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Rib pain

Rib pain can either be one of the easiest problems to fix for a Chiropractor or one of the hardest. Sometimes an injury or awkward movement (like a sneeze while hunching over) can throw a rib right out of place. A little muscle work and the correct adjustment may be all you need. This is the old “one and done” situation. Other times, postural problems or scapular dysfunction can create problems with the muscles in the back that create more chronic (long term) rib pathology. In this case, the underlying dysfunction will need to be addressed, or the rib problem will return, or possibly never really resolve.

Let’s take a look at the area that most often causes a rib problem.

There are many layers of muscles across the back, all of which can be relevant to rib pain. You can see here that the ribs connect to the spine in the back. The levator costae muscles, attach to the ribs. Their job is to help elevate those ribs during breathing and other motions. If there is dysfunction or misalignment in the spine, then these muscles will have to work overtime, spasm, and can become tight and tender. When this occurs, the constant tension can pull that rib head out of alignment. This leads to stress, inflammation, and further spasm & tenderness of the surrounding musculature. Now every time you take a breath, especially a deep one, the pain is intense and can even travel in the rib cage around to the side or front. Labored and painful breathing is a sign of rib pain, but can also mean something more serious.

Treatment for chronic rib dysfunction will usually include correcting misalignments of the spine, manipulation of the soft tissue, therapies targeting muscle spasms and pain, correcting postural abnormalities, correcting scapular dysfunction, and of course… manipulation of the rib itself.

Once in a while, a patient may also present with dysfunction in the sternum and costal cartilages. This is a problem with the front of the chest. In this area, there aren’t technically any ribs, but rib cartilage. You see the ribs stop being bone in the front part of the chest and instead become cartilaginous before they connect to the sternum. When a patient has irritation in the front of the chest, the diagnosis is typically costochondritis. This literally means inflammation of the rib cartilage. A person who experiences these problems often has forward rolled shoulders and forward head carriage. This is really a completely different presentation than rib pain in the back, though the two can be related. In this case, correcting those postural abnormalities is key to improving the condition. Manipulation is typically not possible until the cartilages can be unloaded from the compressive forces of the abnormal posture, simply because they are just too painful to move.

Chest pain of any sort can indicate a very serious problem. So, if you are experiencing sudden chest pain, it is not a good idea to wait. The issue may warrant emergency procedures, especially if you have any difficulty breathing, impending sense of doom, a feeling of significant pressure in your chest, sweating, fever, vomiting, cough, recent cold, or rapid pulse. A trip to the emergency room may be life-saving. However, if this is localized pain without any accompanying symptoms, and it has been going on for several weeks or more, it is not likely an emergency situation. If it is not an emergency situation, or if a physician has already cleared you of any life-threatening conditions, your next call should be to a Chiropractor.

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