Expert: J.R. Strecker, B.S., D.C. - 2/14/2009

Question
How are you? I have a job that deals with physical and mental work. About a couple of weeks ago, I was dumping heavy powders in a drum. When I twisted my body to lift, there was some pain. When I got home however, I laid down and felt a sharp pain in my lower rib area. It's not the whole lower rib, the pain is on the side of the left lower rib, away from the abdomen. Even now I feel a sharp pain when I breath. (Especially when I inhale). I feel this sharp pain when I lay down or turn to the side of the area, and especially when I'm stretching. Even now I'm trying to do some stretching exercises, taking Epsom salt baths, and even Goody powders to alleviate the pain.
What do I have to do to get rid of this sharp pain? Please help. Because to be honest with you, I cannot afford to miss work, which is the reason why I "work with and through the pain.
Thank You Very Much.

Answer
Disclaimer: please do not take any of my advice without at least consulting with your doctor(s) first. If necessary, print this email in its entirety for your doctor(s) to read. In addition, please do not attempt to use this website or my advice as a substitute for your healthcare needs, as a substitute for the advice of your doctor, or as a substitute for any legal advice. There is no way a thorough health evaluation or assessment of any medical condition can be properly made via email. Please only use the contents discussed as a guide or tool to address your health matters with your doctor(s). If any of the information I provide conflicts in anyway with the information your doctor(s) provide, it is always best to default to the information provided by your consulting doctor(s) or to seek additional opinions from qualified, licensed healthcare providers as needed.

Hello T.,

I’m sorry to hear about your pain.  It might be a good idea to let your employer know about what happened, especially because:
a). the injury happened at work
b). you don’t feel like you can afford to miss any work    
c). the pain prevents you from working at your regular level
d) you risk re-injuring it or preventing it from healing properly if you continue the manual labor

This does not mean you do or do not need to pursue legal action.  (I don’t make those sort of suggestions and this is not what this website is for).  However, it is good just to have some sort of documentation at work.

I’m not necessarily saying you should or should not take time off.  However, you should let your employer know and go get checked by the doctor.  The company may have a specific doctor they would like you to see.  In the mean time, it may be possible for you to do less physically active work, such as more office work, while your injury heals.

There is no way I can give you a diagnosis from the information you’ve provided alone; you need further evaluation.  A proper diagnosis may better determine what you are and are not able to do at work safely.  For this, you need to see a doctor.

As far as the pain is concerned, this is one of the more commonly asked questions by patients – how can I decrease rib pain?  It’s common because there aren’t a lot of options and it can be irritating because, as you noted, you feel it every time you breathe.  You could talk to your doctor about taking some anti-inflammatories, painkillers, or muscle relaxers.  The Epsom salt baths will be great for healing, but if you’ve had a physically active day and it’s more painful after work, it might be better to use ice instead of heat to get the inflammation down, while starting your day off in the morning before work with an Epsom salt bath.  When using ice, it’s important to not ice longer than 15 minutes and wrap the ice in a towel so the skin doesn’t get an ice burn.  And lastly, certain pharmacies and doctors sell “rib braces” which act kind of like a girdle.  Their effect varies, but they are designed to provide some support for the rib cage.  Other than that, there aren’t a lot of great pain reducers for rib pain.  Overall, without a doubt, time is biggest reducer of pain when it comes to rib injuries.  And remember to check with your doctor BEFORE following any suggestions discussed.

Best of luck!
Dr. JR Strecker, DC