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.
Conclusion
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.
References
1. J.F.Arroyo,Ph.Joliet, A.F.Junod Costovertebral joint dysfunction:another misdiagnosed cause of atypical chest pain Postgrad Med J (1992) 68, 655 – 659 C) The Fellowship of Postgraduate Medicine, 1992
2. Scaringe JG, Ketner C, Manual Methods for the Treatment of Rib Dysfunctions and Associated Functional Lesions. Topics in Clinical Chiropractic 1999; 6 (3): 20-38.
3. Rainey FL, Costovertebral-costotransverse joint complex as a source of local or referred pain. Journal of bone and joint surgery. 1996; 48: 1451-1452
4. Scott EM, Scott BB. Painful rib syndrome – A review of 76 cases. Gutt. 1993; 34 (7): 1006-8
5. Famag Smythe HA. Musculoskeletal Chest Wall Pain. Canadian Medical Association Journal, 1985; 133:739.
6. Souza TA Differential Diagnosis for the Chiropractor: Protocols and Algorithms. Gaithersburg, M.D.: Aspen Publishers 1987.
7. Gatterman MI. Chiropractic Management of Spine Related Disorders. 1990 Williams and Wilkins
8. Bourdillon JF, Spinal Manipulation. Third edition. London: Heinemann Medical Books; 1982.
9. Cavanaugh JM. Neuro mechanisms of lumbar pain. Spine. 1995: 20 (16): 1804-1809
10. Hertling D, Kessler RM. Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. Lippincott Williams & Wilkins, 2006 p.772
11. Hyde TE, Gengenbach MS. Conservative Management of Sports Injuries. 1997 Williams and Wilkins
12. Hertling D, Kessler RM. Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. Lippincott Williams & Wilkins, 2006 (ref 57)
13. Maurer, EL: The thoraco costal facet syndrome with instruction of the marginal line and the rib sign. ACA Journal of Chiropractic. 13: S-151-S-164, 1976.
14. Grieve GP: Common vertebral joint problems. New York, Churchill Livingstone 1981.
15. Brier SR. Primary Care Orthopedics. St. Louis: Mosbey; 1999.
16. Galanty HL, et al. The Thorax. N: Safren et al. Manual of Sports Medicine. Philadelphia: Lippencot-Raven: 1998.
19. Young BA, et al. Costotransverse joint pain patterns: a study in normal volunteers. BMC Musculoskeletal Disorders October 2008, 9:140,
20. Triano JT, Erwin M, Hansen DT. Costovertebral and Costotransverse joint pain: A commonly overlooked pain generator. Topics in clinical chiropractic 1999: 6 (3) 79-92
21. Costovertebral Joint Sprain. www.physioadvisor.com.au
22. Fruth SJ. Differential diagnosis and treatment in a patient with posterior upper thoracic pain. Phys Ther. 2006 Feb;86(2):254-68.
24. Scaringe JG, Ketner C. Manual methods for the treatment of rib dysfunctions and associated functional lesions. Topics in Clinical Chiropractic 1999;6 :20– 38.
25. Giamberardino MA, Affaitati G, Lerza R, Laurentis SD. Neurophysiological basis of visceral pain. Journal of Musculoskeletal Pain 2002;10 :151-163
26. Cooperstein R. Chiropractic Philosophy and Clinical Technique.” JACA, 2006;43(6):13.
27. Bookhout MR. Evaluation of the thoracic spine and rib cage. In: Flynn TW. The Thoracic Spine and Rib Cage: Musculoskeletal Evaluation and Treatment Boston, Mass: Butterworth-Heinemann; 1996:147
28. Kanna C Murtagh J: Back pain and spinal motion: A practical guide. Boston, Butterworths, 1989.
29. Deyo RA, ed. Occupational Back Pain. Spine: State of the Art Reviews. Vol 2. Philadelphia, Pa: Hanley and Belfus; 1987.
30. Errico TJ, Steckers, and Kostuik JP. Thoracic Pain Syndromes: Frymoyer JW, ED. The Adult Spine: Principles and Practice. Philadelphia: Lippencot-Raven; 1997.
31. Benhamou CL, Rouxc, Yourliere D, et al, Psuedo Visceral Pain Referred from Costovertebral Arthropties. Spine. 1993; 18 (6): 790-795.
32. Johnson HH. Thoracocostal subluxation syndrome: An often overlooked cause of chest and arm pain. Chiropractic technique. 1995; 7: 134-138
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