Rib fracture - aftercare

A rib fracture can be very painful because your ribs move when you breathe, cough, and move your upper body.

The ribs in the middle of the chest are the ones that break most often.

Rib fractures often occur with other chest and organ injuries. So, your health care providers will also check to see if you have any other injuries.

Healing takes at least 6 weeks.

If you injure other body organs or develop a complication, such as a flail segment of your chest or trouble breathing, you may need to stay in the hospital. Otherwise, you can heal at home. Most people with broken ribs do not need surgery.

In the emergency room, you may have received a strong medicine (such as a nerve block or narcotics) if you were in severe pain.

You will not have a binder or a bandage around your chest because these would keep your ribs from moving when you breathe or cough. This may compromise respiratory function, or lead to a lung infection (pneumonia).

Your provider may prescribe the use of an incentive spirometer, a device to help you keep expanding your lungs regularly while your fractures heal. You can hold a pillow gently against your chest while using the incentive spirometer or when coughing to reduce discomfort.

Apply an ice pack 20 minutes of every hour you are awake for the first 2 days, then 10 to 20 minutes 3 times daily as needed to reduce pain and swelling. Wrap the ice pack in a cloth before applying to the injured area.

You may need prescription pain medicines (narcotics) to keep your pain under control while your bones heal.

• Take these medicines on the schedule your provider prescribed.
• Do not drink alcohol, drive, or operate heavy machinery while you are taking these medicines.
• To avoid becoming constipated, drink more fluids, eat high-fiber foods, and use stool softeners.
• To avoid nausea or vomiting, try taking your pain medicines with food.

For pain, you can take ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), aspirin, or acetaminophen (Tylenol). You can buy these pain medicines without a prescription.

• Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ulcers or bleeding.
• Do not take more than the amount recommended on the bottle.
• Do not give aspirin to children.

Tell your provider about any other medicines you are taking as medicine interactions may occur.

To help prevent a collapsed lung or lung infection, do slow deep-breathing and gentle coughing exercises every 2 hours. Holding a pillow or blanket against your injured rib can make these less painful. You may need to take your pain medicine first. Your provider may tell you to use a device called an incentive spirometer to help with the breathing exercises. These exercises help prevent a partial lung collapse and pneumonia.

It is important to stay active. Do not rest in bed all day. Your provider will talk with you about when you can return to:

• Your everyday activities
• Work, which will depend on the type of job you have
• Sports or other high impact activity

While you heal, avoid movements that put painful pressure on your ribs. These include doing crunches and pushing, pulling, or lifting heavy objects.

Your provider will make sure you are doing your exercises and that your pain is under control so that you can be active.

There is usually no need for taking x-rays as you heal, unless you develop fever, cough, increasing pain or difficulty breathing.

Most individuals with isolated rib fractures will recover without serious side effects. If other organs have also been injured, however, recovery will depend on the extent of those injuries and underlying medical conditions.

Contact your provider if you have:

• Pain that does not allow deep breathing or coughing despite using pain relievers
• Fever
• Cough or increase in mucus that you cough up, especially if bloody
• Shortness of breath
• Side effects of pain medicine such as nausea, vomiting, or constipation, or allergic reactions, such as skin rashes, facial swelling, or difficulty breathing

People with asthma or emphysema are at increased risk of developing complications from a rib fracture, such as breathing problems or infections.

Broken rib - aftercare

Eiff MP, Hatch RL, Higgins MK. Rib fractures. In: Eiff MP, Hatch RL, Higgins MK, eds. Fracture Management for Primary Care and Emergency Medicine. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 18.

Herring M, Cole PA. Chest wall trauma: rib and sternum fractures. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 50.

Raja AS. Thoracic trauma. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 37.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.