Chiropractic care is a holistic approach to healthcare that focuses on the relationship between the body’s structure, particularly the spine, and its function. While chiropractors are often associated with back and neck pain, they can also provide effective treatment for rib dysfunction. In this guide, we will explore the causes, symptoms, diagnosis, and chiropractic management of rib dysfunction.

Understanding Rib Dysfunction

Rib dysfunction, also known as costovertebral joint dysfunction, refers to abnormal motion between a rib and its vertebral connection(s). It is a commonly overlooked source of chest or abdominal pain, with studies suggesting that 10-30% of “chest pain” is of musculoskeletal origin [1][2]. The costovertebral joint complex, which includes the costovertebral (central) and costotransverse articulations, plays a vital role in rib motion and stability [7][8].

Causes of Rib Dysfunction

Rib dysfunction can result from various factors, including trauma, arthropathy, postural strain, or repetitive injury [10][11]. Athletes participating in sports like wrestling, rugby, football, golf, or swimming may be more prone to rib dysfunction [10][12]. Biomechanical deficits, such as forward head posture, upper crossed syndrome, hyperkyphosis, scoliosis, or dysfunctional respiration, can also contribute to thoracic and rib dysfunction [7].

Symptoms and Diagnosis

Patients with rib dysfunction often experience localized pain, typically 3-4 cm lateral to the spine, which may radiate along the associated rib [7][9][10][15][16][20]. The pain can vary from focal and burning to sharp, stabbing, and radiating, leading some patients to describe it as being “shot by an arrow” [20]. Activities like breathing, coughing, sneezing, twisting, or bending can exacerbate the pain [2][20][21].

To diagnose rib dysfunction, chiropractors perform a thorough physical examination, including palpation of the ribs, assessment of range of motion, and motion palpation [20][24][25]. They also consider the presence of dermatomal rash, which may suggest herpes zoster, and evaluate other potential viscerally-referred pathology when motion testing does not reproduce the chief complaint [24][25].

Chiropractic Management of Rib Dysfunction

Chiropractic treatment for rib dysfunction focuses on restoring joint mobility, addressing soft tissue imbalances, and correcting biomechanical deficits. Manipulation, also known as adjustment, is a central component of chiropractic care and has been shown to lead to rapid recovery in cases of rib dysfunction [2][11][20]. During manipulation, chiropractors apply precise, controlled forces to the affected area to restore proper alignment and function.

In addition to manipulation, chiropractors may utilize soft tissue techniques, such as stretching and myofascial release, to address hypertonic muscles and improve overall musculoskeletal balance [2]. They may also recommend specific exercises to strengthen the scapular stabilizing muscles and address any associated postural faults [2][33].

Conservative Care and Self-Management

Conservative care, including chiropractic treatment, has been shown to be a cost-effective option for musculoskeletal chest pain related to rib dysfunction [36]. In addition to chiropractic interventions, self-management strategies can also be beneficial. Patients may need to limit certain movements, such as reaching, pushing, or pulling, that exacerbate their symptoms. Temporary modifications, such as switching to a sports bra for women to better distribute pressure over affected ribs, can provide relief [21].

Anti-inflammatory modalities, like ice, interferential therapy, and ultrasound, may help reduce pain and inflammation in the early stages of treatment [2]. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also provide temporary relief.

When to Seek Medical Attention

While chiropractic care is often effective in managing rib dysfunction, there are instances where further medical investigation may be necessary. Patients with red flags, such as unexplained weight loss, a history of cancer, corticosteroid use, osteoporosis, fever, or drug/alcohol abuse, should seek additional evaluation [2][29]. In cases of significant trauma, suspected fracture or instability, lack of improvement with conservative care, or the presence of neurologic deficits, radiographic imaging may be warranted [2][29]. Collaboration with other healthcare providers may be necessary to ensure the best possible outcomes for patients.


Rib dysfunction can cause significant discomfort and affect daily activities. Chiropractic care offers a non-invasive and holistic approach to managing rib dysfunction, addressing the underlying causes, restoring joint mobility, and improving overall musculoskeletal balance. By seeking chiropractic treatment, patients can find relief from rib pain and regain optimal function in their daily lives.

If you are experiencing rib dysfunction or related symptoms, consider consulting a chiropractor, such as Dr. Volz in Ashland, OR, who can provide a comprehensive evaluation and personalized treatment plan tailored to your specific needs. Don’t let rib dysfunction limit your quality of life—take the first step towards relief and recovery today.


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