Medical expert of the article
New publications
Bruised ribs
Last reviewed: 07.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
A rib contusion is considered a common injury that does not have such serious consequences as a head, knee, elbow or other joint contusion. However, despite its “problem-free” nature in terms of complications, a rib contusion is accompanied by intense, prolonged pain and a long recovery period. In addition, a contusion can be combined with other more serious injuries, such as a fracture or injury to the tissues of internal organs.
The severity of the injury depends on the force of the blow, the location of the injury and the presence of concomitant diseases, such as acute respiratory infections, pneumonia, and cardiovascular pathologies.
[ Rib Bruise: Symptoms
A rib contusion can affect the soft tissues of the sternum, which are not so numerous in this part of the body, as a rule, the subcutaneous layer of tissue and a group of muscles are damaged, which swell immediately after the blow. The second manifestation of a contusion is pain, sometimes very intense, due to hemorrhage in the intercostal spaces, the third are breathing problems. The pain appears almost gradually and can intensify with deep inhalations or exhalations, coughing, sneezing. Also, painful sensations are present with dynamic load - turns, bends and even with palpation of the damaged area. The skin at the site of the contusion is often edematous, as a rule, an extensive hematoma develops, an atypical compaction can be felt. Differentiation of a contusion and a rib fracture is not carried out independently. One of the threatening signs that requires immediate medical attention is a strong cough, accompanied by pain and discharge with bloody sputum. An accumulation of air is clearly visible in the chest area, which seems to "squeak" (crepitus) when palpated. This indicates possible damage to the lung and developing emphysema. Delay is dangerous, since this condition leads to heart failure, the pulse drops sharply, breathing is frequent and shallow. The victim must be raised to avoid strain on the heart and an ambulance must be called immediately. A simple rib contusion may also be accompanied by a cough, but neither the pulse nor the pressure changes, and the pain symptom subsides within 24 hours.
How to recognize a rib contusion?
The first thing the doctor does after a visual examination and questioning of the patient is to diagnose the state of cardiac and pulmonary activity. An X-ray of two projections is mandatory - direct and lateral, so that the integrity of the injured rib is determined more accurately and the risk of mechanical pneumothorax (accumulation of air and exudate in the pleura) is excluded. It is also important to exclude the presence of blood in the pleura - hydrothorax, which often occurs with rib cracks or fractures.
Treatment of rib contusion
If the bruise is minor, the pain and swelling gradually subside within 24 hours, self-treatment is also possible, which consists of complete rest and applying a cold compress. This can be chilled water in a flat container, a heating pad with ice, or a simple wet, cold compress. The cold helps to stop the spread of hemorrhage into the subcutaneous layer, partially reflexively relieves painful sensations. The cold should be kept for no more than an hour, periodically replacing it with a new compress, it is important to avoid thermal exposure to the injured area during the first 24 hours.
In case of severe pain, you can take antispasmodics and non-steroidal anti-inflammatory drugs, such as naproxen, orthofen, dicloberl or diclofenac. Limitation of movement should be maximum, it is better to take a horizontal position, slightly raising the upper body to reduce the load on the lungs. You should lie down for at least three days, then restore motor activity very carefully, without making sudden movements. If possible, it is best to see a traumatologist to get professional advice and eliminate possible risks. As a rule, rib contusion is treated conservatively. In all other cases, if an extensive fluctuation hematoma develops (the fluid under the skin seems to move, the hematoma spreads), if the pulse drops and the pain does not subside within two days, you need to call a doctor or call an ambulance to hospitalize the patient. A fluctuating hematoma is usually punctured to aspirate its contents, symptomatic treatment is prescribed, and the chest is immobilized with a plaster cast.
If the contusion is severe enough to cause pneumothorax or bleeding into the pleura (hemothorax), thoracotomy (surgery) may be indicated.
Uncomplicated rib contusion resolves completely within a month; more serious, complicated cases are monitored by doctors, and the effectiveness of treatment depends on the severity of the injury.