The first rib is located at the base of the neck.  It does not move much during normal breathing but when breathing heavily the movement is marked.  The bone serves as an attachment for many muscles including the scalene muscles that run down from the side of the neck and the pectoral and subclavius muscle from below.  It plays an important role in the transfer and dissipation of forces from numerous other structures.   First rib dysfunction is most common amongst people with

• Existing thoracic outlet syndrome
• Respiratory conditions
• Postural deformity including “dowager’s hump”

The first rib may be injured during pulling injuries incurred for example whilst raking, hoeing or sweeping.

First Rib Sydnrome Symptoms

• Shoulder and neck pain at the base of the neck aggravated by deep breathing
• Shoulder and neck pain aggravated by lateral flexion away from painful side (dropping ear to shoulder) and rotation towards affected side
• Shoulder pain and dysfunction
• Thoracic outlet syndrome
• Symptoms in face – small pupil, drooping eyelid, and reduced sweating on one side of the face

First Rib Syndrome Treatment

• Osteopathic manipulation of 1st rib to restore its normal movement and position
• Massage and stretching to rebalance forces acting on 1st rib to prevent reoccurrence of problem
• Assessment and advice on breathing patterns
• Assessment and treatment of postural deformity contributing to dysfunction

Tags: neck injury, neck pain, rib pain