Rib Pain Treatment

Keywords; rib pain treatment, causes of osteoporosis.

Care of the thorax in the chiropractic setting is adapted to the beautiful design of the ribcage. We are indeed fearfully and wonderfully made.

The ribcage was designed to give protection to the vital organs, in particular the heart and lungs. However, compromise was needed to enable us to breathe.

So these organs are surrounded by a cage of bone, interspaced with small gaps filled with rib muscles, and some other structures, nerves and an artery. The ribs have to rise, increasing the space in the chest, drawing fresh air into the lungs, and then drop again as we exhale.

The ribcage

The ribs have a bucket handle configuration, with one joint in the front, with the breastbone, and three joints at the back, with the spine, allowing the ribs to rise and fall rhythmically with breathing.

Not generally well understood, and often poorly managed, breastbone pain can become a monster. Lying close to the breast, if on the left confused with a heart condition, sometimes associated with gastro esophageal reflux disease and heartburn, occasionally a very tender swollen lump may form over the rib breastbone joint. Tietzes syndrome, as it's known, can be extremely debilitating.

Tietze's syndrome responds well to specific chiropractic rib pain treatment but a heavy midback manipulation will worsen the condition.

Rib pain treatment by chiropractors was designed around this beautiful structure. Like anything mechanical, the ribcage too needs maintenance. Both the joints at the front, the costo sternal joints, and the joints at the back, the costo spinal joints, can be injured by freak movements.

An unexpected sneeze, a bout of bronchitis and trauma such as the injury from a seatbelt in an motor vehicle accidents, or a fall on the fist as in skating; all of these can and do injure the ribcage.

Rib subluxations can be exquisitely painful. Every breath may be a nightmare. However, the treatment, correctly done is not usually particularly painful.

Firstly your chiropractor will want to rule out conditions of the chest. For example, pleurisy also causes pain with breathing. So, too, a spinal infection. I've seen only one case in over thirty years, from an epidural, only 1 per 60,000 but it can happen. They key sign was inspiration pain, but bilateral; that was unusual.

For an understanding of the anatomy of the ribcage follow this link. Costosternal anatomy.

Rib pain treatment 

Your chiropractor will likely use one of a number of loosening up techniques prior to manipulation. This could be massage, or a vibrator, or stretching, or a mobilising technique.

"The Sprung Rib"

    Each rib has three small joints which articulate with the spine. A good sneeze, primarily, but any unexpected movement too, can subluxate one of these joints causing extreme sharp pain. It is characterised by pain whilst taking a deep breath.

    The chiropractic rib treatment is likely going to be a gentle thrust straight onto your back, whilst you are lying on your tum. Often the whole area, and your chiropractor will need feedback from you, making sure that s/he is on the correct rib.

The risks associated with rib pain treatment


If you know you have brittle bones, it is important to warn your chiropractor. Most chiropractors will crack a rib occasionally on an osteoporotic patient. It is a risk, but greatly outweighed by the enormous relief millions get from chiropractic care from rib conditions, for every cracked rib. It is painful, and will remain so for a few weeks. You can expect a red faced doctor and a vase of flowers.

Fifty rib adjustments per week times 50 weeks equals 2500 adjustments per year.

One cracked rib every six years is my record. That's one in every fifteen thousand treatments. Seventy cracked ribs per million rib adjustments. That is very safe, much safer that taking pills for example, and a lot more effective for a subluxated rib, but indeed not perfectly safe. And if it was your rib, one cracked rib too many.

Thinking back, every one of those broken ribs should not have happened. After the fact, I could have, and should have done it differently. But it's a self limiting condition; really painful for a few days, then sore for a few weeks, with no long term sequelae.

None of them sued; all could have permanently put me out of business.

Doctors work under incredible pressure. Think twice before suing your doctor, remembering that there's a very fine line between a genuine mistake of judgement and neglect. You may feel vindicated, and receive your pound of flesh, but thousands of others will lose their doctor of choice. I know personally several doctors, medical and chiropractors, who have left the healing professions after being sued.

I treat at least ten patients in their eighties every week, yet continue to hear that medical doctors tell their patients that chiropractic treatment is far too dangerous for elderly bones. Bunkum, but we are careful, and gentle with the elderly. But, yes, iatrogenic illness does occur in chiropractic clinics too.

Iatrogenic illness is not unimportant in that whllst the pain of a cracked rib, by a chiropractor, can be severe, it's self limiting, and the patient recovers completely within a few weeks.

Causes of osteoporosis

Our causes of osteoporosis is the most important page in my opinion at this chiropractic help site. Make sure you read it if you're a young woman. Prevention alas attracts little attention and the page doesn't get too many clicks. It's hard to focus on osteoporosis at thirty five, I guess, but if you realised how important it is to prevent, and what suffering it causes, you might think again. 

Rib Pain Treatment

Pooh needs an adjustment too! He gets the sneezles in the Spring, and sometimes it can spring a rib!


The good wife has had a cold for a few days. Yesterday she sneezed while twisted and within an hour was in severe pain between the shoulder blades. Every breath brought her close to tears, a sharp, stabbing, knife like pain. It was so bad that she was unable to lower herself to the chair to eat lunch. She ate standing up.

Unable to get into the car, we walked with difficulty to the clinic, about ten minutes away. What a joy, it takes me literally two minutes on the bike normally.

Isolating the rib was not difficult, the seventh on the right; it was exquisitely tender on palpation. She had significant immediate relief from my chiropractic rib treatment, and we walked home quite normally, and she slept well last night. It will take a few days and a couple more days to get over it completely.

The rib adjustment, artfully done, isn't usually painfully despite the extreme pain of the condition.

I was given the task of making her favourite dish; an easy soup recipe at our broccoli facts page; see lower down. Did you know this brassica, as they are called, is the number one anti cancer vegetable, and has the double bonus of being very rich in magnesium, a deficiency of which causes chondro calcinosis, a leading cause of arthritis.

Every garden should have a few plants, and don't pull them when the head has been picked. The small florets that continue to come are even richer in those goodies; perfect for broccoli soup. Healthy eating is a vital part of chiropractic help. After all, if you don't look after your body, where are you going to live?

Now that we are retired in sunny South Africa, growing broccoli is high on the agenda; it's such an easy vegetable and goes on for months producing those small florets.

Breast cancer has a nasty habit of metastasizing to the ribs. If you have rib pain then it's very important to tell your doctor. He should ask of course, but these things slip through sometimes.

"Heart-attack rib"

Rib pain occurs sometimes at the junction of the rib and sternum (breastbone). Right over the heart so, if it's on the left, the pain may be confused with a heart attack. The key: tenderness over the breastbone, and its joints with the ribs. This condition is called the Tietzes Syndrome. If the subluxation is of the breastbone joint, then your Chiropractor will use a technique where the hands travel all along the rib, from back to front. His hands may lie close to the breast tissue, so if you feel uncomfortable bring a family member with you.

Rib pain treatment is not usually particularly painful.

Your chiropractor may also use a treatment where s/he stands over you whilst you are lying down, (or behind you whilst you are sitting or standing), giving a sudden vigorous thrust on your back.


'Doctor, what did you do to me last week?'

'What do you means, Mrs Jones?'

'I've had such pain here in my side. Every breath hurts!'

'Oh dear, I may have cracked a rib, Mrs Jones. Let me examine it ... yes, I'm sorry to say, I have done you a mischief.'

'Cracked a rib! How long will it be sore?'

'About three weeks. I'm sorry. I must have been a little too vigorous!'

'Will it remain weak?'

'Absolutely not. Within 3-6 weeks, the time it takes for bone to heal, the pain will be completely gone. It will be as strong as ever.'

'Should I sue you?' said Mrs Jones, with a laugh.

'You could, but then you will lose your chiropractor! Remember how many times over the years you have crawled into this office on hands and knees!'

'But it's so sore.'

'I'm afraid so. You are third person in twenty-seven years in practice. I'm sorry it had to be you. It will get better with no sequelae.'

'Now don't go using the long words again ...'

A bouquet of flowers arrived the following day at Mrs Jones's address! It happens with rib pain treatment. Three times in the 27 years. "Helaas", as we say in Dutch.


A traumatic fall not only damages the bicycle but can also bend the cyclist's chassis. Whilst bruised and even cracked and broken ribs will heal, usually without great dramas, the simultaneous injury to the rib-spine and rib-breastbone joints can continue for months and years. Read more... Chiropractic RIB PAIN TREATMENT CaseFile ...


aka Thoracic Outlet Syndrome

The artery to the arm, and the nerves pass through a narrow space in the neck known as the Inter Scalene Triangle - a triangle made up of two Scalene muscles and the first rib.

Whilst very occasionally something really serious (like a lung tumour) can invade this space, the usual cause of irritation of the artery and nerves is either a first rib subluxation, or Scalene muscle spasm. Often they occur together.

It is the underlying cause of many of the arm pain conditions faced at the Chiropractic Coalface. Frozen shoulder, Carpal tunnel syndrome and the like.


The neck vertebrae are not supposed to have ribs, but 2/1000 people may have a cervical rib. Usually they are small and of little consequence, but very occasionally a monster occurs. Read more here at this cervical rib casefile.

The result as the rib invades the "thoracic outlet" is pain and tingling in arms and hands ...

INTERESTING LINKS @ Rib Pain Treatment

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Interesting challenges of the day

1. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks she was 75 percent improved; no longer vomiting or falling. She's not enjoying the Brandt Daroff home exercises.

2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

4. Mrs V too has two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

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. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.

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.

Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?

Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.