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January 27, 2013


Greetings again from Chiropractic Help. I hope and pray that 2013 is  going to be a happy and healthy year for you. For that to happen, what you can contribute is to exercise more, start to eat a minimum of your five colours a day, and generally a much wider spectrum of foods. It's the only way to get all the vitamins, minerals and phytosterols that your body needs.

Taking less drugs is vital too, and for that to happen you may have to make some changes in your life style. It's scary that 200,000 Americans die each year from iatrogenic illness ... serious side effects of medication in the main.

This month we are going to look at pain in the rib cage. Rib pain is at the Chiropractic Coalface an every day affair. Mostly, dealing with rib pain is fairly straight forward; here are a few of the causes of rib pain.

Hereditary rib pain causes

1. Cervical ribs

Ribs normally pertain to the mid back, or thoracic spine. But occasionally folk may inherit a gene that gives them a "cervical rib". A rib on the seventh cervical vertebra. Mostly these are "rudimentary" ribs, small and of little consequence, but very occasionally these cervical ribs can be very large and interfere with the artery and nerves on the way to and from the arm.

Below you can see large cervical ribs. On the left, the inter scalene triangle through which the subclavian artery passes on its way to the arm. Through this triangle the very large brachial plexus of nerves also passes. If there's a rib also taking up space in the triangle it can severely affect the arm.

The classic sign: the arm tires very quickly, and may tingle and ache, especially when working above your head.

Chiropractic usually helps, but will certainly not in any way "cure" the condition. Surgical removal of the rib may constitute a cure, but it's a grisly operation, sometime injuring the artery or nerves.

The classic test: Adson's test measures the pulse in the arm as you go through complex movements to narrow the gap in the "interscalene triangle."

2. Lumbar ribs

Less uncommon, the first lumbar vertebra may have a rudimentary rib. Usually there is an associated anomaly at the base of the lumbar spine, which is more likely to give trouble than the rib.

However, this lumbar rib may be associated with the many conditions associated with the thoraco-lumbar junction. A Maigne's syndrome that may refer to the buttock and groin via the Superior Cluneal nerves, a Meralgia paresthetica causing numbness and sometimes pain and tingling on the side of the thigh. And other slips of nerves belonging to the Femoral nerve complex passing to the inguinal and genital areas.

3. Leg length inequality

A short leg may be caused by a leg fracture, but it's also an inheritable feature. It frequently causes a scoliosis, often associated with rib pain.

It's not difficult to imagine how a short leg on your reading left in the case above could cause rib (and spinal) pain.

Thought: Ask your child to bend forwards, knees straight and check the spine. Is there an obvious unlevelling of the back? Even an unskilled person can detect this rib pain cause ...

A shower of sneezes

A violent sneeze, especially if twisted at the time, or getting up from a chair, is a common cause of acute, sometimes very acute, mid back rib pain.

Each rib attaches to the spine via three joints. Subluxation of one of these joints causes very severe, stabbing mid back pain. See the red arrows below. The so-called "sprung rib" in chiropractic jargon. The painful sprung rib is a condition that responds, almost always, very quickly to the the Chiropractic adjustment.


Another of the rib pain causes is trauma to the rib cage. A shoulder charge in rugby, a powerful jerk by your car safety belt that may save your life, but leave you with severely contused ribs...

Another, I confess, is an overly robust mid back manipulation. I admit myself to seven cracked ribs in 33 years, all seven recovered with no sequelae but at the time there was quite severe pain with every breath.

Breastbone pain

A dysfunctional rib, for whatever reason, affects not only the three joints between the rib and the spinal vertebra, but also the joint between the rib and the breastbone.

Breastbone pain, aka Tietzes syndrome comes in four grades, the fourth being a swollen node over the joint. It can be extremely debilitating, lasting for years. If over the left side of the chest, patients often think they are having a heart attack or angina. Hence the term "heart-attack rib".

Trauma to the chest is a common cause such as a fall on the fist whilst skating, but also after mastectomy and breast enlargement surgery.

The first rib

The transitional areas of the spine - headache from the atlanto occipital joint, the lower cervical spine, the thoraco-lumbar juction and the lumbo-sacral areas are the most difficult in the management of the spine.

The first rib - T1 rib - is not unusual in this regard, at the cervico-thoracic junction. 

The base of the so-called "inter scalene triangle" a first rib subluxation is a vital part of many arm pain syndromes. Affecting both the artery to the arm and the nerves, a "thoracic outlet syndrome" is a major cause of the pain and tingling in arms and hands syndromes that face your chiropractor every day.

The frozen shoulder for example, and a carpal tunnel syndrome are frequently associated with a first rib fixation. Dealing with this rib pain cause is what makes Chiropractic very successful in treating the arm pain syndromes.

Medical illness

Whilst it's a lot less common at the Chiropractic Coalface, every chiropractor knows that a case of walking pneumonia, a lung tumour, pancreatic cancer, breast cancer... can cause mid back pain, simulating a rib condition.

Metastases from breast cancer to the ribs... it's important that you report "other" medical conditions to your chiropractor. Taking post-menopausal hormones? Research shows that you can expect dramas in your future health.

Three pecan nuts a day...

keeps the doctor away!

The amazing pecan nut, native to North America, and a member of the hickory family according to Wiki has been well researched with some very promising results.

A few basics

Firstly don't purchase already shelled pecan nuts. You'll eat too many and their very special fat qualities are rapidly oxidised. Rather crack three nuts every morning to go on your muesli or oats.

Yes, nuts are fattening, but listen to this: it's now been proven (research from Loma Lima University and published in the Journal of Nutrition, that pecan nuts eaten five times a week have these proven properties:

  • they will lower your bad LDL cholesterol by about the same amount as Statin drugs with none of the side effects.
  • they raise the good HDL cholesterol.
  • They lower the bad triglycerides.
  • They lower the rate of cardiovascular disease.
  • Eaten with carbohydrate they reduce the "post-prandial" blood sugar levels in diabetics. Lowers in effect the "glycemic index".
  • Are twice as effective as the Step I diet in lowering cholesterol, despite being 30% higher in fat, WITH NO ASSOCIATED WEIGHT GAIN. 

Nutrition contents

There is a paucity of information on the net concerning the contents of three nuts, so I measured out this bowl of nuts. It contains 1kg, and 119 pecan nuts to be precise. Purchase a bag every year. 

Australia reaps 2,800 tons of whole nuts which contain 1,500 tons of flesh, most of which is exported to China. The  Chinese consume 20% of the world's production. When did YOU last crack a pecan nut? They are an important part of the North American heritage.

Using a bit of basic math, 3 whole nuts weigh 25g which contain 13.4g (six pecan halves.)

Three pecan nuts


Protein (g)

Total fat (g)

  • Saturated
  • Monos
  • Polys
  • Cholesterol

Carbs (g)





  • 0,8
  • 5,5
  • 2,9
  • 0


Whilst 93 kcal of energy may concern you, if you're overweight, remember that research shows that folk eating small amounts of pecan nuts regularly did not gain more weight than their counterparts on the Step I diet.

1.2g of vegetable protein isn't really significant, needing about 50-100g per day, depending on who you believe, but every bit of non-animal  protein helps.

Note that the mono unsaturated fats, particularly healthy, are very high, and there's zero cholesterol. That's why the avocado and olive are so healthy, too.

Vitamins and minerals in pecans

I won't add a detailed breakdown of the vitamins in pecan nuts, but they are particularly rich in Thiamine, the muscle vitamin; vitamin E, the fertility and prostate vitamin; folic acid, magnesium and zinc, and phytosterols, all anti-oxidant foodstuffs, read anti-cancer foods.

The high folic acid, magnesium and zinc are probably the reason for the heart protective function, since they are vital for reducing homocysteine in the blood.

For those with prostate problems, the most serious malignant cancer in men, the vitamin E is particularly high in the protective gamma tocopherol fraction. Never swallow pure alpha tocopherol capsules.

"Action springs not from thought, but from a readiness for responsibility."

Dietrich Bonhoeffer

Till next month, then...

Helping you take responsibilty for your own health,

Barrie Lewis DC

PS. Feel free to forward this to family and friends, your chiropractor and even your medical doctor!

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