Our ribcage consists of 12 ribs. Between each rib, we have muscles and tendons. Bruised ribs happen when you experience trauma to your torso. The tissue around the rib has been injured, but the bones are not cracked or fractured. Pain accompanies bruised ribs, and there are methods that will help you deal with the pain while you recover from the injury. The important thing is to understand the causes of bruised ribs, notice the symptoms, and make a clear diagnose. With that in mind, let’s talk more about bruised ribs.
Symptoms and how to diagnose
There are several causes of bruised ribs. Now, however, we need to understand the symptoms of bruised ribs. The cause of the problem will help you set up great recovery and treatment plan. But the symptoms are the ones that will tell you it is time to act.
Symptoms of bruised ribs include but are not limited to the following:
- Tenderness or pain when the area is touched
- Pain while breathing
- Shortness of breath
- Pain while moving, especially if you need to twist your torso
- Sharp constant pain
- Difficulty sleeping or laying on the affected area
- Inflammation that can result in chest pain
- Visible bruising
How to diagnose bruised ribs?
The first thing a physician will do to diagnose bruised ribs is ask you for the timeline and history leading up to the injury. He will also perform a physical exam. In some cases, doctors take additional tests to diagnose the severity and extent of the damage.
Doctors also need extra tests to rule out additional injuries. Given the fact bruised ribs commonly happen due to trauma and contact, other organs might be affected as well. With that in mind, here are some extra tests doctors like to perform.
- Chest CT is a sensitive imaging test, more advanced than X-Ray. It is a computerized tomography scan that doctors perform when the diagnosis is inconclusive
- Lateral chest X-ray and Anteroposterior are the common tests for pain and fractures. These tests will give the physician a good look at the structure of your rib cage and help him/her rule out other fractures
- Urinalysis is needed as it may aid in finding blood in the urine to detect kidney injury caused by trauma
- Arterial blood gases help asses if the lungs have been affected and badly bruised. This test helps detect the oxygen transferring ability of the lungs
- Angiography detects the position of the first and second rib. Because they are in close proximity to blood vessels, the angiography will help detect if there is blood vessel or vascular injury
- For all trauma patients, a complete blood count is a must to determine blood loss as well as look at the status of various blood components
Causes of bruised ribs
We talked about the symptoms of bruised ribs before. They include pain at the injury site, pain when then ribcage flexes during movement and taking deep breaths, crunching or grinding sounds when the site is touched, deformed appearance of the ribcage, and muscle spasms.
Now, we need to talk about what are the causes of bruised ribs. As mentioned previously, there are many different conditions that can result in bruised ribs. Identifying the cause will help you diagnose the problem, and result in the right therapy and treatment for the problem.
Blunt force
One of the most common causes of bruised ribs is a blunt force. This is the cause for injury. As mentioned before, rib injuries, including bruised ribs, occur when the chest is directly hit. There are many different situations that can cause blunt injuries in the ribcage.
For example, a crush injury, when a heavy object lands directly on the chest is a common cause of injury. This can happen while working out at the gym, or even in a daily normal situation. Motor vehicle accidents are the next common cause of injury. Typically for motor vehicle accidents, the chest is slammed against the steering wheel. At least for the driver, while the passengers can also experience injury to any part of their body.
Other blunt force situations for injury include assault or getting hit, falling from a reasonable height (One that will injure you, but not kill you), and sports-related injuries like heavy tackles.
Soft tissue injuries
Soft tissue of the ribcage includes the costal cartilage and the intercostal muscles. There are common injuries that happen to these areas. When one of these injuries happen, the result might be bruised ribs.
For example, bruising, or when the blood vessels rupture and leak blood into the surrounding tissue is a common cause of bruised ribs. Bruising of the chest wall is a trauma that happens in many people.
Next on the list are intercostal strains. For those of you that do not know, intercostal muscles are the muscles that allow the ribcage to move up and down. They can be strained by many activities that involve extreme or forceful twisting of the body. Swinging of the arms can also cause strain to these muscles. Golf and tennis are two sports that commonly cause this type of rib injury.
Last, but not least, costochondral separation, when the rib is torn from the costal cartilage and detached from the sternum is also considered soft tissue injury.
Rib Fractures
When you fracture your ribcage, it is only logical that you experience pain and bruised ribs. The curved design of the ribs makes them very resistant to fractures.
The ribs have an ability to flex, which helps the bone to absorb the force of a blow. However, in some cases, the bone might break if the force is stronger than what the bone can structurally withstand. In this case, the rib might fracture at its outer curve, or the weakest point.
It is also worth noting that older people are more prone to injuries and fractures. Their bones thin and become weaker with age. With thin bones to protect the ribs, they are more susceptible and prone to fractures. Children, on the other hand, are less likely to break their ribs because their bones are still relatively flexible.
Flail Chest
This is the most common and serious injury that happen to the ribs. It is a situation when three or more ribs are broken in at least two places, on the front, and on the back. Flail chest happens only in situations of great deal of blunt force.
What happens is that you experience “paradoxical movement”. The natural movement of the ribcage during breathing is now in reverse. As in, the ribcage sinks when you inhale.
This reversal is one of the best early signs of flail chest. Changes to the air pressure in the ribcage are easy to spot, and it is imperative that a person is under medical treatment in this case.
Risks of a serious ribs injury
The anatomy of our body teaches us that the ribs enclose vital organs. Two of those organs include the heart and the lungs. Therefore, a chest trauma, or a rib injury and bruised ribs can actually cause life-threating injuries.
Here are some:
- Cardiac and associated blood vessel injury due to trauma to the blood vessels servicing the heart. Both the coronary artery and the aorta might be injured, and the heart might not get the required oxygen and blood to function properly
- Pneumothorax, or collapsed lung due to changes in pressure within the chest. The condition is usually caused by broken ribs, and symptoms include breathing difficulties, chest pain, and coughing up blood
- Splenic rupture, when the spleen is affected. The spleen is located on the left side of the abdomen and has a role of filtering the blood to remove abnormal cells. During a splenic rupture, the outer capsule has split and the spleen bleeds into the abdominal cavity
Difference between pulled muscles and bruised ribs
Chest injuries hurt a lot, no matter what is the cause. Many people make the mistake between pulled muscles and bruised ribs. It is important to understand the difference, so that you know what treatment plan to follow. The best way to tell the difference is depending on how the injury occurred and the symptoms. The problem is when both pulled muscles and bruised ribs are caused by the same injury and occur together. With that in mind, here are some differences between the two.
Pulled muscles
Muscles attach to the ribs. These muscles allow the ribs to twist and bend forward and sideways. As such, they are vulnerable to injury during sports that require throwing and other forceful arm movements along with trunk movements. For example, sports like bowling and ice hockey can result in pulled muscles.
In some cases, pulled muscles can also occur due to heavy and forceful sneezing and coughing. The pain caused by pulled muscles is instant, and over the affected area of your rib cage. In rare cases, there is bruising.
Bruised Ribs
Bruised ribs, on the other hand, are often caused by damage to the cartilage that holds the ribs together. It happens with blunt trauma, such as seat belt resistance during a motor vehicle accident. Bruised ribs also happen with the same activities that can cause pulled muscles. For example, heavy exercise and heavy coughing. As the name suggests, bruised ribs occur when the blood vessels rupture. They cause tenderness over the injured area that is increased with breathing and trunk movements.
Broken or bruised ribs?
Broken ribs are way more painful than bruised ribs. And while bruised ribs can heal within a week or two, broken ribs require three to six weeks of healing time. Ribs cannot be supported lie bones, so you are left to heal naturally.
If the symptoms do not improve over one week period, you definitely need a medical advice and attention. And if the ribs get broken due to an accident, you should seek medical attention immediately. During the treatment, it is important to breathe properly in order to clear mucus from lungs and prevent further chest infections.
Treatment for rib injuries
Broken ribs cannot be set in a cast. Bruised ribs require time to heal themselves. Therefore, the treatment for ribs is different than treatment for bones. The goal is to relieve pain while the injury heals.
The healing period can take up to six weeks if a fracture is the cause, and up to 12 weeks or even more if the ribs have been torn from the cartilage. Treatment for bruised ribs is the same. The difference is bruised ribs heal quicker.
Options for treatment for bruised and broken ribs include:
- Rest
- Prescription pain-killing medicine
- Icepacks that can reduce inflammation at the early stages
- Non-steroidal anti-inflammatory drugs
- Mechanical ventilation that helps with breathing in case of severe flail chest
- Avoiding activities that can aggravate the injury
You can get help at your doctor’s office, at a physiotherapist, a physician specializing in sports medicine, and emergency department of the nearest hospital. In case of an emergency, always call an ambulance.
It is important to notice that the ribs are close to vital organs, so it is crucial to look for damage to other organs. Chest trauma can cause bruised ribs, but also life-threatening injuries like punctured lung or ruptured aorta.
How to relieve pain from bruised ribs
As we mentioned previously, you can treat bruised ribs at home. Once you identify the causes of bruised ribs and notice the symptoms, you should start with the treatment plan. There are several different home remedies and treatments that help. Here are some.
Ice packs
Ice packs help relieve inflammation to the area in the early stages. This treatment works best if applied immediately after the injury occurs. If you do not have ice packs, make one by putting ice cubes or frozen food in plastic bag and then covering with a hand towel. Apply the ice pack on the affected area for 10 to 15 minutes.
Apple cider vinegar
Another compress you can make for your bruised ribs is apple cider vinegar. Mix a table spoon of ACV with one tablespoon of water. Dip a clean muslin rag or paper towel into the mixture, and hold it against your bruised ribs. Raw and unpasteurized ACV has been traditionally used to heal bruises as it stimulates blood circulation. Vinegar helps remove the clotted blood from beneath the skin which speeds up the healing process.
Epsom salt and lavender oil
Our body absorbs magnesium sulphate through the skin. This compound is crucial in reducing inflammation of the bruised ribs. Add a cup of Epsom salt to a warm bath, few drops of lavender oil, and repeat every day for one week. The bath will promote relaxation of the muscles and improve the healing process.
Turmeric
Turmeric powder is completely natural and safe remedy that helps with almost any injury. Curcumin is the active ingredient in turmeric, and it has potent anti-inflammatory properties. Some studies show turmeric is much more potent and effective than over the counter painkillers.
For this remedy, take a teaspoon of turmeric powder, add it in hot water, and drink it three times per day.
Blackstrap molasses tea
Another home remedy that you can use to treat bruised ribs is blackstrap molasses tea. Arthritis patients have known this remedy for years and use it as an alternative method to relieve pain. Dissolve a tablespoon of blackstrap molasses into a water, and drink it once per day. Packed with minerals like iron and magnesium, the beverage supports your body’s healing process.
