Rib Contusion: Causes, Symptoms and Care

A rib contusion doesn't differ much from one that we can see on the skin after receiving a blow. However, this injury to the chest wall will cause respiratory problems.

The ribs are horizontally arranged bones, whose main function is to protect the organs located in the rib cage and in the upper part of the abdomen. They can suffer a wide variety of injuries, most notably rib contusion.

Human bones have two well-defined areas: a cortical and a trabecular. The trabecular region is much less rigid and more vascular than the other, making it more prone to injury.

In general terms, contusions are injuries caused by the rupture of blood vessels in a certain area. A rib contusion is nothing more than the rupture of some blood vessels in the trabecular area of the bone and the formation of a hematoma.

What are the symptoms?

The symptoms experienced by patients with this type of injury don’t vary much from those presented by people with a rib fracture. The characteristic symptom is pain in the affected area, which appears immediately after the blow.

Pain from a rib contusion can last 3-6 weeks, increasing with breathing movements. Other common symptoms that people may have are the following:

• Inflammation in the area of the injury
• Change in skin color or cutaneous hematoma
• Shortness of breath
• Muscle spasms on the affected side
• Increased pain when coughing, sneezing, or moving

The main causes of a rib contusion

Any situation that can injure the chest wall is capable of generating a rib contusion. In this sense, trauma is the most frequent cause. In fact, studies show that trauma-associated chest wall injuries are a major cause of morbidity and mortality.

For the blood vessels to rupture, there must be a direct transfer of energy to the bone surface. Situations such as traffic accidents, falls, or contact sports can often cause this condition.

There are also other conditions capable of causing a rib contusion, such as the case of patients with chronic obstructive pulmonary disease (COPD) or when lifting heavy objects. These situations generate an increase in intrathoracic pressure and can cause injury.

Risk factors

Certain conditions predispose people to bruising, despite not being a direct cause. Among them, some osteoarticular diseases stand out, such as osteoporosis, which weakens bone tissue and makes it more prone to breaking.

Pregnant women are also at increased risk of rib fractures and bruises from the enlarged uterus. Studies show that even the slightest blow or a coughing episode can cause such an injury.

How do doctors make the diagnosis?

The diagnosis of a rib contusion is made by asking about the symptoms, and a proper physical examination by the specialist. The doctor will ask about how the injury occurred and the symptoms that appeared after the injury.

They will also listen to the patient’s breathing to verify that it isn’t affected. The specialist will inspect the area where the injury occurred in search of any hematomas, deformities, or anything else of clinical interest.

The symptoms of a contusion and a fracture are very similar, so a chest X-ray will be indicated. This examination will allow the doctor to establish exactly what has occurred.

Finally, other tests, such as an MRI or CT scan, may be necessary to rule out the presence of lesions in other organs and tissues.

Treating a rib contusion

Contusions are treated very similarly to rib fractures, so surgery is hardly ever necessary. However, the injury shouldn’t be bandaged because this would interrupt respiratory movements, increasing the risk of suffering from pneumonia.

In this sense, absolute rest is one of the main measures to promote proper bone regeneration. If this is impossible, then reducing daily activities and avoiding sudden movements is usually more than enough.

The doctor may also prescribe analgesic and anti-inflammatory drugs such as ibuprofen. In the most severe cases, a pain reliever may be injected near the injured area.

Respiratory physiotherapy can be useful for those patients with respiratory difficulty. The exercises indicated will help people regain the ability to expand the rib cage.

Recovery and recommendations

A rib contusion isn’t as severe as it appears and has a fairly quick recovery time. The bone should have healed in no longer than 6 weeks, however, it can be extended up to 8 weeks, depending on the patient.

The recommendations that patients can follow are simply resting and taking the respective analgesics. However, some measures to reduce inflammation and pain in the area are helpful:

• Apply ice for 10 to 20 minutes where there’s pain
• Avoid smoking
• Sleep in a semi-sitting position and don’t sleep on the affected side
• Don’t perform activities that may cause pain.

Rib contusion: a summary

Rib contusions are injuries that are very similar to fractures. They usually have the same origin.

However, bruises are less severe injuries, as there’s no complete breakdown of the bone, and so they take less time to heal.

However, a rib contusion is an injury that shouldn’t be underestimated. The pain it triggers can lead to respiratory failure.

Therefore, it’s best to go to the specialist when you suspect you may be suffering from it. Only professionals will be able to give a correct diagnosis and indicate the appropriate treatment.