How to Tell If You Have a Bruised Rib or a Broken Rib

If you recently injured a rib, you may be wondering if it’s a bruised rib or a broken rib. Both can be really painful, and it can be hard to tell the difference. But does it even matter? 

The treatment can look similar. But a broken rib can be associated with some complications. And the recovery time is likely longer. Let’s take a closer look at how you can tell if your rib is bruised or broken, the differences in treatment, and when to go to the hospital.

Bruised vs. broken rib: What’s the difference?

Both broken ribs and bruised ribs can result from injuries to the chest. They might feel similar, but there are some important differences.

What is a bruised rib?

A bruised rib is an injury to the bone that doesn’t cause a break in the bone. It’s like a typical bruise, except you can’t see it because it’s on the bone. In some cases, you may have a skin bruise in the same area. Rib bruises tend to happen with lower-impact injuries, such as a fall.

What is a broken rib?

A broken (fractured) rib describes an actual break in the bone. It’s usually a more serious injury than a bruise. You’re more likely to have a broken rib if the injury involved a lot of force — like a high-speed car accident. A broken rib tends to be more painful, and it may take longer to heal.

Sometimes, even a low-impact injury can break a rib. This can be the case for people with weaker bones, such as older adults with osteoporosis, or people who take certain medications. 

How do you diagnose broken and bruised ribs?

Since bruised ribs can feel just like broken ribs, the only way to know for sure if you have a broken rib is with an X-ray or a CT scan.

X-rays

X-rays of the chest can show if you have broken ribs, though sometimes the breaks can be hard to see. This is especially true for very small breaks, or when the X-ray is performed immediately after the injury. 

CT scans

CT scans are better than X-rays at diagnosing rib fractures. They provide a more detailed picture of the ribs and all of the organs inside the chest. But they also involve more radiation exposure than X-rays, so they’re not the first choice for testing. They’re usually used to look for other injuries in addition to rib fractures. 

In many cases, neither an X-ray nor a CT scan is needed to help diagnose a broken rib. This will depend on the type of injury, your symptoms, and your other medical conditions. 

You may need an imaging study to check for broken ribs if:

• You’re an older adult.

• You have a chronic lung disease, like chronic obstructive pulmonary disease (COPD).

• You have osteoporosis.

• The injury seems serious or involves a lot of force.

• You’re having trouble breathing, or your oxygen levels are low.

• You’re in severe pain.

What are the symptoms for broken ribs?

Since they can feel similar, bruised and broken ribs can be difficult to tell apart. They both cause sharp pain that tends to worsen with any movement of the rib cage. People tend to feel the pain more when doing things like laughing, coughing, or sitting up. 

But there are some signs that are more suggestive of a broken rib. You might have a broken rib if you:

• Feel a bump or break when you run your finger over the rib

• Heard cracking during the injury

• Feel cracking when you move or press on the injured area

If you have these symptoms, consider seeing your healthcare professional. They can help with your pain and make sure your breathing isn’t affected.

How do you treat a bruised or broken rib?

The main treatment for a bruised or broken rib is time. But there are things you can do to help the pain as your bone heals: 

• Over-the-counter (OTC) medications like ibuprofen or acetaminophen can be really helpful. And these medications can be taken together for added effect.

• Using an ice pack on the injured area can also help with pain. This is most likely to be helpful in the first 48 hours of the injury.

• If the pain is more severe, your healthcare professional might recommend prescription pain medications.

What are the risks of a bruised or broken rib?

Bruised or broken ribs aren’t usually serious. But there are some complications that can develop. These can include:

• Severe pain that oral medication can’t control 

• Any bleeding in or around the lung

• A collapsed lung (pneumothorax), which can be a complication of rib fractures 

• Pneumonia

It’s really important that your pain is controlled so you can continue to take deep breaths — otherwise you may be at risk for pneumonia. If your pain is severe enough to limit your breathing, your lungs don’t fully expand. This deflates the bottom parts of your lung, which can lead to pneumonia. 

Pneumonia leads to coughing, more pain, and low oxygen levels. It’s hard to recover from pneumonia at the best of times, but it’s even harder when you have a rib fracture. 

In addition to good pain control, you can decrease your risk of pneumonia when you:

• Practice deep-breathing exercises. This requires taking several deep breaths every hour to keep your lungs inflated. Some people will use a special device called an incentive spirometer to help with this.

• Avoid wrapping the chest. Some people are tempted to do this to try and brace the ribs. This is not recommended because it can restrict your ability to take a deep breath. If you need to cough or move in a certain way that you know will be painful, you can temporarily brace the chest with your hand or a pillow to help.

If you have any of these complications from a bruised or broken rib, you may need to be treated in the hospital. 

Do you need to go to the hospital for bruised or broken ribs?

In most cases, people will recover with bruised or broken ribs at home. But in more serious cases, someone with broken ribs may need treatment in the hospital.

If you have a bruised or broken rib, you should go to the hospital if you have:

• Pain that prevents you from taking a deep breath

• Pain that feels like it’s getting worse rather than better

• Shortness of breath

• Fever

• New cough or congestion

How long do bruised or broken ribs take to heal?

The time it takes to heal a rib injury depends on how serious the injury is, your age, and your other medical conditions. Anywhere from 3 weeks to 3 months may be normal. Expect a broken rib to take longer to heal than a bruised rib.

Why trust our experts?

Written by:

Michael Dreis, MD

Dr. Dreis is an emergency medicine physician currently practicing in Milwaukee, Wisconsin. He went to medical school at the University of Wisconsin – Madison and completed his residency at Henry Ford Hospital in Detroit, Michigan.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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