Broken rib - average painkiller use
March 28, 2024 10:09 AM Subscribe
A relative has broken a rib and is in a lot of pain. They received two days' worth of opioid painkillers at the hospital which have been used and they are still in too much pain to sleep or work. Before requesting an additional prescription, we wanted to know what the typical prescription is for a broken rib.
The internet is all over the place, from "people take opioids for more than a week" to "just take NSAIDS".
Note that my relative cannot take NSAIDs due to another health condition. They are at the maximum tylenol dose and it's not helping.
My relative does not want to get flagged as a drug seeker but is also in a lot of pain.
The internet is all over the place, from "people take opioids for more than a week" to "just take NSAIDS".
Note that my relative cannot take NSAIDs due to another health condition. They are at the maximum tylenol dose and it's not helping.
My relative does not want to get flagged as a drug seeker but is also in a lot of pain.
My mother was given a week’s worth of Percocet after badly bruising her ribs in a fall.
posted by jeszac at 10:19 AM on March 28
posted by jeszac at 10:19 AM on March 28
I've twice been hit by cars. Have cracked many ribs and broken most. The first time I was given nothing but for one pill while in the emergency room.
The second time, which was much worse, I was given 7 days worth of Oxy. After a few days the pain became more of a discomfort and I stopped using them as it seemed unnecessary.
In short: it'll depend on the doctor but many will just say grin and bear it.
posted by dobbs at 10:20 AM on March 28
The second time, which was much worse, I was given 7 days worth of Oxy. After a few days the pain became more of a discomfort and I stopped using them as it seemed unnecessary.
In short: it'll depend on the doctor but many will just say grin and bear it.
posted by dobbs at 10:20 AM on March 28
I got seven days of Tramodol for my mildly broken rib in 2022. Didn't use them all.
This was at a Zoomcare. Very anecdotally, I've found that Zoomcare is chiller about dispensing painkillers -- have received Tramodol for both fractures I've had treated there.
posted by Sauce Trough at 10:39 AM on March 28
This was at a Zoomcare. Very anecdotally, I've found that Zoomcare is chiller about dispensing painkillers -- have received Tramodol for both fractures I've had treated there.
posted by Sauce Trough at 10:39 AM on March 28
Not just the opiod epidemic; doctors being wary of prescribing painkillers has been a result of the War on Drugs for many years.
I wasn't prescribed any opioids for a broken rib
Nor was I. Maybe depends on which rib? In my case it was one of the lowest, and it only hurt when I coughed.
posted by Rash at 10:54 AM on March 28
I wasn't prescribed any opioids for a broken rib
Nor was I. Maybe depends on which rib? In my case it was one of the lowest, and it only hurt when I coughed.
posted by Rash at 10:54 AM on March 28
If your relative is a woman, going back to the doctor with a male partner or male friend or male relative in tow vastly increases the chance of your relative being given adequate pain relief.
posted by chariot pulled by cassowaries at 11:17 AM on March 28 [11 favorites]
posted by chariot pulled by cassowaries at 11:17 AM on March 28 [11 favorites]
I was prescribed 3 days of Oxy followed by about a week's worth of high-dose Naproxen and Acetaminophen (alternating between the two) when I broke a couple ribs and had some other injuries in a downhill mountain biking crash. I was able to manage without the Oxy after like the first day and a half. This was within the past few years in the US.
The amount of pain can definitely depend on which ribs are broken.
posted by theory at 11:18 AM on March 28 [1 favorite]
The amount of pain can definitely depend on which ribs are broken.
posted by theory at 11:18 AM on March 28 [1 favorite]
Not a rib but broken ankle that required surgery, I was given six (6) tylenol with codeine, with no option for a refill.
posted by goatdog at 11:19 AM on March 28
posted by goatdog at 11:19 AM on March 28
I think the fact that NSAIDS are contraindicated for your relative is highly relevant here, since I suspect many of those not given opioid painkillers were expected to take an over the counter NSAID to manage whatever pain they had. If your relative can’t take anything over the counter but Tylenol and that’s not cutting it, they are going to need to ask for an additional analgesic (or just grin and bear it). It’s possible they will be denied or even be labeled as drug seeking, depending on the health care provider’s disposition and your relative’s presentation. Dressing in a clean cut way, bringing someone else to advocate for them, and speaking directly but not pleadingly about the pain might help. Best of luck to your relative.
posted by reren at 11:22 AM on March 28 [12 favorites]
posted by reren at 11:22 AM on March 28 [12 favorites]
I was given a week of Oxy for broken ribs. I used it for about 4-5 days; I stopped when I realized on the last day of usage that I was not just not-in-pain, but was sliiiightly high.
FWIW, I was 21 and healthy at the time, and I think I felt rib pain for another 2-3 weeks. Sucked.
posted by samthemander at 11:36 AM on March 28
FWIW, I was 21 and healthy at the time, and I think I felt rib pain for another 2-3 weeks. Sucked.
posted by samthemander at 11:36 AM on March 28
One thing is, don't go in and "ask for opiods". You don't want opioids per se and you don't even want to be completely pain free per se. What you want is to be able to resume activities to the degree possible and right now you can't. This is impacting the person's ability to hold their job and make a living and that is actually the most salient issue.
(Though be open to the possibility that taking a break from work for a few days might be the best course of action - if at all possible.)
Cracked ribs can be super-painful, and the pain can vary by person and also exact injury, so this is perfectly a reasonable thing to bring up.
But go in explaining the symptoms, the pain level, the effect it is having on daily living & ability to work, and the restrictions that are making this difficult for you to solve (ie, no NSAIDs - a very common restriction people have to work around), and let the doctor figure out the solutions vs you proposing them.
There are quite a few possible solutions, including different pain medications that are not NSAIDs and not Opioids, and also there is a whole ladder of different opioids with vastly different effects that doctors can consider. Just for example, things like tramadol and codeine have a much lower effect than something like oxycodone, which in turn is much lower than something like fentanyl. So even within the opioid options there is a whole range and you don't have to immediately jump to the strongest/most potentially addictive.
Again, describe the issues and let the doctor decide - that's what they are supposed to be expert in. You might be pleasantly surprised at what they come up with. You're less likely to be perceived as drug-seeking because you're not. You're looking for solutions, not any particular drug.
Also I will just mention there are topical options like lidocaine patches that have been pretty effective for some of my relatives with somewhat similar issues. They're available over the counter - though stronger ones are available by prescription.
posted by flug at 12:06 PM on March 28 [13 favorites]
(Though be open to the possibility that taking a break from work for a few days might be the best course of action - if at all possible.)
Cracked ribs can be super-painful, and the pain can vary by person and also exact injury, so this is perfectly a reasonable thing to bring up.
But go in explaining the symptoms, the pain level, the effect it is having on daily living & ability to work, and the restrictions that are making this difficult for you to solve (ie, no NSAIDs - a very common restriction people have to work around), and let the doctor figure out the solutions vs you proposing them.
There are quite a few possible solutions, including different pain medications that are not NSAIDs and not Opioids, and also there is a whole ladder of different opioids with vastly different effects that doctors can consider. Just for example, things like tramadol and codeine have a much lower effect than something like oxycodone, which in turn is much lower than something like fentanyl. So even within the opioid options there is a whole range and you don't have to immediately jump to the strongest/most potentially addictive.
Again, describe the issues and let the doctor decide - that's what they are supposed to be expert in. You might be pleasantly surprised at what they come up with. You're less likely to be perceived as drug-seeking because you're not. You're looking for solutions, not any particular drug.
Also I will just mention there are topical options like lidocaine patches that have been pretty effective for some of my relatives with somewhat similar issues. They're available over the counter - though stronger ones are available by prescription.
posted by flug at 12:06 PM on March 28 [13 favorites]
I'd also not say outright "I can't take NSAIDs", but explain in detail that say, "my hematologist said I should not take any NSAIDs because I have low platelet levels". This has the bonus that if the doctor is aware of any drugs that are technically NSAIDs but have lower chances of a particular side effect - like dexketoprofen being easier on the stomach - they can try some sideways solution or medication combination.
(In my experience a relative got a full box of Tramadol, like a month's worth, for very badly bruised ribs from a fall. She chucked it a week in.)
posted by I claim sanctuary at 12:11 PM on March 28 [4 favorites]
(In my experience a relative got a full box of Tramadol, like a month's worth, for very badly bruised ribs from a fall. She chucked it a week in.)
posted by I claim sanctuary at 12:11 PM on March 28 [4 favorites]
My ribs are often broken. I don't remember having ever been prescribed opioids after breaking them. Wrapping them well seems to manage the pain better than anything else I've tried.
It's hard to get a prescription for opioids. They weren't prescribed to me for a broken patella, a broken vertebra, a broken zygomatic, a broken collarbone, broken metacarpals, dislocated shoulders, dislocated fingers, or a broken toe.
A week's worth of vicodin was prescribed to me once for some broken fingers, and again for several broken teeth, but it didn't reduce the pain much more than did scheduled cycles of ibuprofen and acetaminophen.
Last year after breaking a humerus I was given three weeks of an opioid that noticeably diminished my discomfort; the only other occasions that come to mind were following shoulder surgeries.
On the other hand, I've avoided requesting painkillers, after receiving only visible suspicion and a hospital bill when years ago I sought relief from an extremely painful medical event. Maybe, under other circumstances, all a person has to do is ask, but my sense of timidity and this experience left me reluctant to repeat the experiment.
If it's worth noting, I'm adequately educated, appropriately groomed, neatly dressed, and male, without tattoos or piercings.
posted by cthlsgnd at 1:19 PM on March 28 [1 favorite]
It's hard to get a prescription for opioids. They weren't prescribed to me for a broken patella, a broken vertebra, a broken zygomatic, a broken collarbone, broken metacarpals, dislocated shoulders, dislocated fingers, or a broken toe.
A week's worth of vicodin was prescribed to me once for some broken fingers, and again for several broken teeth, but it didn't reduce the pain much more than did scheduled cycles of ibuprofen and acetaminophen.
Last year after breaking a humerus I was given three weeks of an opioid that noticeably diminished my discomfort; the only other occasions that come to mind were following shoulder surgeries.
On the other hand, I've avoided requesting painkillers, after receiving only visible suspicion and a hospital bill when years ago I sought relief from an extremely painful medical event. Maybe, under other circumstances, all a person has to do is ask, but my sense of timidity and this experience left me reluctant to repeat the experiment.
If it's worth noting, I'm adequately educated, appropriately groomed, neatly dressed, and male, without tattoos or piercings.
posted by cthlsgnd at 1:19 PM on March 28 [1 favorite]
flug wrote:
Also I will just mention there are topical options like lidocaine patches that have been pretty effective for some of my relatives with somewhat similar issues. They're available over the counter - though stronger ones are available by prescription.
Seconding this. Last fall my elderly father had a fall and broke a couple of ribs. He said the lidocaine patches helped a lot -- his were prescription strength.
posted by JonathanB at 1:51 PM on March 28 [1 favorite]
Also I will just mention there are topical options like lidocaine patches that have been pretty effective for some of my relatives with somewhat similar issues. They're available over the counter - though stronger ones are available by prescription.
Seconding this. Last fall my elderly father had a fall and broke a couple of ribs. He said the lidocaine patches helped a lot -- his were prescription strength.
posted by JonathanB at 1:51 PM on March 28 [1 favorite]
I cracked a rib or two and the hospital gave me normal Motrin and Norco. The Norco did nothing but make me irregular.
posted by rhizome at 3:19 PM on March 28
posted by rhizome at 3:19 PM on March 28
My dentist, after yanking an impacted wisdom tooth, prescribed some kind of opiate, I said nah.
He then recommended take Ibuprofen with Tylenol, said it actually works better.
It does.
posted by Max Power at 4:03 PM on March 28
He then recommended take Ibuprofen with Tylenol, said it actually works better.
It does.
posted by Max Power at 4:03 PM on March 28
The "No NSAIDs" thing is definitely very relevant. I can't take oral NSAIDs and have a lot of chronic pain issues that tylenol doesn't touch, so make sure to mention that to doctors. (Ideally this should be documented in your chart - my doctor put it down as an "allergy" even though it's not technically an allergic response, but it gets the point across.)
On the off chance your relative's issue is with oral NSAIDs, toradol injections have been a lifesaver for me when things are really bad. And I've found doctors are quite willing to give those. But that's going to depend on exactly what the NSAID issue is. Obviously this won't help if the issue is something like reduced blood clotting.
But if your relative is enough pain that it impedes sleep/daily activities, go to the doctor and be specific about the impacts the pain is having on those specific areas, explain the "No NSAIDs" and the medical reason for it, then see what the doctor says.
Agreed that if your relative is female presenting, bringing a man along can be helpful.
posted by litera scripta manet at 4:22 PM on March 28 [3 favorites]
On the off chance your relative's issue is with oral NSAIDs, toradol injections have been a lifesaver for me when things are really bad. And I've found doctors are quite willing to give those. But that's going to depend on exactly what the NSAID issue is. Obviously this won't help if the issue is something like reduced blood clotting.
But if your relative is enough pain that it impedes sleep/daily activities, go to the doctor and be specific about the impacts the pain is having on those specific areas, explain the "No NSAIDs" and the medical reason for it, then see what the doctor says.
Agreed that if your relative is female presenting, bringing a man along can be helpful.
posted by litera scripta manet at 4:22 PM on March 28 [3 favorites]
Is your relative BIPOC? That’s a tough one. My husband never gets appropriate pain relief, except at our actual primary, who is an MD with a DEA number. Lots of urgent cares don’t have a DEA number, so it would be worth following up with their primary, if they have one. The relationship should help.
posted by toodleydoodley at 4:58 PM on March 28 [2 favorites]
posted by toodleydoodley at 4:58 PM on March 28 [2 favorites]
I was given three days of Percocet for a broken knee and was in pain for weeks. It depends on your pain threshold, but really it depends on the willingness of a supposedly licensed doctor to take care of your pain, sadly, because we are unfortunately in the midst of a narcotics epidemic that makes most doctors unwilling to take on the risk of caring for pain.
posted by They sucked his brains out! at 6:52 PM on March 28
posted by They sucked his brains out! at 6:52 PM on March 28
average and typical sounds like a request for data. I cracked two ribs in a paragliding fail. I was working in a teaching hospital at the time, and asked one of the junior doctors to crepitate my ribs to determine that there was a break rather than a big bruise. He wouldn't get that close and personal but did write a chit for Radiology. The Xray confirmed two fractured ribs. The pain wasn't incapacitating. I didn't request or receive any pain-killers.
posted by BobTheScientist at 12:06 AM on March 29
posted by BobTheScientist at 12:06 AM on March 29
I've cracked ribs, but I haven't had a complete break. I was told to use OTC painkillers. The last time I had an opioid was after oral surgery, but the constipation it gave me was bad enough that I swore off them.
The worst pain I had was when I had to cough, and the best advice my doctor gave me was to hold a pillow firmly against the broken rib if I had to cough or take a deep breath. That made a huge difference in my comfort. He said that they generally don't recommend taping ribs anymore because it increases the risk of developing pneumonia.
posted by brianogilvie at 12:39 PM on March 29 [1 favorite]
The worst pain I had was when I had to cough, and the best advice my doctor gave me was to hold a pillow firmly against the broken rib if I had to cough or take a deep breath. That made a huge difference in my comfort. He said that they generally don't recommend taping ribs anymore because it increases the risk of developing pneumonia.
posted by brianogilvie at 12:39 PM on March 29 [1 favorite]
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