Burning and pain down neck and arms, slipped ribs. Please help!

by Melissa
(Hammondsport, NY)

I was diagnosed with bi-lateral slipping rib, where the 10th rib goes up under the 9th. The only part that slips is the cartilage. I have had condition for 18 months. My worst pain was a constant dull pain in abdominal muscles next to ribs slipping point. After a few months of not being diagnosed, I began having upper trapezius pain, then neck and upper chest pain. I feel a tight band sensation under my collarbone that wraps around chest. I have more recently been getting burning upper arm pain, and burning near armpits. I get tingling in ring and pinky fingers on both sides. I see a chiropractor weekly, and feel it's helpful, but the ribs slide in and out all day. My MRI shows a herniated disc at T8-T9 and mild kyphosis. I also have a slight right sided turn to upper thoracic spine. I have the most pain on the right side of my body.

I have a constant need to pop my back at bra strap level and it always pops. But, then I feel the need to do it again minutes later. It took 25 doctors to get a diagnosis, and finally saw a thoracic surgeon. He said surgery is the only option to fix, but only a 50/50 chance of improvement or not injuring something else. He has never performed this operation before. Pain management will not see me because he gave a steroid/lidocaine injection into my abdominal pain point, and the pain was back 2 days later.

I would love to have some feedback, as apparently this is very rare. Do you think surgery is the only fix? I also do physical therapy weekly, the e-stim brings some relief. I have used heat, ice, dry needling, trigger point injections, and possibly every anti-inflammatory known to man. I also feel the need to push at sternum level to get more relief. Riding in a car is the worst. I have tried a rib belt, and got pneumonia, and sternum pain. KT tape is good, but I don't know if I'm doing it right. It seems to me that this injury can never heal with the rib not being in the place to connect to the cartilage. It mainly stays up under the ninth rib, and pops in and out with most activities. The collarbone pain and burning and trapezius pain are my worst pain right now, probably 7 out of 10 most of the day. Abdominal pain has settled to a 3 out of 10, which is improved. I also have developed a persistent shortness of breath only upon inhalation, where I can't take a full breath unless I lay flat on my back or a rubber roller at bra strap level. The day I hurt the rib, twisting while dancing, I started experiencing a constant need to belch, and some other GI complaints, gurgling and motility changes. I am 39, very healthy and no other issues. I am 66 inches and 115 lbs. I have 6 children and the injury happened while I was still breastfeeding number 6 baby. I would love any thoughts on exercise, or any thoughts that you could offer. Thanks so much!

Hello Melissa,
This is very trying I can see. Let's take these symptoms one at a time.

1. Abdominal pain. This is possibly due to medication you have been taking; do keep an eye on your stools; any sign of blackness is ominous and warrants an immediate consultation with your doctor. Has a diagnosis been made of the abdominal pain? My best shot at this is to start taking a probiotic. You can get it in pill form, but my recommendation is typing 'kefir benefits' into the search function on your left; then you can make it in your own home. It's very simple and the best source of calcium; 6 pregnancies will have sucked it out of you!

2. Constant need to pop your back. Unfortunately cracking your own back has made the joint even more unstable. Things will never improve until you stop doing that; very hard I know, but I'm serious. I recommend no more that 25 adjustments of a joint in a year, and you are probably doing that in a week.

3. I'm not sure about the disc herniation, uncommon, but sometimes surgery is the only solution when you've tried all else.

4. Breathing pain. Every time we take in a breath the ribs have to move to increase the volume of the lungs; it often goes with this condition.

5. Collar bone and trapezius pain, and tingling in C8 dermatome. Does the tingling increase or decrease when you raise your hand above your head, as in hanging the washing?

Run your fingers down the joints of the sternum, beginning with the sterno-clavicular. Are any of them particularly tender, and is there a little palpable swelling or lump? Go to our page on Tietze's syndrome, if you find a lump.

In short, I'm not sure and unable to examine you, it's really difficult putting my oar in; I hope the above contributes.

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 have left alone. After seven treatments his pain and stiffness is 50 percent better, and he is 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 is 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 pain-free. 

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 is well pleased; sixty-five percent better after three treatments.

5. Mr T is a wise man; he has 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 stroll 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; he has a short leg.

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. X-rays 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 few months 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 is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year 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 could not 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 should not be treating the elderly most medical sites state but that is so much bunkum.

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