Medicines for Broken or bruised ribs

What it is

Broken (fractured) or bruised ribs are common injuries to the chest, usually caused by a blow to the chest, a fall, or a crush injury — for example from sports, road accidents, or falls (and in older people or those with fragile bones, from relatively minor injuries). Bruised ribs (where the rib is injured but not broken) and broken ribs cause similar symptoms and are managed in a similar way, so it is often not necessary to distinguish between them, and an X-ray is not always needed. The main symptom is chest pain, which is typically worse when breathing in (especially taking a deep breath), coughing, sneezing, laughing, moving, or pressing on the area; there may also be tenderness, swelling, or bruising over the injured ribs, and the pain can make it uncomfortable to breathe deeply or cough. Most rib injuries, though very painful, are not serious in themselves and heal on their own over a number of weeks (commonly around six weeks) without specific treatment to the ribs. The most important aspects of care are managing the pain well and continuing to breathe deeply and cough gently — because if pain stops a person breathing deeply, the lungs are not fully expanded, which can lead to a chest infection (a common complication, particularly in older people). So, perhaps counter-intuitively, good pain relief that allows normal breathing and gentle coughing is central to recovery. While most rib injuries are managed at home, it is important to be aware of features that need medical attention — such as severe difficulty breathing or shortness of breath, coughing up blood, a serious injury or multiple broken ribs, signs of internal injury, or symptoms that worsen — as these can indicate more serious problems (such as a punctured lung or injury to organs). The key messages are that rib injuries are painful but usually heal on their own over weeks, that good pain relief and keeping breathing well are important to prevent chest infection, and that certain warning signs need urgent attention.

How it is treated

Broken or bruised ribs usually heal on their own over a number of weeks, and the mainstays of care are good pain relief and keeping the lungs working well, along with recognising warning signs. Because rib injuries are managed similarly whether the rib is broken or just bruised, an X-ray is not always needed, and the diagnosis is often based on the history and examination. Self-care at home is usually sufficient: taking pain relief regularly (as advised, and enough to allow comfortable breathing) is central — a pharmacist or GP can advise, and adequate pain relief is important because it allows the person to keep breathing deeply and cough gently; holding a pillow against the chest when coughing can ease the pain; applying an ice pack (wrapped) in the early days may help; resting but staying gently mobile (rather than lying still for long periods); and breathing exercises — taking regular slow, deep breaths and gently coughing to keep the lungs clear — help prevent a chest infection, which is the main complication to avoid. It is best not to strap or bind the chest tightly, as this restricts breathing and increases the risk of a chest infection. Recovery usually takes several weeks (often around six weeks for the pain to settle substantially), and gradually returning to normal activities as the pain allows is encouraged. It is important to seek medical attention for warning signs that suggest a more serious injury or complication: severe or increasing difficulty breathing or shortness of breath; chest pain that is severe or spreading; coughing up blood; a high temperature or feeling increasingly unwell, or a productive cough (which could indicate a chest infection needing treatment); a serious injury, or several broken ribs; or signs of internal injury. Older people, and those with lung conditions or several fractured ribs, are more at risk of complications and may need closer monitoring or hospital care. The reassuring message is that rib injuries, though very painful, usually heal on their own over weeks, and that the keys to a smooth recovery are good pain relief and keeping breathing deeply and coughing gently to prevent a chest infection — while certain warning signs need urgent medical attention.