back rib subluxation (at height of shoulder blades)

My 92-year-old mother has for 10 years experienced problems with intermittent rapid heartbeat, breathlessness, exhaustion and poor sleep.

Eight years ago she had a heart valve replacement but since then there has been little improvement.

The most specific symptom is immediate exhaustion when doing anything that involves lifting her hands above her shoulders. Her heart begins to pound and she has to lie down for hours to recover. She had a complete heart work-up a few months ago and the cardiologist said there's nothing wrong with her heart (though his comments suggest that he is the sort of doctor who believes the elderly should just learn to accept the limitations of old age -- and to be fair, he may have just been trying to read what he thought my mother wanted. In the past, for example, when she expressed fears of heart surgery, he would say he didn't blame her and he certainly wouldn't want to undergo something so dangerous, better to just live with the limitations, etc.).

A few weeks ago another doctor listened to her symptoms, felt her back, found a sore spot when he pressed on either side of her spine at about the height of her shoulder blades. He recommended that she see a chiropractor who could probably fix the problem in one or two visits. After her first treatment she had an immediate improvement. She was able to make beds, dust the whole house, walk a few hundred feet to the corner of her street -- all of which have been close to impossible without hours of resting after each little task.

A week later she had a second treatment as the chiropractor who had worked on only one side of the spine and she wanted her to do the other side. That was on a Tuesday. When I next spoke to her, I learned that by the following Saturday she had completely relapsed and was back to the exhaustion, rapid heartbeat, inability to do anything, etc.

She now doesn't want to have any further treatment whereas before she was willing to consider the possibility of regular massage and/or of further chiro. treatment. She feels the problem is her heart although the cardiologist told her nothing is wrong. She believes he was just trying to protect her from the truth about her condition.

My question is can a rib subluxation cause rapid heartbeat. I have found many articles on the internet indicating that all of her other symptoms are consistent with rib subluxation but nothing specifically related to heartbeat.

The answer to your main question, is that, no, I don't think a rib subluxation can affect the heart rhythm and rate, but pain does strange things.

Secondly, it seems clear that both her cardiologist and chiropractor were correct. The treatment obviously addressed the cause of her symptoms.

Thirdly, it's clear that the relapse had nothing to do with the second treatment. If it was it would have started sooner.

And lastly, after such a long period of pain and disability to jump back into the deep end, making beds and dusting the whole house was clearly foolish. And I would say that if she was 62!

To a degree I would agree entirely with the cardiologist. At 92 one must accept there are some limitations. But this is clearly treatable but to expect an eight year old problem to resolve after chiropractic treatments is obviously absurd.

Deal gently with Mum, but get her back to her chiropractor. She's obviously doing a great job. And then make sure that she keeps to the shallows. And no raising her hands above her head for a period, and perhaps for the rest of her life. It puts her into spine into extension and closes down the interscalene triangle, cutting off the blood and nerve supply to the arms.

Good luck. It's a wonderful achievement to reach your nineties, but it comes with its problems!

Dr B

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

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