Patient information · Urgent care
Rib injury
why breathing deeply is the treatment
Bruised and cracked ribs are painful and slow, but they heal by themselves. Ribs are not strapped or fixed. The reason we care so much about pain relief is not comfort alone — it is that pain stops people breathing deeply, and shallow breathing is what leads to chest infection.
Call 999 or go to an emergency department if you have
- increasing breathlessness, or difficulty breathing at rest
- coughing up blood
- severe pain in the abdomen, particularly the upper left or right side — the spleen and liver sit under the lower ribs
- dizziness, faintness or a racing heart
- chest pain that spreads to the arm or jaw, or feels crushing
- a part of the chest wall that moves inwards as you breathe in
Injuries involving several ribs, the very elderly, people with osteoporosis, and anyone with existing lung disease need lower thresholds for assessment. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Why an X-ray is often not done
A simple rib fracture is treated exactly the same way as bruised ribs, and small cracks frequently do not show on X-ray anyway. Imaging is used when we are concerned about the lung, the spleen or liver, or when several ribs are involved — not to confirm what would not change the treatment.
The breathing exercises are not optional
Shallow breathing allows the base of the lung to collapse and secretions to pool, which is how a rib injury turns into pneumonia. This is the main complication and it is largely preventable. Every hour while you are awake: take ten slow, deep breaths, holding each for a couple of seconds. Then cough deliberately, hugging a pillow firmly against the injured area to brace it. It will hurt. Do it anyway.
Pain relief
- Take painkillers regularly and by the clock for the first week or two, not only when the pain becomes bad. The aim is to stay comfortable enough to breathe deeply.
- Paracetamol and an anti-inflammatory such as ibuprofen together are usually more effective than either alone, if both suit you.
- Take a dose before your breathing exercises and before bed.
- If the pain is not controlled, tell us. Under-treated rib pain is what causes the complications, and stronger options exist.
Do
- Keep moving and walking around the house
- Sleep propped up or on the injured side if that is more comfortable
- Use a warm pack over the area for comfort after the first couple of days
- Stop smoking, at least while healing
Do not
- Do not strap or bind the chest — it restricts breathing and causes chest infection
- Do not lie still all day or take to bed
- Do not suppress a cough with medicine; you need to clear the chest
- Do not lift heavy loads or return to contact sport until pain-free
How long it takes
Pain is usually worst in the first week to ten days, and is often worse in the morning and when you turn over in bed. Sneezing, laughing and coughing will be sharply painful for some weeks.
Come back to us if
- you develop a fever, or start coughing up green or yellow phlegm
- you are more breathless than you were, or breathless at rest
- the pain is not controlled by regular painkillers
- pain is worsening rather than easing after the second week
- you feel unwell in a way that seems out of proportion to the injury
Book an appointment if you need your chest examined, oxygen levels checked, an X-ray, or stronger pain relief. We can assess and image you in a single visit, seven days a week — and if you have an underlying lung condition or are over 65, a review at around a week is worth arranging from the outset.
Chest examined, X-ray arranged quickly
Same-day appointments most days, seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.