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Rib pain making it hard to take a breath? 

What’s going on?

Ribs come in pairs and travel between the spine and the breastbone (sternum). They move in a bucket handle motion as you inhale and exhale. There are 2 joints between the spine and each rib called the costovertebral and costotransverse joints. There is one joint between each rib and the sternum called the costosternal joint. Pain can come from anyone of these joints. Rib pain can be near your spine, next to your spine or near your sternum. Pain can be localized or travel around the rib.

Each rib joint contains cartilage that holds the rib in place. Ribs can move out of position which in turn can inflame the cartilage and other joint structures. Even small changes in position can cause moderate to severe pain. Movement is often painful and transitioning from laying to sitting or from sitting to standing may be difficult. Taking a deep breath may also be painful and a grinding or popping sensation may be felt over the affected joint.

How does the rib get out of place?

Falls, traumatic events, poor posture, sleeping in an awkward position, weak muscles and stretching can all cause rib alignment issues. Pain is sometimes preceded by an obvious accident or sports injury. Other times the pain can seem to come out of nowhere. We’ve seen cases where ribs become displaced from a motion such as opening a door or picking something up off the ground. Pain over the joints, around the rib, with specific movements or with breathing may indicate a rib alignment issue.  Sometimes a bump can be felt over the joint. Patients may also note a change in posture or a change in the overall position of the ribcage.

Which rib joint is out of place?

Joints are areas where the rib meets other bones. These junctions are often the source of rib pain because they have bones, cartilage, muscles, ligaments and tendons in close proximity and all of these structures can cause pain. The majority of the ribs have three joints: 2 with the spine and one with the sternum. The two joints with the spine are called the costovetebral and the costotransverse joints. Alignment issues with these joints will cause pain right at the spine (costovertebral joint) or about an inch to the side of the spine (costotransverse joint). The other rib joint occurs between the rib and the sternum (costosternal joint). An alignment problem with this joint will cause pain where the rib connects to the breastbone. This condition is also called costochondritis, Tietze Syndrome or slipping rib syndrome. Costochondritis is often related to a respiratory illness due to coughing although we have seen cases in otherwise healthy athletes. It’s important to realize rib pain from any joint may radiate around the rib.

What is the treatment for rib pain?

Every case is different but rib cases typically respond well to a chiropractic adjustment for designed to restore the proper position rib. Fairfax chiropractor Dr. Ward specializes in identifying the specific alignment issue and gently correcting it with an adjustment. In some causes posture can be an underlying cause of rib dysfunction. People with a lot of upper back stiffness (e.g. professionals who work on computers or people with rounded upper backs) may have recurrent rib alignment problems, since their ribs move more to compensate for the lack of back motion. This increased rib motion can result in ribs that chronically slip out of place. That is the reason why our approach evaluates the entire interconnected system that impacts the rib not just the rib itself. 

In individuals who experience recurrent rib issues, exercises aimed at reducing thoracic spine stiffness would likely be helpful. A great way to do this involves exercises that use a foam roller to loosen the upper back. Check out our blog post for more information: Exercises to Reduce Upper Back Stiffness.

 

We pride ourselves in our caring and long-term relationships we develop with our patients, so to request an appointment, please contact us today. We look forward to seeing you at your Fairfax chiropractic.

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Dr. Ward and his staff are fantastic! When I came for my first visit, I was welcomed warmly and didn't wait long at all. Each time I was able to make an appointment without any problems. The pain in my hips has improved significantly and faster than I was expecting. Having found this wonderful office, I am able to be active again without pushing through pain.

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Fairfax, VA

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