DEAR MAYO CLINIC: My husband, 71, slipped on the stairs and now has a painful area on his rib cage. He has fractured a rib before and says there’s no way to treat it, so he has not gone to the doctor. Is it true that nothing can be done? Does he need to see a doctor?
ANSWER: It is true that usually not much can be done for a fractured rib that isn’t moved out of normal position and alignment (displaced). Treatment for a rib fracture is usually limited to providing adequate pain control, avoiding strenuous activities and letting it heal. But your husband should be seen by a doctor to rule out other underlying injuries.
Rib fractures are one of the most common types of fracture in older adults. In one study that looked at causes of rib fracture in older adults, about 25 percent of fractures were caused by major trauma, such as a car accident. These account for the most severe injuries, where multiple ribs are fractured, and when fractured bone ends are displaced. Displaced bones can cause many life-threatening complications, and emergency care is appropriate in most cases of major trauma and for anyone with three or more fractured or displaced ribs.
But most causes of rib fracture don’t occur as a result of major trauma. In the same study, one-third of the rib fracture causes were due to moderate trauma, such as falling from a standing height. And for about 40 percent of the fractures in the study, there was no identifiable trauma that caused the fracture, which means that nontraumatic events — such as the repeated stress of a coughing spell or swinging a golf club — may have caused it. This may be more likely to occur in someone with weakened bones due to osteoporosis. A tiny percentage of fractures had a direct pathological cause, such as a cancer that had spread to rib bones.