Dislocated Ribs: Symptoms, Treatment, and Causes
A dislocated rib or rib separation is one of the most uncomfortable things you might experience in life. Unfortunately, it is something that happens commonly in people. A rib dislocation can cause difficulty when moving or breathing.
A dislocated rib is a rib bone that has been disconnected from the spine or breastbone. It will not quickly heal by itself, but it will heal. It is recommended that you seek medical attention immediately when you dislocate a rib. If left untreated, the rib may damage nearby blood vessels, nerves, and/or ligaments.
Your Ribs, Spine, and Breastbone
If you look at the human skeletal system, you will notice that ribs come in pairs. It is easy to know if a rib is causing the problem if only one side of your chest hurts. So, do not panic.
Each of your ribs is anchored or connected to your spine (or a thoracic vertebrae in the spine) and breastbone or sternum. Contrary to what you might have thought, ribs are fragile, thin, and flat bones. Also, take note that they are not solidly connected to your breastbone and spine.
Your spine has 33 vertebrae bones. Twelve of them are thoracic vertebrae that are connected to your ribs. In total, you have 24 rib bones or 12 pairs of ribs. Also, only 22 of those ribs are connected to your breastbone. The bottom most rib pair are not connected to the sternum, and they are referred as floating ribs.
Your ribs are connected to your spine and breast bone via cartilage sockets. They are connected to the costochondrical joints to the breastbone while they are connected to the costovertebral joints to the spine.
What's the Difference Between Broken Ribs and Dislocated Ribs?
- A rib is broken when it is damaged or cracked.
- It is dislocated when it gets disconnected from the costochondrical or costovertebral joint.
Rib dislocation is very common. However, ones that have fully popped out of cartilage sockets are those that cause the most pain. If you're lucky, you might only experience subluxation. Subluxation happens when a rib is partially disconnected or is positioned unnaturally in a cartilage socket. But of course, you will still need immediate dislocated rib treatment for it.
Can You Dislocate a Rib?
A rib can pop out of the sockets of the two joints if the body was forced to be positioned in a very awkward way or if the rib cage or chest area undergoes trauma. A few of those traumas can be from a direct hit to the ribs, severe rib sprain, contact sport, a vehicle accident, or a fall.
A dislocated rib in back is common in those with flabby bodies and weak muscles. When people with those conditions exert physical effort together with awkward body positions, a rib might pop out of a joint socket.
The first two common signs of a dislocated rib are a lump on the injured area and tenderness when you breathe.
You have high risk of having a dislocated rib if you play sports like football, boxing, wrestling, hockey, or basketball.
- Also, if you have experienced rib sprain or rib dislocation before, you have a high chance of having a dislocated rib once again. Repeatedly suffering from chest injury also also increases your chances of rib sprain.
- On the other hand, people with arthritis, rheumatoid, or gout will likely have a dislocated rib if they are physically active.
- Additionally, obese people with weak bodies can easily have a dislocated rib.
- Also, certain medications that weaken cartilages in your body can make you more susceptible to rib bone separation.
Symptoms of a Dislocated Rib
Depending on which rib has been dislocated, the discomfort or pain may be felt in your back or chest. After some time, the skin over the dislocated ribs may swell and bruise. The moment the injury happens, a popping sound can be heard and a lump may surface over the rib.
A few other things that you might experience are the following:
- Difficulty and excruciating pain whenever you sit up, breathe, or strain
- Pain when walking or moving
- A lump on top of one of your ribs
- Painful coughing
- Difficulty in breathing
- Tenderness of the injured area
- Other ribs becoming numbed or paralyzed
However, be reminded that if you felt the following dislocated rib symptoms, it does not necessarily mean that you have dislocated ribs.
It could be something else, such as rib that is already broken. In the worst case scenarios, it could be pleurisy, pneumonia, or cancer. Do not ignore these dislocated rib symptoms and instead seek medical attention as soon as possible.
A doctor will ask you about the recent activities that you did and the dislocated rib symptoms you felt. Aside from that, you will also be asked about your medical history. They will also check your body for any other injuries and perform external examination.
After that, you will undergo x-ray for your spine and chest. In some cases, you might need to undergo MRI (Magnetic Resonance Imaging) to check if the dislocated rib was able to do any further damage to your internal organs.
If the rib was only subluxed, the doctor may or may not correct the rib depending on the severity of its dislocation. More often than not, doctors prescribe pain killing medications to help the patient recover and let the subluxed rib heal on its own.
On the other hand, if a dislocated rib is found, the doctor will correct its location. Usually, dislocated rib treatment is performed by administering light anesthesia or strong sedative to the patient. And then correct the location of the rib by pushing the rib back to the socket.
If the bone is back on its proper place, the doctor or nurse will put some compression bandage on the correct area. The elastic bandage will help the rib stay in place and reduce the pain.
Usually, there is no need for any invasive procedure. However, if the rib is angled badly or if moving it around may damage some internal organs, the patient might need to undergo surgery. Also, invasive procedure is needed if internal damages happened to the patient. Before surgery, the doctor might instruct you to drink water only and prevent eating solid foods. Take note that solid food in your system can be dangerous if you are in effect of general anesthesia.
In case that the dislocated ribs has damaged some ligaments, the latter will take six or more weeks to heal after the dislocated rib has been corrected.
The doctor may advise you to wear gentle compression clothes or chest paddings to aid in relieving the discomfort you will feel while moving.
Depending on the severity of the injury, the doctor will prescribe you with muscle relaxants to make it easier for you to recover. Your medication might include acetaminophen to reduce pain, stool softeners to make it easier for you to defecate, antibiotics to prevent infection, and narcotic pain relievers in case that you had a severe injury.
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If you have ever felt that your rib has been dislocated or you heard something pop in your chest, then you should apply some first aid. And before anything else, do not think of using a warm compress. Tell somebody to get you an ice pack, lie down on your bed or sofa, and place the pack on top of the area where the pain originates.
Remember the RICE mnemonic that stands for
Of course, if the pain worsens, do not waste time. Immediately consult a healthcare professional and let them check to see if you do have a dislocated rib or something more serious. If it is possible, your rib must be immediately corrected within six hours.
In case your rib dislocation is serious and it harmed internal organs, you only have around six hours to prevent your body from experiencing shock. Normally, it takes six hours before your body fluids and any internal bleeding may lead to that. Also, prolonging your injury may make it more difficult to fix since your tissues will lose their elasticity by then.
A couple of days after your rib is treated, you can start rehabilitating. If you are relaxing, you can use a warm compress to alleviate the pain and the swelling of the area that was affected by the separated rib.
Instead of a warm compress, you can also use heat liniments, ointments, lamps, soaks, or a hot shower. If you have access to whirlpool treatments, then do that. Every time you treat yourself, make sure that you replace the elastic bandage you use.
The heat will improve healing speed and blood flow. It will also make you feel comfortable. However, when applying heat to your injured area, be sure that you lie down straight or in a natural position. If done correctly, the muscles on top of the rib will become relaxed and will make you feel relief.
If you have undergone surgery, you will need more time to heal. Do not resume any of your normal activities, and forget about engaging in sports for a while. Take note that if you resume your activities not fully recovered, the healing of the injury will be prolonged. Also, do not forget that you cannot drive a vehicle or a bike until you are fully healed.
When it comes to diet, you need to eat protein rich foods. Protein will help you develop muscles easier. A few of those protein rich foods you can eat are eggs, milk, cheese, poultry, fish, and meat. The extra muscles will help protect your ribs.
In some cases, your doctor may tell you to take vitamin and mineral supplements to hasten your recovery.
Reducing pain with OTC (over-the-counter) painkilling drugs is recommended. Painkiller drugs that contain ibuprofen or acetaminophen are safe to take and will help reduce the chances of your body having an inflammation.
Your doctor, on the other hand, might give you a prescription for muscle relaxants and general anesthesia if the pain is too unbearable. They might also prescribe some stool softeners for you to have better and easier bowel movement. Lastly, they might give you some antibiotics to prevent inflammations in case you have undergone surgery or if your case is severe.
Exercise and Rehabilitation
For a few days, it is recommended that you stop doing any strenuous physical activity. From time to time, you can also use ice packs to alleviate the pain. You can use ice packs to relieve the pain for three to four times a day, 20 minutes every session.
The amount of time you need to recover depends on your physical condition, age, and severity of the injury. Most people, however, recover after six weeks of rest.
Make sure that you rest and prevent your chest from moving unnaturally or too much. If you've treated your injury too late, then it is probable that most of the muscles surrounding the separated rib has adapted to its distorted state.
You need your muscles to readjust to their normal positions before you start rehabilitating your muscles with exercise. Also, be aware of your posture. Always be aware of how you sit, stand, walk, and lie down. If you feel that your muscles or ribs are resisting your movements, then consult your doctor again.
On the other hand, if you have recovered and are able to do some rehabilitation exercises or muscle strengthening workouts, massage the are with ice. Massage it for 10 minutes. If you do not have ice cubes or tubes ready, you can fill a cup with water and freeze it in your freezer. Take out the ice from the cup, and use that ice to massage your injury.
Some of the most effective workouts to strengthen the muscle groups in your chest are rotational motions, pull downs, and rowing. If you plan to do some bench presses, make sure that you have someone to spot you. Bench presses can be dangerous if you have had a recent injury since the weights can fall down on you if you suddenly experience muscle failure.
When rehabilitating your muscles, you do not need to put a lot of effort into building strength and you don't have to do so many reps that you achieve muscle failure. This is risky as well as a lot of work. All you need is to stress your muscles in order for them to grow and become strong enough to prevent another injury.
Of course, when starting out, make sure that you use light or small weights. Also, be gentle with the workout. You need to stress only your muscles, not your whole body.
On the other hand, if it is a regular activity that caused your injury, stop doing it for a while. If it is an accident that caused it, you just need to be more careful and cautious. If you have no idea what caused it, you might want to analyze your lifestyle. Your doctor might help you figure out the area of your lifestyle that need changing.
Nobody wants to dislocate a rib. If you have not experienced it yet, you probably want to make sure that it doesn't happen to you. Here are simple tips to avoid such injury:
- Exercise—Strengthening the muscles in your chest area is the best way to protect your ribs from being dislocated. Bench presses or pushups are ideal for this.
- Warm up before doing any activity—If you do strenuous physical activities, whether for work or for recreational purposes, always warm your body up. A few people advise that you should stretch first. However, it has proven that stretching before a workout raises the chances of you injuring yourself.
- Wear protective clothing—If you are into contact sports, always be sure to wear chest protective clothing when sparring or practicing. Save your body for the real game.
- Prevent contact sports altogether: if you have dislocated a rib in back before, it's best to avoid contact sports altogether. Just a light blow on your ribs can lead to another dislocated rib again.
As you can see, muscle conditioning is the best way to prevent this type of injury. Also, take note that arthritis can also worsen the injury, so if you do activities that put you at risk of having another dislocated rib, it's better to stop.
If you cannot let go of your hobbies and you have been injured, you must make sure that you rehabilitate your body first. Always wear support wraps while recovering. To hasten the healing, you can perform ice massages on the injured area before you work out.
After your injury, be wary of the condition of the injured area and your body. Even if you do not feel any dislocated rib symptoms, you should watch out for the following:
- The skin on your chest area is cold, pale, and/or numb.
- You become nauseous and you vomit frequently.
- You still experience difficulty in breathing and shortness of breath.
- You experience possible signs or symptoms of infection such as fever, dizziness, muscle aches, and/or headaches.
- You feel tingling and prickling sensations on your chest.
- You feel new uncomfortable sensations in your body, especially during your recovery and medication period. Though, that might be the side effects of your medication.
- You hear audible pops from your chest.
- You experience minor rib dislocation that you can push back to normal repeatedly.
If you experience any of the following, immediately talk to your doctor.
Despite being a common, a dislocated rib in your back can cause many complications that can be life-threatening. They rarely occur, but you should be well informed just in case one happens to you.
First of all, you can experience body shock, which was mentioned earlier in this article. A dislocated rib, just like a broken rib, can damage your blood circulation. And if your blood circulation becomes impaired for more than six hours, your body can go to a state of shock.
This situation has a higher chance of happening if the dislocated bone is one of your upper ribs. After all, a loose rib on that part can damage vital organs such as your lungs and heart. Also, the bone can put pressure on the nerves on your shoulders and arms, which can impede their normal functions due to blood supply interruption.
Also, if your rib punctures anything inside your body, you could bleed internally, which might lead to shock, too. Aside from that, the rib can damage tendons, muscles, and other connective tissues.
When the rib gets completely detached, its bone cells might die off due to blood supply loss. If you went under surgery to fix the dislocated rib, you might be at risk for an infection. Also, once you get injured, your chances of getting injured again are higher due to weakened socket joints, which actually may have been an initial cause of the injury.
As mentioned before, you might easily mistake a dislocated rib for a fractured rib since they have similar symptoms. Unlike a dislocation, however, fractures can happen to multiple ribs at the same time. Also, rib fractures are rare since the collarbone (clavicle) protects the rib cage from getting damaged.
Normally, rib fractures are associated with other injuries and accidents. For example, the first and second pair of ribs commonly become fractured when a person experiences facial or head injuries.
Commonly, the ones that get fractured a lot are the ribs in the middle part of the rib cage. They are fractured when a person experiences crushing incidents and direct blows to the chest. The most prone to fractures are the seventh and tenth rib pairs.
When it comes to the lower ribs, a fracture can be life-threatening. The lower rib cage houses the diaphragm. When those ones are fractured, the person might experience diaphragmatic hernia. Its treatment will most likely involve surgery.
Just like dislocated ribs, rib fractures make it painful to move and breathe. However, rib fractures tend make people have flail chest — a part of the chest that moves differently or independently. Also, grating sounds can be heard when breathing.
On the other hand, adults are more prone to have rib fractures than children are. Unlike older people, children still have chest walls that are more flexible. It will require a huge amount of force for their ribs to fracture because their bones tend to bend rather than break.
Pregnancy and a Dislocated Rib
Dislocated ribs are a common problem in pregnant women. However, contrary to popular belief, the baby is not the prime reason a woman could have this injury while pregnant.
Usually, the main culprit is the hormone relaxin. Relaxin is a polypeptide that causes pelvic ligaments and the cervix to relax. It makes things it a bit easier for women during delivery.
Unfortunately, too much of this hormone can make women feel pain in their ribs and can cause torn ligaments. Even if the problematic rib is corrected, it might pop out again.
The best way to help women with dislocated ribs is to let them wear an orthopedic rib brace every day. The brace can lessen the pain that the rib is causing. Sadly, as weeks go by, other ribs might become dislocated, too, which might make it necessary for pregnant women to visit therapists to adjust their ribs frequently.
Thankfully, the dislocation of the ribs will disappear once the pregnancy is over. This is because the body will stop producing relaxin.
It is sad to say that rib dislocation is a part of life that you cannot fully avoid. You might not experience it if you are lucky and if you follow the preventive tips mentioned in this article.
Never forget that if you think you've experienced this injury, you should follow the first aid procedure RICE. Alleviate the pain first, and then seek medical attention. Hopefully, you might not need to undergo expensive and painful surgery.
Even though it is a common injury, a dislocated rib can pose threat to your life. Take note that if your rib damages any of your internal organs, you are at high risk for your blood circulation being disrupted and your body entering a state of shock.
Once you are treated, make sure that you avoid any activities that may cause you to dislocate your ribs again. Take your time and rest. Again, resuming normal activities immediately after rib correction will only prolong the healing process and may cause you to dislocate your rib again.
After recovering, it is recommended that you do some rehabilitation exercises. Primarily, these need to be exercises to make your chest muscles leaner and stronger. Performing chest exercises and eating a protein-rich diet is the easiest way to do that. Nevertheless, exercise caution and do not strain yourself.
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