Rib Pain and How to Fix It

When people are experiencing intense rib pain they often say to me, “Doc, I think I’ve got a rib out!” It’s a phrase that we chiropractors are well used to hearing. Costovertebral dysfunction, the cause of most rib pain, goes by several names and descriptions including “rib sprain”, “tipped rib”, or most often “I think I got a rib out”. It is characterized by a number of signs and symptoms including muscle spasming, pain in the mid back, rib cage, and/or from of the ribs (sternum) and is often made worse by heavy breathing, coughing, bending and twisting the torso. Sometimes people will describe a feeling like they’ve been shot through the chest with an arrow. Rib pain and dysfunction at the costovertebral joint can be caused by a variety of ways but typically people will describe that it began after reaching, pushing, or pulling with arms. Heavy coughing due to smoking or an illness is another common cause of this complaint. Today’s blog will cover rib pain, and specifically rib pain caused by costovertebral dysfunction.┬áIt is a relatively common condition and one that we manage in and out overy day in our office.

The first thing that we watch for when someone describes rib pain is we ask to see if a rash has developed on the chest. If there is a rash present, it may be a sign of shingles and would warrant a medical referral. If the usual red flags are cleared, an orthopedic examination will commence. Generally limited motion in the chest (especially with pain), accompanied by muscle tension, joint fixation, and other musculoskeletal changes are the most common findings in this part of the exam. Like shingles, we will be on the lookout for other rarer possible conditions such as ankylosing spondylitis, cardiac conditions, organ pain referral, or thoracic disc issues as we examine your complaint.

Once the diagnosis of costovertebral dysfunction has been established we will work to restore proper motion, rehabilitate the tissues, and of course decrease the rib pain itself. Treatments for rib pain including manual manipulation of the costovertebral and thoracic vertebrae joints, soft tissue work of the surrounding musculature, stretches, exercises and foam rolling if necessary. Though it can be a bit of a rough ride in the beginning, these typically respond well and pretty fast. One complicating factor is that the rib cage moves with every breath we take which can be irritating in especially painful cases. Practicing diaphragmatic breathing can sometimes help with this complication. I recommend that you check out the video at the bottom of this page to see what our typical treatments look like for rib pain caused by costovertebral dysfunction.

Foam rolling is an absolutely fantastic home soft tissue treatment when used appropriately.

Don’t let nagging rib pain get in the way of your workout or other fun activities that you’re trying to do. The underlying causes are often easy to manage and you can get out there feeling and moving better than ever with a short treatment plan. More importantly, a chiropractic assessment of your spine, muscles, and other tissues can identify movement restrictions and other problems which can lead to dysfunction and pain. Potentially it could impede your ability to perform your daily activities. If you, or someone you love is experiencing pain in their rib cage, especially the kind that stops them from enjoying the things that they love to do in life, I encourage you to make an appointment to get it thoroughly checked out. As always, have fun out there. Summer is full swing and you don’t want to miss a thing.


Dr. Kelly


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