Question
i saw chiropractor last thursday he pushed down hard on my chest to manipulate and there was a very loud craking soud(even shocked him)and i couldnt breathe at first
Pain got worse went to hosp next day no xrays but said rib was broken how do they know no other damage without xrays? pain so severe still worse  on moving or coughing from front of chest to back,NOT made worse when breathing can it be anything else

Answer
Dear Jackie,

The fracture of a rib is one of the most common complications of chiropractic manipulation.  I know that it causes a lot of pain, and for that I am sorry!  The good news is that usually this is simply something that will heal up on its own. You can try binding your chest with an ace bandage or similar compressive brace.  

As far as other issues... chest x-rays can help to rule out a collapsed lung, although you would have difficulty breathing, I would imagine, if that were the case. If the lung is damaged in some other way, it is probable that you would cough up some blood.

I hope that when you went to the hospital that the doctor there listened to your chest and was only able to hear normal lung sounds. This is done with a stethoscope at several points on the front and on the back, both right and left.

A very important part of any diagnosis workup is the history. It sounds like during your history taking at the hospital you were exhibiting symptoms of an uncomplicated rib fracture.

There really is nothing that can be done for the fracture other than let it heal over time. If, on the other hand, you begin to experience any breathing difficulty, or any other new symptoms, I would recommend a return visit to the ER for another evaluation.

The main concern that I would have is why you suffered the rib fracture in the first place. Chiropractic adjustments are generally very safe. I have had a couple of patients who have suffered from fractured ribs during adjustments. One was a chronic asthmatic that was on long term steroid medications. The other was an older woman.  Both had very weakened bone structure due to their medications and/or advancement of osteoporosis. Ribs that are healthy are rather difficult to break. Why did yours break?  How old are you? Do you have osteoporosis? Have you been on any medications that over time can cause a loss of bone mass or structure?

I am sorry for your pain and discomfort.  I bet that your chiropractor feels pretty bad as well... we work so hard to help, and when things don't go as planned, we feel very bad about it.

Good luck in your healing. Give it about 1-2 months. The pain will gradually subside during that time.

Keith Biggs, DC
http://www.eastmesachiropractor.com