Answer by Researcher byrd on Sun 22 Mar 2009 - 11:04 pm UTC:

Hi Happyengineer, 

Sorry to hear about the hug that hurt. What you describe certainly sounds
like a rib injury, which is a very common injury and not usually dangerous.
Yes, broken ribs are very painful, but there are lesser injuries that might
cause the symptoms your fiance is describing, ranging from a dislocation,
to a tendon/ligament injury, to bruising, to a hairline fracture, to what
is known as a "costochondral separation," which is when a rib tears away
from the cartilage attaching it to the breastbone, or any number of other
possibilities. 

Many doctors still advise an x-ray if there's a chance of a fractured rib,
though they can often feel whether or not a rib is broken just by palpating
it, without need of an x-ray. Others will suggest a wait-and-see tack at
first, using pain and other symptoms as a guide. If symptoms worsen, then
go see a doctor; if they don't, then wait it out. Some doctors still
advocate taping up the ribs, but quite a few others now advise against it
due to the risk of pneumonia. 

For rib injuries, even if you do get a formal diagnosis, it is still
generally suggested to initially follow the RICE protocol: Rest, Ice,
Compression (or support), and Elevation. So your girlfriend should keep
quiet and avoid strenuous activity, apply ice to the site of the pain, 10
minutes on 10 off, use a wrap or support of some kind (though not tight
taping), even a tight sweater or athletic shirt, and stay generally upright
rather than lie down flat. After the first 24 hours, it is then generally
suggested to use heat instead of ice. It is also usually suggested to use
NSAIDs such as aspirin or ibuprofen to help relieve pain and any
inflammation. 

This information is largely taken from personal experience, as I have been
Red Cross First Aid certified a number of times in my past, as well as
raised two boys, taken care of two (now teenaged) grandchildren, and nursed
a spouse through a broken rib. In the case of my spouse, no x-rays were
taken, and it was advised not to use a rib belt or taping. It took about
six weeks to fully heal to the point that all vestiges of soreness were
gone. There were no lasting ill effects. 

Here are a few links to online sources with some good information and
advice about rib injuries, as well as a few personal experiences that are
similar. 

"What is a Rib Injury?"  (University Sports Medicine)
http://www.ubsportsmed.buffalo.edu/education/rib.html 

Broken or Bruised Ribs
http://www.medicinenet.com/chest_pain/page4.htm 

"Rib Injury, the Annoying Pain"
http://www.newsfinder.org/site/more/rib_injury_the_annoying_pain/ 

"Pain from getting bear hug," question/answer in Pain Management Community
on MedHelp
http://www.medhelp.org/posts/show/752295 

Question/Answer: " A 6' 2' 345 person gave me a bear hug to the point of
lots of pain and felt something move in my ribs. I feel pain when I touch
that area...."
JustAnswer
http://www.justanswer.com/questions/1odyt-bruised-ribs-its-two-weeks 

=================================================

If you do want to check with a health professional, here are a couple of
links where you can do so online via chat or by email. 

eCureMe
"No more long waits on the phone or at the doctor's office. We'll connect
you with a physician or therapist immediately. Through email or video,
eConsult Live provides you with quick, easy and affordable access to
medical advice...."
http://www.ecureme.com/econsultlive/splash/econsultlive_splash.asp 

JustAnswer - Medical
Online doctors instantly answer your medical questions. 
http://www.justanswer.com/medical 

If the symptoms do worsen, your fiance should probably go ahead and see a
health professional without delay and of course nothing stated here should
be construed as medical advice or taken as a substitute for advice from a
doctor or health professional, but is provided for your information only.

However, I do hope the information is helpful. Please let me know if you
need anything else. My best wishes to your fiance for a speedy recovery. 

Regards, 

Byrd