Rib fractures are a painful and disabling injury occurring in at least 300,000 people each year in the United States.  The majority of rib fractures occur during motor vehicle accidents, but falls, large animal incidents (for example, horses), sports injuries, and coughing are also frequent causes.  Many patients with rib fractures require admission to a hospital, either for pain management or other injuries.  Rib fractures can lead to lung collapse, internal bleeding, lung damage, pneumonia, and respiratory failure.  If you suspect you have suffered rib fractures, you are encouraged to seek urgent medical attention.

The pain of rib fractures is legendary and can be difficult to control, particularly in the first few days.  Aggressive, in-hospital pain control measures may be necessary, including intravenous narcotics or even an epidural pain control catheter.  Less aggressive measures, including oral narcotics, anesthetic patches, and other oral analgesics, may allow pain to be controlled in a non-hospital setting.  Rib belts may be of benefit in some patients with less severe fractures, but may cause bleeding around more severe fractures.  Rib belts should only be used at the recommendation of a health care professional experienced in injury management.   Whether at home or in the hospital, rib fractures patients are encouraged to keep their pain under control in order to allow frequent deep breathing.  An incentive spirometer  may be prescribed to facilitate deep breaths and prevent progressive lung collapse.  Rib fracture repair is only indicated in the most severe cases.
   
Recovery from rib fractures depends on how many fractures are present, how severe they are, and the presence of other injuries.  Rib fracture pain will diminish over several weeks but may persist at a low and hopefully tolerable level for several months or even longer.  A course of physical therapy   may be beneficial to help ease the patient back into pre-injury levels of activity.  Patients with no other injuries can expect to be off work for at least several days and more commonly 2 – 10 weeks.  Patients with employment requiring physical labor and patients desiring to return to significant athletic activity are encouraged to give their rib fractures at least 4 – 6 weeks to heal before resuming physical activity that could re-injure the fracture area.  Patients with more severe injuries may develop long-term complications such as chronic pain, fracture non-unions, and even lung function impairment.  It is currently uncertain whether early rib fracture repair can prevent long-term pain and disability.