that needed to heal but you also have the nerves that run along each of the ribs that can also g...
Dear Joelle,First let me thank you for your personal and informative comments on this forum. Perhaps I may I ask you question as well.Three weeks ago I fractured at least one rib at the left lateral side of my chest during a stupid fall with my ATB. It was not seen on routine X ray, but later an ultrasound clearly showed the crack, with slight dislocation of the fractured ends. Pain is manageable now, even without much painkillers. I still suffer from some "clicks" now and than, with certain movements.I did understand your remarks about "callus" formation in about six weeks and slow calcification during the months thereafter. My problem is that I am moving with care to the extreme, not so much because of pain but because I am concerned movement may shift the fractured ends and may eventually lead to non-union. Is it wrong to move as normal as possible, as long as it causes not too much discomfort?? Or should I take as much rest as possible. When do you think it is possible to go back to sports? I am quite anx...
I had a bilateral 1st rib resection in July/August last year for arterial Thoracic Outlet Syndrome. Unfortunately I had a rare complication whereby within a week of the second resection both my 2nd ribs completely fractured, one displaced. Six months down the track one is healing, the other however is still displaced and has a poor prognosis of reunion. My question is this. I work in an area that requires alot of manual upper body movement (pushing heavy loads and working in autopsy theatre). I have been given another six months to let the fracture try and heal. Given that I have 1st ribs resected, and 2nd ribs fractured do you think it is likely that I should look for another career. Given that no one understands why I fractured the first time there are concerns for future fractures, and concerns that the third ribs may be compromised. Any advise would be greatly appreciated
Dear Gert,Thank you very much for your mail AND for advising your location; it's really fun to understand the reach that this blog has!You bring up several great questions that haven't been addressed on this blog.The mechanism of injury and the extent of trauma to the chest wall widely varies person to person. Two people could have the exact same mechanism of injury but could look very different on imaging. Without viewing your films I can't fully understand what's happened mechanically/physiologically to your chest wall as a result of the injury but suffice to say that your report is consistent with early rib fracture injury. As I've noted previously, the chest wall is always in motion and given the improbability of splinting the ribs unless you have them surgically plated, it's likely that they won't heal in perfect alignment. This said, the body does amazing things and it is capable of putting itself back together given the proper setting. If you're an otherwise healthy person including well nourished...
Dear Leah,The body is sophisticated enough to heal itself but it definitely needs tincture of time the proper setting. Even in the most optimal healing conditions, it takes a an absolute minimum of six weeks for the bones to start bridging in the repair process and provide some stability but the healing and stability is not anywhere near where it needs to be to endure another fall without injuring them again. Given the risk and intensity of hockey, I wouldn't recommend someone play this sport for at least 12 weeks following injury. There are many other things you CAN do to maintain fitness and cardio and I would encourage this.I would recommend referring to some of my prior comments to learn more about how the healing occurs; it may be helpful in understanding how your body puts itself back together and safe approaches to reintegration of activity.Wishing you a full recovery,Joelle
Dear John,I am sorry to hear about this and perplexed about your persistent pain in this clinical setting. If your pain was truly from positioning from a routine hip replacement, I would expect you to be fully recovered within a month following the procedure. Without reviewing your operative report, examining you and taking a full history, I can't fully appreciate what this looks like. I would recommend you see a medical rehabilitation/physiatry doctor for full evaluation and determination of what your underlying pain is so you can make a plan to get better. I would aim for finding answers and a rehab plan that returns you to 100% of your baseline before that surgery.Warm regards,Joelle
Dear Pat,Your report is not uncommon. Depending on the location and severity of your injury, it can take a long time before the rib cage is ready to sustain the kind of force from laying and twisting in a dependent position such as lying in bed. When I have these discussions with people, I usually start by determining if the problem is getting better, worse, or it's unchanged. Putting it this way and with some thought, most people will report that the condition is very slowly improving. If you are not improving and certainly, if you are sliding back in your recovery then you should see your medical provider for re-evaluation. If you are making small, incremental, improvements then hang in there; things will get better. On another note, the type of pain you are experiencing at night can be sheer mechanical pain from laying on those bones that are still healing. It can be muscles spasms in the chest wall at the site of the injury in which case, an evening heating pad before bed or muscles relaxants may b...
Dear Janet,My sincere apologies, I misplaced your message in my filing system and just now discovering this! SO sorry for my tardiness!!We have seen folks like you who have had an old injury that continues to hassle them. The ability to repair the underlying defect depends on many things including the location of the injury. In our experience, it's difficult, even in the early period after injury to fix things under the scapula or close to the spine. The site of your injury may have healed just fine but it's very plausible that the local scar tissue that was integral in the healing/stabilizing of your injury is causing mechanical disruption now. Given the location of your injury, I think it is likely not an option to fix it now. I have a clinical background in the primary care setting. I have taken care of many patients with a variety of injuries and I DO want to tell you that I have seen people respond to many alternative modalities of treatment with complaints such as yours. I always believe there's...
Dear Collette,I am very sorry to hear about your prolonged experience and current circumstances!It's truly difficult to fully appreciate the setting here and what the long-term prognosis is for you from this perspective on a blog; so sorry. In the surgical world I would say it's too soon to make firm decisions about changing your career and encourage you to give your body more time to repair itself and certainly avoid heavy lifting in the short term. Don't give up hope. I've witnessed people endure major operations who really do make strong recoveries, with the benefit of time. Additionally, it can be helpful to gain another professional opinion from a Thoracic Surgeon who specializes in Thoracic Outlet Syndrome. It's not too early to do this and may help you understand what's next for you.All the best to you Collette!Warm regards,Joelle
I was involved in a MVA in Aug.2014 with injuries of left side rib fractures 4, 8 thru 12 (9 and 10th ribs displaced which punctured lung) ruptured spleen, grade IV, and fractured T9 transverse process. I had two VATS. The first VATS removed ribs from lung and were sutured in place. I had 4 chest tubes because the 9th rib displaced again and was impaled in the lung for 4 weeks before being found. The second VATS was an attempt to plate the 9th rib which was unsuccessful and a resection was performed instead. Now, 6 months post MVA, I am having increased pain which my MD ordered a 3-D CT Scan. It showed that the 10th rib is displaced again by 1.5 inches and the 6th and 7th rib still nonunion/non healing. It was recommended to me to have all 3 ribs plated. Have other patients had this procedure completed? Is their pain resolved and can they return to normal activities? Prior to the MVA, I cycled 3100 mile that year, I want to get back to my bike and breathe deep without pain. Thanks for any feedback.
Hi There, I was a mature fit woman of 53, and had an accident at work, last dec 2013 where a person knocked me to the hard frozen ground and fell across me breaking 4 ribs. i still feel a lot of painto this day on my left side where they were fractured. i am now under going nerveblocks and still on medication for pain. i had Fibromyalgia previously but it was dormant for some time and not really bothering. since april of 2014 my Fibromyalgia has hit the roof and i am taking 120 mg of cymbalta daily. I went for an exray today because when i laugh or lay in bed im still feeling pain and discomfort. i seen on my xray that one of my rib is not healed right and off th the side where it should have completely callasued over and healed..is this what is causing me all the pain right now, thank you dearly for your response.
Cathy,I was in a mva in November 2014 and had 11 broken ribs. 4 of them were plated. I also had a collapsed lung, lacerated spleen, and damaged wall. I just wanted to say that even 3 months later, I am still healing and it still hurts to take a deep breath. Give it time.... Hopefully it will eventually get back to normal. :)
Dear Cathy,YOU have been through A LOT with this significant trauma and multiple procedures not to mention your ongoing symptoms. I suspect your good health going into this event has served you well but can imagine your frustration with the shift in your routine and health.I truly wish I could tell you that plating would be a guaranteed fix and take you to a pain free place in your life but I don't think anyone can tell you that. Given my clinical experiences with trauma patients both major and minor events, I have accrued some opinions and that one prevailing opinion is that the body ever forgets what's happened. There will always be residual reminders of what the body endured. I do believe that people can restore their health and physical well being through a number of modalities, especially if they are highly motivated.In terms of your specific injury and the possibility of rib plating this far out of injury. There are potential risks and side effects of surgery such as infection, more pain, and in thi...
Dear Bobby,Without having the benefit of examining you and correlating your films with the physical exam and your report, it's difficult to say where the pain is arising from. Given that you're getting nerve blocks and on medication that would target these symptoms, I assume that you're under the care of someone who has reviewed all these items and putting the whole clinical picture together.There are a number of pharmacologic approaches to nerve pain and if one is insufficient, you might want to try another.You might also attempt o or a combination of complimentary methods of treatment for your symptoms including physical therapy, acupuncture, massage, reflexology etc. Strengthening and routine stretching are also critical elements to long-term management of symptoms following this type of injury. Some of these might be helpful for fibromyalgia too!All the best to you in this journey of health and recovery.Warm regards,Joelle
Phyllis, ALL great questions!!Straight forward rib fractures in an otherwise healthy person should stabilize within 6 weeks. Meaning that the ribs should start forming that callus and stop moving around. In my experience, people notice that there's less popping and mobility around 4 weeks and their ability to do more things, including lifting more, occurs closer to the 6 week mark. The pain takes much longer to resolve and I wouldn't recommend going all out with activity at 6 weeks. Just slowly reintegrate activities of daily living, as tolerated.It is not uncommon for people to report that popping activity with certain movements and that acute pain is associated with that movement of those ribs. Remember that most of the ribs have muscle that attaches to them and prevents them from wild motion despite that constant motion of the chest with every breath and just merely living. The pain should settle down as the ribs become less mobile.With each passing week from your injury, you should notice small but ...
Fx'd T5-10 of spine; 2cm displacement & fx's of R ribs 2-11; a shattered R scapula & other injuries. 10 months post accident ribs nonunion. They plated them (5-10). 20 months later scapula is still nonunion/comminuted. 11th rib is still nonunion. How do we reduce my constant pain & treat nonunions
I got hit by a car on my right arm and ever since my right shoulder has been hurting then when im sitting for too long i feel a shortness of breath. In my chest area , the rib on my upper right side close to my right breast felt sandwiched. Like it was shifted over the rib under that. Idk exactly. So i push hard , putting pressure on where the uncomfortable feeling my rib snap into place i think because i no longer feel like its out of place but now it burns where i felt and heard the crack.
I was massaging my grand mother age 75 and I had put my whole weight on her upper back on the right side and there was a crack sound and she felt alot of pain and couldnt turn and later on she felt pain in her chest on the right side. Please suggest me what to do.
Dear Alex, First off, I’m sorry for your injury! It’s difficult for me to know when this injury occurred but if it was recent, I would recommend you see your primary care provider for further evaluation and treatment as soon as possible. Perhaps you have done this already. Burning is often a symptom of nerve pain; again, it would be very helpful for you to check in with your doctor or other health care provider. Wishing you all the best in your recovery. Joelle
I broke my rib the middle of September 2015. I still have some pain under my arm and breast. I have bronchitis and the coughing is painful. Is this normal? One other question. My mother recently passed away from end stage lung cancer which metastasized into her rib. When I had my rib xray only the brake showed. I was told if there was a problem it would have showed up on the xray. Am I just being paranoid? Thank you.
Dear Donna, Thank you for your message. I would recommend you spend some time browsing the info on the blog; you’ll learn a lot about your injury. In short, it takes at least 6 weeks for the fractured bones to fuse and become more stable but it really takes at least 3-6 months to get strong enough to not hurt when you endure significant force in the thorax/chest, like vigorous coughing. I would recommend splinting the chest with a pillow when you have to cough. I am very sorry about your mother; much of the work I am involved with is lung cancer. I understand too well what you just experienced. Sincere condolences. Your concerns about your own health after witnessing your mother’s experience is very real and valid. It is true that if your bones are involved with cancer, they would not look normal on imaging. If all that was seen on imaging was the bone break/fracture then likely that is all that was seen. Radiologists are always looking for any abnormalities to report. Wishing you all the best in your recovery. Do take some time over a cup of tea and review many of the entries in the blog; I think it will be validating and helpful. Warm regards, Joelle
I've been sick with bronchitis for over a month now but a week ago I suffered intense pain in my lower front right ribs with pain radiating to side to the point of not even being able to raise my right arm. I have to do everything I can to stop any cough. Can't even blow my noise without it causing horrible pain. Touching my lower ribs are extremely painful with one being the most painful. I had x-rays done 6 days afterwards and all that is showing up is an old healed fracture of my 7th anterior rib which I do not remember ever happening. Can it take longer than 6 days for a rib fracture to show up? I am still coughing. I also have Osteoporosis. Otherwise could an old fracture area become this painful when a person develops severe coughing? The x-rays also showed up a old healed left 4th anterior rib fracture but I remember when this fracture occurred. The pain I have now on the right is significantly worse than when the left rib was fractured. Thanks so much, Deanna
I broke my ribs playing rugby a year ago and my left ribs that were fractured still hurt at some areas. My ribs have healed but my left ribs are lower as in deeper than my right. What should I do?
Dear Deanna, Chest xrays are often not sensitive enough to clearly demonstrated fractures in the ribs; you most definitely could have a fracture that is not showing up on plain film. The gold standard study that will fully illustrate the current status of your old and any new fractures in your ribs are a CT scan with 3-D reconstruction. If look back in this blog you’ll see pictures of a 3-D reconstruction. All the best to you in your recovery. Joelle
i injured my chest 3 months ago while i was working out in the gym. Afyer one month i went to see a doctor. She checked it by ultrasound and x ray. They found there is fracture in my 4th rib, gave some pain killers and told it should be disappeared after 2 weeks but it didnt. They checked it again and said we should wait there is nothing to do more. Now it has been already 3 months since i injured my rib. And i feel like it is not getting any better. İ feel like i have to live with this pain till the end of my life. İs there anything that you can suggest me??, thanks in advance
Greetings and thank you for your inquiry. It is difficult to understand what might be the underlying cause of your pain. Further evaluation by your primary care provider or a medical rehabilitation doctor (physiatrist) may be helpful. Warm regards, Joelle
When someone breaks 7 ribs and their clavicle on the same side, anatomically there is no proper brace you wear.......is this true? No one has been able to answer this question so far...thank you.
Hi. I fractured a rib just under my right breast on Labor Day 2015. I was told it could take up to 10 weeks to heal, and that there was nothing to be done except take it easy and was prescribed strong ibuprofen. It became much easier to move in about 3-4 weeks and I did well, except I kept spiking high fevers with flu like symptoms it seems every other week. After multiple trips to the Dr. And urgent care, I was diagnosed with walking pneumonia, as I was still able to work, etc. most of the time. They cleared that up, I mostly felt fine until we started having abnormally cold dry weather in Southern California, when I would get a deep ache in the rib area. That went away, but just very recently, at the approach of several severe storms, I have been getting sudden, sharp stabbing pains in the tub. This takes my breath away and I can't move for 10 seconds or so.. My question is, is this just a case of the barometer dropping, or can I have residual nerve damage?
Hi Joelle, Firstly, I want to thank you for your responses above. With the exception of this site- it seems like something very unusual is going on if one has pain after 6 weeks. Your responses have truly helped shed some light on my own injury. I am a 50 year old woman who has been competing as an amateur triathlete for 3 decades. In late August I had a high speed bike crash (front tire blow out going over 20mph around a corner). I finally had a plain film of my chest done after 6 weeks because I was so miserable. It showed 5 broken, but not displaced ribs (6-10) I wasn't able to do anything workout-wise for 9 weeks because my chest pain was so acute. I have slowly increased my activity and can now ride the stationary bike and run without serious pain. Reaching overhead is still an issue. I would like some general information about how stable non-displaced fractures tend to be. When is it typically safe to return to activities like skiing or riding a bike? (not that these are particularly safe activities) Having recovered from other injuries in the past I know that some pain is very normal when rehabilitating. I would like to start swimming again but do not want to set myself back. I really miss my pre-injury life but want to get completely better. I am actually visiting Seattle. How far out is your clinic typically booked? Thank you in advance for your response.
Dear Felix, The content of this blog will answer many questions you might have about your injury. If you spend time in the gym routinely, you might have not taken enough time (6 weeks) to allow proper healing of your ribs. I would suggest that if you are not making slow and steady progress in your recovery, you should seek another medical opinion. Joelle
Dear Andy, Thank you for your interest and inquiry. Historically, chest binders have been discouraged because it was felt that they don’t encourage people with chest wall injury to take deep breaths and places people at higher risk for pneumonia. There is no current data to support the use or disuse of binders. There is no specific medical product out there, that we’re aware of, for such use. Our surgical group performs large surgeries on the chest and there are no surgical binders available either. I hope this is helpful to you. All the best, Joelle
Hello about 3 years ago I was lying on the floor my wife was lying on the couch messing around I pulled her down and directly on on my chest and heard a pop almost like I was only one who could here it definitely in a vulnerable position thank God she only weights abt 115lbs but non the less xray showed 2 very visible fractures I was given same advise that's always given in ER along with anti-inflammatory and pain killers now over past 3 years I was pain free until 1 year ago I took a harmless hit during a hockey game that stole my breath nd hit a solid 9 on pain scale for cup months I couldn't belive the amount of pain I was dealing with it became an issue almost daily now just today I have no clue what I did but I am literally on this site because I need some sort of direction to go besides going to ER I know its same rib it's located right under arm pit as I touch it the exact same spot again have no idea how happened except that rib is very susceptible to anything I quess is there anything you can do?
Hello. I fractured a rib while boogie boarding many years ago. It was a very severe impact with the top of the board sticking into the sand floor and the bottom of the board thrust into my chest. For years I have reinjured the same rib dozens of time. It's happened from people hugging me, trying to open a window and most recently from sleeping on my stomach. I am 57 years old and very active and in decent shape. However, I have osteoporosis very bad and the rib issues are causing me back problems too. This last episode has left me in such pain and each time it happens it takes so long to heal. I believe that the rib never really fully heals and that's why it keeps being re-injured. I had an MRI that showed a probable nerve root sleeve cyst in the right t6-t-7 foramen and central disc herniation. A chiropractor told me she thinks I likely hurt myself worse than I thought in that accident and that the board impact is right where the MRI is referencing. I am very concerned that the older I get this will just get worse and worse. Each time it happens I'm told to put ice on it, take Advil and it will heal after several weeks. This time it was extremely painful and still is. I had to take time from work and coughing is unbearable. My question is this. Is rib plating ever considered in a case like mine?Could the rib that keeps being reinjured be repaired? Or is this only done immediately following an accident? Thanks.
This message is for Lynne Keane, wrote to you on January 6, 2016. I am a 60 year old female, recreational triathlete and was involved in a serious auto accident in the end of August 2015. I was told by a level one trauma center hospital in Sacramento that I had broken one rib. Ten weeks later, I found out I had broken five ribs, numbers six through ten. Like you, I tried to swim, bike and run (very gently) around twelve weeks but the pain was unbearable. Finally, my doctor referred me to physical therapy here in the Chicago suburbs. I have almost completed six weeks of strengthening and stretching and along with deep tissue work on the rib muscles. Last night I slept for the first time on my injured side and I'm slowly returning to triathlon training. For me, it's taken nearly five months to heal five ribs, longer than everyone said it would take. Hang in there, girl!
Dear Brenda, Your complaints sound consistent with an onset of nerve pain. Nerve pain following injury often is a later onset than the acute pain from the initial injury. If you read back in this blog you’ll see much discussion about nerve pain. As you get more active, you might also notice some painful days. If this doesn’t improve over time, I would recommend you follow-up with your primary care provider for further evaluation. There are treatments for persistent nerve pain. Wishing you a great 2016! Joelle
Dear Jim, Given your history and that you’re have recurring symptoms that may be consistent with a re-injury of a susceptible area, I would recommend you locate a thoracic surgeon that will gain a Cat Scan of your chest with a 3-D reconstruction (the 3-D reconstruction is critical) to optimally view the anatomy of your ribs and determine the underlying nature of your pain and what can be done about it. Wishing you much luck! Joelle
Hi I fell forward onto my chest and lost my breath for a few moments while snowboarding. While I carried on snowboarding for the rest of the day, I was in a lot of discomfort for the rest of the day and today, which is day two. The tender area seems to be directly on one part of my ribcage, but I am not sure if it is cracked or bruised. My symptoms include acute pain in one particular area of the ribcage, some discomfort when I take a deep breath, major discomfort when I cough or sneeze, and also major discomfort when I try to sit up from a rested position, similarly to a sit-up. Most other movements seem slightly uncomfortable. I do not see any discoloration, deformalities, or bruising in the specific area, unless gentle pressure is applied. I do not experience any other health issue related to rib injury. Is there any way to know if this is a bruised rib or fractured rib?
Hi I have fractured my Rib bones ( 2 bones fractured and 1 hairline fracture) after a bike accident on 3rd January. For the last two week I was on pain killers and now the pain is bearable. I have stopped the pain killers for the last 1 week. But I have a nagging pain on the left side thou its bearable but its very irritating. Im unable to get a sound sleep..more often I get to be sitting on a chair whole night. On my last follow up with doc he advised to have a sleeping tablet to address the sleeping problem. I wanted to know for you that how long will it take fix this, will this pain let for long time..... what are things I should do and should not do for a speedy recovery.... or should I live within pain. Should I do some specific exercises to strengthen my muscles.... Might sound a lil over concerned hope you can understand as the pain and no sleep is irritating.
Hello. I have a fractured rib I'm pretty sure I have a fractured rib at first I thought it was a Muscle strain but a couple of days later I started to feel discomfort when I breathe. I began to back away from heavy lifts in order for the healing to hurry. But I'm scared of a bigger problem occurring later. After doing research I believe I'm able to just ignore the discomfort and let it heal on its own. I don't sleep face down anymore, I don't do push ups. That's where I am at
Hi there, I'm just desperate at this point to understand what can be done, specifically, for chronic pain around my 5 year old fractures. When I was 53, I fell and broke 9 ribs on the right side. I have been in quite severe, daily pain since. I'm a nurse - have been to physical therapy, chiropractic, and am now seeing a pain mgt doc for novocaine nerve blocks. I am not getting any relief, at all, and am becoming quite depressed and exhausted. I've read through your articles (thanks!), but am not able to see any specific recommendations for the neuralgia and terrible muscle spasms. I prefer non-medication options as I don't care for drugs and would like to remain clear as I need to work, but I am unable to sit, drive, walk for any length of time without the pain and spasms. I would LOVE to hear of any successes you might offer, specifically, besides those options I have tried and another referral to pain mgt. What, besides the novocaine blocks might help? Or can you refer me to someone in the VA area who might be helpful? I really have arrived at the end of the road here, am just exhausted from the pain. Thanks so much! Louise
Hi! I'm 20 weeks pregnant and having a very bad cold with very strong,persistant cough. Few days ago my rib broke.In A&E dr confirmed it and gave me antibiotics for cold.I'm still coughing and it hurts very much.I can't lay down at all,spending 3rd night sitting on the sofa, hardly sleeping at all.Because of the pregnancy,dr told me to just stick with Paracetamol but it doesn't make any difference.They never done the x-ray for the same reason so I have no idea how bad it is.I'm very worried how's this injury going to affect the rest of my pregnancy and the labour?If I could only get a few hours of pain-free sleep!Could you tell me when will the worst pain ease off?Thank you very much!
Is the 1 and 2 rib typically corrected if fractured or left unattended? I was not treated a Swedish so don't worry there is a malicious attempt here please. I had a right clavicle and right 1 and 3 posterior rib fracture in a motorcycle accident in 2009. My ribs have now fused together.There was other injuries such as an right 3-4 transverse process fracture, right c5-7 transverse foramen fractures, prior c5-6 anterior fusion. CT of the neck showed a right vertebral artery and question bilateral internal carotid artery injury. CT of the face showed right zygomatic arch and maxillary sinus and orbit fractures. CT of the head showed a small interpeduncular notch subarachnoid hemorrhage. I was treated for the face fractures and head injury.
Is there a way to view the entirety of your responses, Joelle? comments that are not complete end with a ... and I would love to read the whole thing!
4 days ago I asked someone to pop my back by hugging me. I felt a very painful crunch. Now in pain..especially when aplying pressure. It is on the left upper area.
Hello, this blog is helpful, particularly to know that feeling quite a bit of pain for weeks in may be reasonable. In a skiing accident, according to a CT scan (X-ray was not clear) have five broken ribs (4-7 front and 11 in back). Front rib pain has become tolerable, but the upper back on the same side pain ( between scapula and spine) has been relentless and intolerable. Prescribed oxycodone initially and moved to percoset at first doctor follow up. Have been trying to work off pain killers, But the question is could their be an internal organ injury or torn labrum complicating this. Have an allergy to iodine so hospital could not really assess internal organs with CT scan. Any ideas about back pain would be helpful.
Dear Sax, Thank you for your questions. There are many factors that go into healing and pain relief. There are many tips that have been discussed in this blog and if you haven’t I would recommend reviewing the entire blog for more information and those helpful tips. One thing for sure to consider in your recovery is to listen to your body so that you don’t reinjure yourself. It takes a minimum of 6 weeks for the bones to fuse and provide stability from the bones moving with activity but it takes much longer for them to be strong again. Comfort with sleep is one of the last things to improve because when you lie down, you apply pressure on the area that has been broken. All the luck to you as you recover. Warm regards, Joelle
Dear Mike, Thank you for your mail! I can’t tell how old your injury is but if it’s less than 6 weeks old, I would expect a fair amount of pain until those ribs fuse. People are often on narcotic pain relievers until that 6 week mark then start to wean and that is our general practice here. If you are past 6-8 weeks from injury and still experiencing the acuity of pain that you are describing then would revist your physician or health care provider for consideration of further imaging including MRI. Be sure that you are not engaging in activities that could be disrupting the healing of your fractures. This would include heavy lifting. All the best to you in your recovery. Joelle
Dear Shane, Unless the ribs are very displaced and so separated in distance that they can reach each other to fuse in the healing process, they will heal together. I hope this answers your questions. Best, Joelle
Dear Masa, I encourage you to read through this whole blog; you will get a lot of helpful information from it. In short, it should take about 6 weeks for your ribs to fuse/heal and they will continue to get stronger after that. You should be fine by the time you deliver your baby. The most important things right now is to avoid coughing so that the ribs can heal and avoid heavy lifting. Wishing mother and baby a health pregnancy and safe delivery! Warm regards, Joelle
Dear Louise, I am sorry to hear of your situation and the impact this is having on your quality of life! I'm unsure of how long ago your injury occurred and what the source of the nerve pain is but you might want to consider meeting with one of these thoracic surgeons for a more thorough assessment. These are the sources we are familiar with. If you haven't had a CT scan with 3-D reconstruction of your chest wall, this would be helpful in understanding how you healing and if you have a displaced rib or non-union of the bones that could be plated. There are no guarantees but worth a look and consideration given your current circumstances. Benjamin Kozower in Charlottesville Thomas D’Amato in Harrisonburg Wishing you all the best in your quest for normalcy. Joelle
I fell while climbing on rocks and broke 4 ribs, #6-9. Although I have had a lot of relief after 2.5 weeks, I feel like there is so much tenderness on my breast bone and sometimes it throbs. It also feels like there is a layer of a liquid like substance that moves around, and is very tender. What I'd like to know, is if this is just the normal healing process or should I see another doctor. I originally went to a sports medicine doctor, but I'm wondering if it's more of a chest related issue. Thank you, Lisa
6 months ago I broke 9 ribs on the right side (most in multiple places) and severely displaced at least 3 along with breaking all the transverse processes of my spine. I didn't go to the ER right away, it was almost two weeks later (I was out of town, waited till I got home) and the ER Dr told me I should've been hospitalized when it happened. I then found out I have osteopinia (sp?). I broke ribs 3 through 11 in multiple places. Occasionally where I broke rib 3 and the ones right under my breast burn badly. Those ribs were severely displaced and they were concerned about my lung. I was told by 6 months I'd be fine. I'm trying to do the things I used to, but every time, after a little work I'm hurting too bad to do anything more than lay in bed. Do I need to give this more time? The trauma specialist was a jerk, didn't listen to me and told me the osteopenia is no big deal (regular Dr ordered the bone scan, trauma specialist refused). I can run with my dogs, play with my kids, do yard work. I don't know what to do. Regular Dr won't deal with this and the specialist won't listen. Please, any advice? I'm in Virginia btw.
Hello, Three weeks ago I fell on some big, sharp rocks and hit my ribs and head. The ribs right under my breast are still very sore. There is a burning, pressure feeling that radiates to my back. It hurts mostly when I lay down. I still cannot lay on my back or my left side (the injured side) because of the pain. Sleeping is difficult. My question is is this all normal; the pain when not moving, not being able too lay on my back, etc.?
My 16 year old son somehow broke his 5th rib 7 months ago, we are unsure of the exact cause. According to the CTs and MRIs he has done there was callus formation but not complete healing. He is a competitive swimmer and due to the pain with breathing he has been unable to participate the last 7 months and it is really upsetting to him. We have seen 11 different doctors, including a cardiothoracic surgeon, and done a bone stimulator for several months and he is still experiencing pain. We are desperate to find an answer for him other than that he needs to stop doing the things he loves at 16 years old. Does your clinic see 16 year old patients? We are in Texas but willing to travel to receive answers because we just do not seem to be making any headway where we are. Thanks so much!
Greetings Debra, Thank you for your message. It sounds that you’ve injured your chest wall but it’s difficult to know what you’ve injured until you’ve been examined by a medical professional. If your pain and other symptoms are not improving and you have not been evaluated, I would recommend you visit your primary care provider. If you do have a rib injury, there is volumes of content in this blog that discusses the experience and timeline of healing with this type of injury. Wishing you a speedy recovery. Joelle
Dear Lisa, Ribs take a very long time to heal. I would recommend that you spend some time reading through the blog entries; you’ll find a lot of helpful information about the experience of rib fractures and the continuum as well as nuances of that experience. In regards to the “liquid like substance that moves around”, I would recommend that you seek evaluation by a medical professional about this. Hoping you heal soon. Warm regards, Joelle
Dear Jennifer, I’m so sorry to hear of your plight! We would suggest you visit a thoracic surgeon for further evaluation by CT scan with 3D reconstruction and in person consultation. These are some folks out there we can recommend: Benjamin Kozower in Charlottesville Linda Martin in Charlottesville Peter Roberts in Portsmouth Tom D’Amato in Harrisonburg Or if you are in Seattle you could schedule with my colleague, Dr. Eric Vallieres. Wishing you all the best in your health endeavors. Joelle
A CT (for something else) showed 2 broken ribs, posterior left 10 and anterior left 7. from a bicycle fall 7 weeks ago. They said the fractures appeared "lucent". I am not feeling pain now, just when area has pressure against it. Should I go see my PCP about it, or wait?
I was sledding with my grandson on Presidents Day and wiped out epically. I heard my ribs crack but I was just so grateful that I didn't break my neck (seriously!) that I never had it checked by anyone. Today was Easter and I was in church praising and now it hurts pretty bad again. It's never stopped hurting but the pain had gotten to where it wasn't so raw. The broken rib(s) are under my breast so it's hard to assess but today even my lower breast itself felt tender to touch. At this point is it even worth it to be seen by a Dr.? I assume it has a long way to go if it's still so sore at this point. I just don't want anything worse to happen. This has been bad enough.
I slipped while shoveling snow in my very inclined driveway. As I was falling I dropped the snow shovel but then ended up falling on it. I fractured a rib on the side (#9 false rib). It hurts slightly, mostly when bending over, but I continue to play tennis. Is this likely to delay the recovery? I also started using an electrical stimulator with the electrodes placed on either side of the fracture. Do these things actually work? I have it adjusted for a pulse every 1/2 second and at a high enough level that the muscle in the area react pretty dramatically. I use it a couple of times a day for about 20 minutes each time. And after a week or two, does the use of cold or hot compresses help any?
Dear Leanna, Our rule of thumb on this is: if you don’t continue to make slow and steady progress then you should see a medical professional for evaluation. I would recommend, if you haven’t already, review much of the blog entries. I think these discussion will help you decide if you are on the right trajectory of expected recovery from a rib fracture. Wishing you a solid recovery, Joelle
Dear Steve, If you are having symptoms that aren’t improving, you should see your PCP. All the best, Joelle
I am 18 days post fracturing my 4th, 5th and 6th rib, displaced. Fracture site is right hand side, at the back, between my scapula and spine. Since day 7-10 I have started getting moderate to severe pain, sometimes on inspiration, sometimes position, random, on the front right hand side at the same level as the fractures and toward the sternum. I think it has something to do with my injury but I am a bit concerned by the severity and randomness of the pain. The xrays and cat scan show no other boney injury. Can you help?
Dear Michael, So sorry for your injury! It is plausible that what you’re experiencing is movement or displacement of your broken rib beneath the scapula. It is absolutely possible that there’s been a shift in your rib fracture. Unfortunately, other than symptomatic treatment, there is nothing to mechanically do about it. It can be irritating a correlating nerve at that rib. Stability in the ribs should occur between 4-6 weeks when they are fused with new bone. Would recommend avoiding heavy lifting and positions that seem to cause significant movement of that area of injury. Recommend follow up with your primary care provider for further evaluation as needed; they can help evaluate the type of pain you’re having and assist in management of that pain. All the best to you in your recovery, Joelle
Two months ago I broke 8 ribs and punctured a lung in a skiing accident. I'm 71 years old. I spent eight days in Wenatchee Central hospital where my pain management was apparently very good. After coming home I was able to reduce pain medication and now take only OTC medication when I feel the need which is almost never. My X-rays showed that some of the ribs were displaced but no surgery was recommended. My question is this: if one of those ribs was distended such that it could not knit with its "partner" what would happen? Would it's end continue to grow attempting to find purchase? What problems would that cause? I've seen the x-rays and to me it does look like a couple of them were severely distended. I'm of course a layman and don't doubt the competence of my doctors but am concerned about possible complications and wonder about the effects of future activity like working in my garden and playing golf. Do I have any valid concerns? Thank you for your time, Bill
CAN you help. I fell twenty feet over five years ago. I have T& T8 compression fractures. I have right side 10th rib non union fracture. I had a spinal injection whech helped for a couple of weeks. No medication helps. I, am at the end of my rope with the constant pain. I have lost my jb as a RN and my house.
I am on day 3 after a fall. Was walking with a load in my right arm. Tripped on a log and fell onto the load i was carrying. Was a pretty hard fall. Day after fall, i had some pain but was expected. Went to work and had some discomfort but made it thru with some Aleve. Today i woke up and am in excruciating pain in the posterior chest region. Pain seems to be in the latissimus dorsi / spina erector region. Does not hurt to breathe but if i use my trunk/arms on my right side it can be extremely painful. What could it be?
In 2012, I was run over me with a truck. I had a flail chest. Right side. I have 5 titanium plates and 32 screws. Two questions: 1) Why do I hurt when the weather changes? I am in pain each day it's just a matter of severity. 2) Will I ever be able to run again? I was pretty competitive at running and boot camp activities until this event. Now, going to work is tiring. Current age 50. I do not feel as if my right rib cage can expand as it once did before the surgery, breathing can be more labored at times.
I had a traumatic injury about 5 years ago. I lunged over and behind my vouch to grab some dogs who were fighting. I went to the ER a few days later. They diagnosed me with a muscle strain. I didn't have health insurance so they didn't xray. Over the last five years, the pain returns about 2-3 times a year. The pain and movement restrictions would last for a week, sometimes two. I've had xray done 3 times with negative results. This last episode has lasted going on eight months. Finally, a doctor ordered a ct scan and it showed two displaced fractures. They are saying that nothing can be done. Should I seek a second opinion? Are there options for me? I feel like this is now a permanent condition and I am distressed at the thought of a lifetime with this pain and I am not keen on pain killing pills for long, either. What do you suggest?
I am a 57 year old man with frontal pain in the chest wall over the heart,the pain is dull and is under my breastbone. This uncomfortable pain increases during respiration and with body movement this happened within two days. I dont have complains of cough neither shortness of breath no episode of chest pain or significant hypertension no CAD , DM and hyperlipidemia as far as i know. Any help please from you doctor. Thank you.
Dear L Webb, Thank you for your comment! There are many things I can't comment on because there is much that I don't understand about your injury and the mechanism by which it occurred but I can surmise, given the volume of hardware you've reported in your chest, you had a very significant injury! I always remind folks that the body is never the same after any injury and it never forgets it's been broken; the body has a memory. One of the results of any kind of injury is that the puts itself back together and finds a way to compensate but this compensation isn't always ideal and can result in other issues, if not corrected soon after the injury. Some people feel that they make a complete recovery following rib fractures but in my experience, the more extensive the injury, the harder it is to achieve a 100% recovery. If one of your goals is to run again, I would start aiming for that goal and taking gradual steps to get yourself there. This might start with an evaluation by a medical rehabilitation doctor that reviews your films/injury both before and after your repair. Then they can evaluate your current challenges and counsel about what is possible moving forward and advise on any specific approaches and limitations. You're labored breathing should be evaluated by your primary care providers ASAP. Wishing you all the best in your continued recovery. Warm regards, Joelle
I am an active mid-forties male that was involved in a road bicycle accident that resulted 5 broken ribs (right side, 4-8). CT scan reveals two nonunion ribs and two others reveal fragmentations. The nonunions appears to slightly overlap and there seem to be no gaps.The ribs are not flailed. I am approximately 5 weeks out and after 3+ weeks of acute pain I am off all pain medicine (but discomfort persists). There was pneumothorax and I developed pneumonia however my lung appears to be healing well. I had a CT scan performed in the hospital the day of the accident and just recently had a second one (w/ 3D reconstruction). Here is my issue: I have seen 3 thoracic surgeons and each one has recommended a different course of action. Surgeon 1 suggested plating 3 ribs but then changed her mind and recommended natural healing. Surgeon 2 recommended plating at least 2 ribs and cleaning up some of the fragments. I was told that the recent CT scan revealed that healing was not occurring properly and if I didn't do the plating i may develop chronic pain at a later stage and that it would be more difficult to fix. Surgeon 3 recommended no action at this time and to come back at the 6 month period for reevaluation. He didn't see any evidence that healing was not occurring and said that there is not much risk of chronic pain later and that I can expect a bit of discomfort for possible 6-12 months from the plating procedure if we were to go that route. Also, plating at the 6 month point wouldn't be any more difficult to fix than now. All 3 surgeons are from prominent NYC area hospitals. All have experience with plating. Surgery, of course, presents it own risks - including infection and nerve damage. I wish to remain active but difficulties could also develop due to the loose fragments. I am obviously not a doctor but I am responsible for my health decisions. I am trying to research the topic to decide on the best course of action however there are no long term studies (that I am aware of) that can influence my decision. Is there a risk in waiting??? Im sure the extent of your advice is limited given that you have not seen my medical records however any decision-making guidance or directions to studies on the topic would be most appreciated. Thank you for this informative blog!
Hi i really came down on my left side of ribs, 3 yrs ago, at the time they were so sore i had an xray and they said nothing was broken.. after all this time i am still having bad pain, went back to Dr and had more xrays in the same place as before and they have came back clear, have had an ultra sound and they said all is ok.... why am i in pain where i hurt 3 yrs ago ? I have scleroderma, any suggestions would be great. thank you
Dear Mr. Thomas. Thank you for your submission. I would recommend you seek local medical care with your primary care provider or emergency room as soon as possible. Joelle
Dear Gary, I'm sorry for your plight! This is distressing and your question is a good one. We would recommend you take your films to a thoracic surgeon who performs rib plating and determine their assessment and etiology of your pain syndrome and if you are a candidate for rib plating. You can learn more about rib plating on this blog or at this link. https://www.youtube.com/watch?v=fXrDrnxrJsA Wishing you all the best in your journey of health. Warm regards, Joelle
Dear Judy, I would suggest you continue to seek answers for this pain and see a specialist who has expertise in the thorax (chest wall) such as a thoracic surgeon. If you review this whole blog, you’ll learn more about CT scans and the benefit of 3-D reconstruction of those CT scans for the best images and visualization of the bones in the chest. If you don’t have access to a thoracic surgeon, would alternatively recommend a medical rehabilitation doctor, often known as a physiatrist. All the best to you, Joelle
Hi I need help my mum who is 67 years old fell from a ladder but not backwards, the ladder slipped with her, the ladder was etal not aluminium. We took her to hospital because she was injured badly, and they performed x rays and CT scan and no fractures resulted. But she is in a lot of pain and bruised badly. Now after a week and a half she is complaining of rib pain, dificulty to breath, and difficulty to walk because of pelvic pain. Can there be a fracture and didn' t result in X ray and CT scan. Please help
Dear R Shrek, At 5 weeks out and improving, off pain meds, I would agree with the 3rd surgeon and would not recommend ORIF of some or all of your fractured ribs at this time. The odds are very good that you will heal without need for surgical intervention. It is definitely too early to ascribe a diagnosis of non-union at this stage. If you still have pains with movement at 6 months or longer, one could consider ORIF at that time if radiological assessment then suggests a lack or deficiency in healing. Wishing you all the best, Dr. Vallieres and Joelle
question: I fell 3 weeks ago and X-rays showed fractures in ribs 7,8, 9 (or maybe it was 8, 9, 10?). Received painkillers and that machine you have to breathe hard into to be sure you're properly using lungs. Haven't had any pain for the last 10 - 14 days, and can move pretty freely (meaning I'm careful.) Um... is it safe to have sex or will ribs get crushed and misplaced.
Please help! In March of 2015 I fractured one of my right upper ribs (right under the breast). I was unable to get proper care at the time. I also had a massive URI which took forever to clear up. Since then I have been seeing a pulmanalogist because of the prior damage to my lungs. They have yet to find a reason for my poor lung function. Since then the fracture has healed but every time I get an URI (which seems to be frequently) it seems like the rib is broken all over again. The pain is excruciating and there is absolutely nothing I can do about it. I have not had recent xrays to see what the healing looks like or to see if my rib does in fact separate a little when I get sick like this. All I really know is that the fracture point reverts to the same pain level as when I broke it originally, when I have these infections which cause me to cough intensely. Since this obviously is not going to resolve itself, then my question is this... is there anything that can be done to fix the problem this long after the initial fracture? It really was not a complex fracture originally and on the xray it seemed more like a hair line fracture (which I was unable to get the xray until weeks after the initial incident). Also, they where more concerned with my lungs at the time and so never took a direct x-ray for the purpose of looking at the rib fracture, they just did a CT of my lungs and said that the CT did show that there was a fracture. Any possibility of fixing this issue so that I am not dealing with this pain for the rest of my life?
Hello, my dad is 67 and was playing a game with us and was running and slipped on the grass and fell on his stomach. He had his cellphone in his shirt pocket and feels a lot of discomfort mostly under his breast, he also has a lot of scrapes on his stomach as a result of his fall. He has difficulty talking and it hurts him everytime he moves or attempts to walk. Is it possible for him to have fractured a rib???
Dear Fiona, Thank you for your message about your mother; I’m so sorry for her plight! You are accurate, there can definitely be fractures that weren’t detected. Most importantly, if she’s having unrelenting pain following a trauma, whether it new or the same, I would encourage her to seek another assessment by a medical provider. Given your mother’s current condition it sounds that you are not confident in its accuracy. Re-evaluations and second opinions can be invaluable in this setting. Wishing you and your family much health and a 100% recovery. Warm regards, Joelle
My husband is a very fit 62 yr. old who crashed hard on his mountain bike last sunday, breaking 4 ribs, one of which slightly punctured his lung. His treatment at Denver's St. Anthony's hospital have included a chest tube, and he is close to being able to be released. Problem is, we live at close to 8,000 ft., and normally would have to drive over 2 spots over 10,000 ft. during our 3 hour drive home. the hospital has told my husband he cannot return home for two weeks! An absence of this amount of time would seriously impact my husband's business, and we are really questioning the liklihood of his having a problem, not only during our drive home, but also just in living at altitude in general. Is he really at that great a risk if his lungs are used to life at 8,000 ft, and he is really fit? He will go crazy and take us all with him if he is told he can't travel. Worse yet, he is simply likely to make me take him back, risks be damned! What should we do???? Couldn't we just drive home around the mountain (about a 7hr trip) and have his doctor monitor him once we returned home? HELP!
I had pneumonia in February and fractured 2 ribs from coughing so hard. Everything healed, then certain days for no reason, the area where the fractures were, has a very dull ache. Will this go away?