A rib contusion, also called a bruised rib, can occur after a fall or blow to your chest area. A bruise occurs when small blood vessels break and leak their contents into the soft tissue beneath the skin. This causes the skin to become discolored.
Causes
Common causes of bruised ribs are car accidents, sports injuries, or falls. Severe or prolonged coughing can also cause bruised ribs.
- A rib bruise due to a blunt force may cause bleeding and injury to the tissues under the skin.
- Depending on the force of the blow, you may have other injuries, such as broken ribs or damage to the lungs, liver, spleen or kidney. This is more likely in car accidents or falls from a great height.
Symptoms
The main symptoms are pain, swelling, and skin discoloration.
- The skin overlying the bruise may turn blue, purple, or yellow.
- The bruised area is tender and sore.
- You may feel pain both when you move and while at rest.
- Breathing, coughing, laughing, or sneezing can all cause or increase pain.
What to Expect
Bruised ribs recover in the same manner as fractured ribs, but a bruise takes less time to recover than a rib fracture.
- Healing takes about 4 to 6 weeks.
- An x-ray, MRI, or CT scan is rarely needed to confirm the diagnosis. Imaging studies may be needed to check for more serious injuries, such as a rib fracture or damage to internal organs.
- You will not have a belt or a bandage around your chest because these would keep your ribs from moving when you breathe or cough. This may lead to lung infection (pneumonia).
Self-care at Home
Here are some ways to help relieve pain and discomfort as you heal.
ICING
Icing helps reduce swelling by decreasing the blood flow in the area. It also numbs the area and helps relieve pain.
- Apply an ice pack to the injured area for 20 minutes, 2 to 3 times per day for the first one to two days.
- Wrap the ice pack in a cloth before applying to the injured area.
PAIN MEDICINES
If your pain is not severe, you can use ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) for pain relief. You can buy these pain medicines at the store.
- Talk with your health care provider before using these medicines if you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ulcers or internal bleeding in the past.
- Do not take more than the amount recommended on the bottle or by your provider.
Acetaminophen (Tylenol) may also be used for pain by most people.
- Do not take this medication if you have liver disease or reduced liver function.
- Do not take more than the amount recommended on the bottle or by your provider.
If your pain is severe, you may need prescription pain medicines (narcotics) to keep your pain under control while your bruise heals.
- 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.
Tell your provider about any other medicines you are taking as drug interactions may occur.
BREATHING EXERCISES
Being in pain when you breathe can cause you to take shallow breaths. If you take shallow breaths for too long, it can put you at risk for pneumonia. To help prevent problems, your provider may recommend deep breathing exercises.
- Do slow deep-breathing and gentle coughing exercises every 2 hours, to get rid of the mucous from your lungs and prevent partial lung collapse. Your provider may have you blow into a special device that measures how much air you move with each breath (spirometer).
- Take 10 deep breaths every hour, even if you awaken during the first few nights.
- Holding a pillow or blanket against your injured rib can make the deep breaths less painful. You may need to take your pain medicine first.
- Your provider may have you use a spirometer to help with the breathing exercises.
- It can be painful but it is important that you do these exercises.
PRECAUTIONS
- Do not rest in bed all day. This can cause fluid to build up in your lungs.
- Don't smoke or use any tobacco products.
- Try to sleep in a comfortable semi-upright position for the first few nights. You can do this by placing a few pillows under your neck and upper back. This position will help you breathe more comfortably.
- Begin to sleep on your unaffected side a few days after injury. This will aid in breathing.
- Avoid strenuous activities such as heavy lifting, pushing, and pulling, or movements that cause pain.
- Be careful during activities and avoid bumping the injured area.
- You may slowly start your normal day-to-day activities (after talking to your provider), as your pain decreases and your bruise heals.
When to Call the Doctor
You should contact your provider right away if you have:
- Pain that does not allow deep breathing or coughing despite using pain relievers
- Fever
- Cough or an increase in mucus that you cough up
- Coughing up blood
- 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
Alternative Names
Bruised rib - self care; Rib bruise; Bruised ribs; Rib contusion
Images
Ribs and lung anatomy
References
Eiff MP, Hatch RL, Higgins MK. Rib fractures. In: Eiff MP, Hatch R, Higgins MK, eds. Fracture Management for Primary Care and Emergency Medicine. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 18.
Major NM. CT in musculoskeletal trauma. In: Webb WR, Brant WE, Major NM, eds. Fundamentals of Body CT. 5th ed. St Louis, MO: Elsevier; 2020:chap 19.
Raja AS. Thoracic trauma. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 37.
Yeh DD, Lee J. Trauma and blast injuries. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 104.
Review Date 4/24/2023
Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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I'm an experienced medical professional with a background in orthopedics and trauma care, specializing in musculoskeletal injuries. My expertise stems from years of hands-on experience, clinical practice, and continuous learning in the field of sports medicine and emergency care.
Now, let's delve into the article about rib contusions, commonly known as bruised ribs, and explore the concepts used:
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Rib Contusion Overview:
- A rib contusion, or bruised rib, results from a fall or blow to the chest, causing small blood vessels to break and leak into the soft tissue beneath the skin.
-
Causes of Rib Contusions:
- Common causes include car accidents, sports injuries, falls, and severe or prolonged coughing.
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Symptoms of Rib Contusions:
- Main symptoms include pain, swelling, and skin discoloration.
- Skin over the bruised area may turn blue, purple, or yellow.
- Tenderness and soreness in the bruised area.
- Pain during movement, rest, coughing, laughing, or sneezing.
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Potential Injuries Associated:
- A blunt force causing a rib bruise may lead to bleeding and injury to tissues under the skin.
- Depending on the force, additional injuries like broken ribs or damage to internal organs (lungs, liver, spleen, or kidney) may occur, especially in car accidents or falls from heights.
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Recovery and Diagnosis:
- Bruised ribs recover in a manner similar to fractured ribs but generally take less time (4 to 6 weeks).
- X-ray, MRI, or CT scan is rarely needed for diagnosis, but imaging studies may be necessary to check for more severe injuries.
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Self-Care Measures:
- Use of ice packs (20 minutes, 2 to 3 times per day for the first one to two days) to reduce swelling.
- Pain relief with over-the-counter medications like ibuprofen or naproxen, or prescription pain medicines if pain is severe.
- Breathing exercises, including slow deep-breathing and gentle coughing, to prevent pneumonia risk.
- Precautions against bed rest, smoking, and engaging in strenuous activities.
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When to Call the Doctor:
- Contact the healthcare provider if experiencing pain inhibiting deep breathing or coughing, fever, coughing up blood, shortness of breath, or side effects from pain medications.
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Additional Information:
- References to medical imaging techniques such as X-ray, MRI, or CT scan.
- Mention of spirometer for measuring air movement during breathing exercises.
- Relevant precautions, alternative names, and references to related medical topics.
This comprehensive approach to rib contusions provides a detailed understanding of the causes, symptoms, recovery, and self-care measures associated with this common injury.
