The Rib Cage- All You Need To Know

What is the Rib Cage?

The rib cage, also called the thoracic cage, is a bony structure made up of the rib bones and their connective tissues. The rib cage forms part of the body’s respiratory system. It enables expansion of the chest cavity so that the lungs can expand and breathe in oxygen. The rib cage also encloses the thoracic cavity and helps protect the heart and lungs from damage.

Rib Cage Continued

There are 24 ribs in the human body, divided into two sets of 12 curved, flat bones. Each ones is attached by cartilage at the back to the thoracic vertebrae. The first upper seven ribs are known as ‘true ribs’ and are directly attached by cartilage to a long flat bone at the centre of the chest called the sternum (breastbone). The remaining pairs of ribs are known as ‘false ribs’. The eighth, ninth and tenth ribs are also attached to the sternum but not directly. The eleventh and twelfth ribs are called ‘floating ribs’ as they are not directly attached to the sternum. Some people are missing these ribs, while others may have an extra set.

How many ribs do we have?

While there are variations on the numbers of ribs, both men and women generally have the same number of 24 ribs. Men’s rib cages are usually larger than women’s as testosterone during puberty triggers expansion of the rib cage to allow for better oxygen inhalation.

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What conditions affect the rib cage?

Conditions affecting the ribcage include:

Bruised, cracked or fractured ribs- the most common condition affecting the rib cage.

Flail chest- a potentially serious condition where more than one rib is fractured and can affect expansion of the ribcage and ability to breathe.

Pectus excavatum- sunken chest is a congenital deformity where several ribs grow abnormally.

Pectus carinatum- also known as pigeon chest, a deformity that causes the sternum and ribs to stick out.

Bifid or bifurcated ribs- a congenital deformity where the end of the rib is split in two at the sternum.

Sternal fracture- relatively uncommon and linked with severe trauma. This can be fatal due to associated heart or lung injuries.

Rib removal- this can be done surgically for cosmetic or therapeutic reasons.

Cervical rib- where an extra rib occurs on one or both sides and can cause nerve problems in the arm.

What can cause rib cage pain?

Costochondritis- inflammation of the cartilage near the sternum

Osteoporosis- a common type of bone disease that can cause fractures

Pleurisy- swelling of the lining of the lungs that causes rib pain with deep breathing

• Sports injury

• Domestic fall

• Assault or body injury

• Forceful coughing

What are the symptoms of rib complications?

• Shoulder and neck pain radiating to the arm

• Weakness, tingling, numbness in the arms or fingers

• Difficulty with hand movements

• Blood clot formation causing red or black blotches on fingers

• Raynaud’s

• Excessive Coughing

How can rib complications be treated?

• Physiotherapy

• Stretching and exercising

• Massage

• Anti-Inflammatories

What are the symptoms of a rib injury/broken rib?

• Pain with breathing

• Swelling and tenderness on the affected rib cage area

• Skin bruising

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When to seek medical advice for rib cage pain

Seek medical advice if you have ongoing pain in the rib cage. You may be asked the following questions by your GP:

• Start, duration and severity of the pain

• If the pain is sharp, stabbing, aching or pressured

• Location of the pain (one or both sides)

• If twisting or bending or breathing deeply worsens pain

• Prior injury to the chest

• Your medical history and any other symptoms

• Your GP if necessary will then conduct further tests which may include a chest x-ray or a bone scan to determine what rib condition you are suffering from and you may be referred to a specialist.

What treatments are available for rib cage conditions?

Treatment of rib cage conditions will depend on the cause of the condition. Bruised or fractured ribs are treated the same way, which means a chest X-ray is not usually necessary. As ribs cannot be splinted like other bones, painkillers, rest, icing and immobilisation may be recommended, so they can heal naturally. Supporting ribs with a pillow while coughing should help and it’s important not to smoke during recovery. Rib injuries usually take about 3 to 6 weeks to heal.

Emergency Situations Rib Injuries

Where several ribs are injured due to a fall, crush or car injury, you will need immediate medical attention and assessment. Seek urgent medical help if you have:

• Difficulty breathing

• Increasing chest pain

• Coughing up blood

• Temperature over 38C (100.4F) The above symptoms may indicate a chest infection. More rarely, rib injuries can trigger serious lung problems such as pneumothorax or lung collapse. This happens when a broken rib has damaged a lung.