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Chiropractic Helps Rib Pain

Do you have sore ribs? If your ribs feel like they are in a different position than they should be, maybe chiropractic can help.

The human body has 24 ribs, 12 on the right side of the chest and 12 on the left side. It is possible for the ribs to sometimes shift slightly out of their natural positions. Even though they are still connected to the breastbone in the front and attached to the spine in the back, their angle can change. A rib can move forward (anteriorly). A rib can move backward (posteriorly). A rib can also move upwards or downwards. This can cause pain where 2 ribs pinch close together. This is because there is a nerve that runs horizontally between each pair of ribs. A person can have discomfort if 2 ribs become slightly separated. This is because there are intercostal muscles that cross diagonally between adjoining pairs of ribs. When these muscles stretch too far, they can become sore and irritated.

A rib that has shifted or changed angles can make it difficult to draw a deep breath. It can cause sharp chest pain. It can also make it extremely hard to find a comfortable position in which to sleep. Sometimes a misalignment that is located very high on the ribcage can mimic shoulder pain because the pain is so close to the area of the shoulder. People who experience an unrelenting deep ache between their shoulder blades whenever they lay down on their side for longer than 15 minutes may, in fact, have a rib misalignment.

There are a number of ways that ribs can be pushed out of their normal location. Here are some possible causes of rib misalignments. Most of this information has been provided by patients we have treated over the years.:

  • Sports injuries. Sports where an athlete must swing a bat, club, or racket are especially more likely to cause rib injury. Whenever an athlete must bend and reach while swinging, the ribs are at risk to misalign.

  • Boating injuries. When the boat is skipping on small waves, or on choppy water, it can cause a harsh up-and-down motion. This can cause ribs to approximate each other (compress against the rib below).

  • Coughing violently or coughing continually for weeks. It is possible to misalign or “pinch” a rib during a terrible coughing fit. Sometimes constant coughing can also irritate and injure the intercostal muscles (that are located between the ribs). A misaligned rib combined with sore muscles along the ribcage can make sleeping difficult.

  • Falling on stairs can often result in rib injury. Ribs can be moved out of position when the step forces the rib into the chest cavity. The side of the body, beneath the arms, is especially vulnerable to rib fracture and misalignment.

  • Falling into other irregular-shaped objects. Examples: falling into the bushes, falling onto a metal dog crate, falling onto a tree stump, falling against a table or chair.

  • Being slammed against a hard surface. Examples: being pinned against the wall by a heavy object compressing the chest very quickly, being crushed by a large object as it moves past you, being struck in the chest while on the ground or pressed against the wall.

  • Sleeping while the back is curved to the right or to the left. Examples: sleeping in a vehicle while leaning too far to the side, sleeping in a chair while leaning against someone.

  • Remaining for hours in a position that places continual pressure on one side of the rib cage. Examples: being hunched over while caring for a sick pet, watching a long movie at the theater, sitting uncomfortably during a long flight, sitting uncomfortably in the vehicle with luggage or other items awkwardly positioned around you. This can sometime result in somewhat of an accordion-movement of the ribs, where a group of ribs on one side of the body move very close together, while ribs along the opposite side of the body separate further apart.

  • Pregnancy. Sometimes, if the growing baby is positioned high, there will be pressure created along the lower ribs. This causes the ribs to shift upward. Sometimes one of the ribs will protrude forward to “make room” for the expanding womb.

  • Horse-riding injuries. For the record, horse-riding traumas are its own unique category of amazing and incredulous injury. Ribs can move in very unusual directions after a riding injury. Examples: falling from the side of a horse, falling over the top of a horse, falling partway off a horse and being drug behind it, being pinned under the weight of a horse.

  • Heart surgery. Rib pain is especially seen in babies, children, and teens who have had their ribcage separated during heart surgery. After surgery, the rib cage can also become asymmetrical or misshapen, which leads to poor biomechanics. In this situation, the sooner the ribs are gently placed into a more healthy position, the better the outcome.

  • Lawn maintenance. Examples: Holding a weed eater for hours while the rib cage is tilted forward or to one side, hunching forward while using hedge clippers, angling the rib cage while pulling weeds, repetitive rotating while raking leaves.

Because the ribs form a circle (that begins at the breastbone and curves around to connect to the backbone), sometimes an injury that occurs to one section can cause pain in another. For example, a person who gets struck in the left upper chest by a fast-moving baseball, may later experience pain in their back between their shoulder blades. It just depends upon how the ribs have shifted.

Many times, rib pain will go away on its own. If you bump your ribs against a hard surface, you might be sore in that area for a few days until the body heals and repairs. Unfortunately, sometimes a rib (or group of ribs) can shift out of position and remain “stuck” there. Muscle relaxants may not help.

Sometimes the best solution is to see a chiropractor who understands how to reposition ribs. The chiropractor can determine which rib(s) are affected through 1) looking at your posture, 2) testing the strength of certain muscles, 3) checking how well your ribs move when you breathe and move, and 4) searching for any ribs that may have shifted out of their correct position. An x-ray may or may not be necessary.

After the chiropractor understands what ribs have been affected, the next step is to gently place them back into their proper location. This may be done by hand or with an adjusting instrument. Some patients report instant relief. However, if a person’s ribs have been misaligned for longer than one month, or if they have a long history of rib pain and problems, multiple chiropractic appointments may be necessary in order to restore the rib cage to its normal shape. In this case, a patient will notice a gradual improvement over several weeks.

At our office, we have a group of patients that experience chronic rib misalignments. This is usually because they have an old injury that was quite serious, or that they didn’t receive the necessary treatment for. These people are more likely to reinjure their ribs, especially when they engage in certain physical activities (such as cleaning, lifting luggage, holiday decorating, raking leaves, painting the house, and moving furniture). We show these patients specific muscle tests so that they can realize when they have a rib misalignment, even before they begin to experience rib pain. This often gives them time to schedule a chiropractic appointment, so that their ribs can be adjusted back into a correct alignment prior to any unpleasant symptoms.

No doctor can be an expert at everything. Not all chiropractors are especially trained and skilled with rib misalignments. Find out if your chiropractor has training and experience with repositioning ribs. Restoring the rib cage to a healthy shape will strengthen your core, help you to sleep better, and enable you to breathe more comfortably.

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