Chest injury

What are the causes of chest wall injuries?

This advice and information is designed to assist with the healing process following any of the following chest injuries:

• Fractured ribs (broken ribs)
• Sprained inter-costal muscles (the muscles between and supporting the ribs)
• Fractured sternum (breast bone)
• Chest wall bruising
• Muscular strains

Why do I have pain?

• Injuries of the chest wall are always painful and you will have been advised about the most appropriate pain relieving medication at the time of being seen. Due to the movement of the chest wall, deep breathing, coughing and sudden movement will hurt but are an important part in making a full recovery. Chest wall injuries can take several weeks to heal and often longer if the sternum or ribs have been broken.

What is the treatment?

There is no specific treatment for this type of injury and splinting is avoided as it can restrict breathing and make complications more likely. A chest x-ray is not always necessary. Isolated rib fractures often do not show up on a chest x-ray and the treatment is the same if the rib is fractured or not.

• The most important treatment is to have good pain relief. The pain relief helps you to breathe and cough properly. Simply putting up with the pain is not a good idea as it can lead to shallow breathing.
• The main complication is that chest injuries can cause restricted breathing that can lead to stagnation of normal lung secretions and an increased risk of a chest infection. This risk is higher in those who smoke and those who have an existing chest conditions such as chronic obstructive pulmonary disease (COPD) or heart failure.

Things you should do:

• Keep moving around your home
• Take the recommended pain relief / and or anti-inflammatory tablets / gel / cream. This will help you heal more quickly.
• Do regular deep breathing exercises every hour, while you are awake, by sitting or standing in an upright position with your shoulders relaxed and concentrating on taking deep breaths down the base of your lungs
• If you feel the need to cough it is vital that you do so despite the pain, coughing will be less painful if you support the injured area with a pillow or your hand as you cough.
• Aim to alternate periods of rest with gentle activity over the next few weeks. Keeping mobile will assist in the drainage of normal lung secretions and help prevent complications.

Things you should not do:

• Try to lift anything or strain for up to 4 weeks
• Stay in bed
• Smoke
• Try to strap or bind your ribs. This can be harmful.
• Try to suppress any cough as it is important to clear the sputum to ensure that it does not collect and contribute to an infection.

Other care advice

• Ensure that you sit in a well-supported position, in a chair that is easy to arise from.
• When getting in cars put your bottom in first then swing your legs around.
• When getting up from lying down roll onto your unaffected side and sit up sideways,
  supporting your side with your hand and/or a towel.
• Ensure good ventilation of the room you are in.

Go to the nearest Accident and Emergency Department at once if:

• You become short of breath
• You start to cough up yellow, green or blood stained phlegm (sputum)
• If the cough increases dramatically, you develop a temperature or feel generally unwell with a temperature.

Please contact your GP or NHS 111 for any queries or concerns.

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