Fractured ribs are commonly associated with collisions, falls or other forms of trauma. These injuries can lead to extended periods of disability in athletes.
The human rib cage consists of 24 ribs (12 on each side) connected to a bone in the center of the chest called the sternum and attached in the back to the thoracic vertebrae. There are muscles, nerves and connective tissue located between the ribs.
The rib cage is designed to protect vital organs including the heart, lungs and major blood vessels. It is also an important functional component as part of the respiratory system. The rib cage will expand and contract with each breath.
Fractured ribs in adults are most commonly the result of falls and motor vehicle accidents. In young people these injuries result from blunt trauma associated with athletic injuries. The middle and lower ribs are most often injured. The involved trauma is often a sudden, high impact to a small focal area such as that inflicted by an elbow or a baseball.
Rib fractures are the most common serious injury to the chest. Severe fractures can result in a punctured lung. Multiple fractures can cause a condition called flail chest that will diminish the ability to effectively exchange air. Intense pain is the most common initial symptom. The pain intensifies with breathing, coughing or any activity that requires movement of the chest wall.
Treatment involves the use of rest, ice and pain medication. Pain medication can range from non-steroidal anti-inflammatory medications to narcotics.
An ongoing study at St. Francis Hospital and Medical Center in Hartford involves the comparison of current medical treatment including narcotics versus marijuana administered in a fixed-dose pill form.
"Rib fractures are an excellent condition for this trial since it fairly predictably results in pain that improves in six weeks and resolves in eight weeks," reports Dr. James Feeney, associate director of trauma and principal investigator for the study.
Returning to sports after a rib fracture can be expedited with early recognition and effective treatment.
Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu
Avoid long-term use of narcotics for chronic nerve pain
Chronic pain has become an accepted complication of a career in high-velocity collision sports and combat sports. Unfortunately, the pain doesn't end with retirement and in fact can intensify with age. Novel approaches to treatment are needed to avoid chronic use of opiate medications.
The human nervous system is divided into the central nervous system and the peripheral nervous system. The central nervous system consists of the brain and spinal cord. The peripheral nervous system is made up of the nerves that extend from the spinal cord to the muscles, joints and skin.
Pain is transmitted via signals from peripheral receptors to the brain where they are interpreted. Peripheral nerve pain from contact sports is often the result of direct trauma or stretching of large nerve trunks.
Trauma to sensory nerves can result in sensory loss. Often, injured sensory nerves will typically transmit misinformation called paresthesias. These "perversions" of sensation are typically described as burning, crawling, tingling or pins and needles. They can escalate from being an annoyance to debilitating.
The key element in treating chronic pain is to avoid the use of narcotics or other habit-forming medications since they are not a long-term solution. Opiates and other narcotics are designed for short-term therapy only.
Non-pharmacologic treatments in the form of mindfulness meditation, regular aerobic exercise and yoga are accepted approaches. Acupuncture also has been reported to show significant benefit in reducing pain for some patients.
Non-narcotic medications are often successful in treating chronic pain. Antiepileptic drugs as well as antidepressants are designed to treat conditions that affect the brain by altering brain chemistry. These medications also are effective in treating chronic pain.
Non-narcotic treatment of chronic pain demands a multidimensional approach for the best chance of success.
Further research into innovative approaches for the long-term treatment of pain, including the role of cannabis, is necessary.
Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu
The human nervous system is divided into the central nervous system and the peripheral nervous system. The central nervous system consists of the brain and spinal cord. The peripheral nervous system is made up of the nerves that extend from the spinal cord to the muscles, joints and skin.
Pain is transmitted via signals from peripheral receptors to the brain where they are interpreted. Peripheral nerve pain from contact sports is often the result of direct trauma or stretching of large nerve trunks.
Trauma to sensory nerves can result in sensory loss. Often, injured sensory nerves will typically transmit misinformation called paresthesias. These "perversions" of sensation are typically described as burning, crawling, tingling or pins and needles. They can escalate from being an annoyance to debilitating.
The key element in treating chronic pain is to avoid the use of narcotics or other habit-forming medications since they are not a long-term solution. Opiates and other narcotics are designed for short-term therapy only.
Non-pharmacologic treatments in the form of mindfulness meditation, regular aerobic exercise and yoga are accepted approaches. Acupuncture also has been reported to show significant benefit in reducing pain for some patients.
Non-narcotic medications are often successful in treating chronic pain. Antiepileptic drugs as well as antidepressants are designed to treat conditions that affect the brain by altering brain chemistry. These medications also are effective in treating chronic pain.
Non-narcotic treatment of chronic pain demands a multidimensional approach for the best chance of success.
Further research into innovative approaches for the long-term treatment of pain, including the role of cannabis, is necessary.
Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu
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