Ribs 1-10 attach to the spine at the costovertebral joints.  The head of the rib articulates with the spine and is surrounded by a joint capsule.  The outer layer of the capsule is strong and fibrous and acts to limit movement.  The joint is further reinforced by a series of ligaments.  The capsule contains synovial fluid that nourishes and lubricates the small flat joint surfaces.  Each of these joints permits movement allowing the ribs to rise and fall as we breath, and accommodate small movements as we perform other activities.  Pain occurs as a result of a sudden traumatic movement or long term repetitive strain that cause a restriction of normal movement or and a displacement (subluxation).

Symptoms

• Costovertebral dysfunction causes pain local adjacent to the spine that may radiate (spread) into the arm and front of the chest.
• If the intercostals nerve is impinged a sharp pain can radiate in the space between adjacent ribs (intercostal space) from the back all the way round to the front of the body.
• One rib may be felt to be more prominent than the others
• Pain is aggravated by
  • Breathing
  • Rotation of the trunk (sometimes)
  • Movements of the arm (sometimes)

What you can do

• Rest
• Ice therapy to reduce inflammation in affected joint
• Heat therapy to reduce muscle spasm
• Anti-inflammatory medication as directed by doctor or pharmacist

What we can do

• Manipulation of affected ribs to put it back in place and restore normal movement
• Stretching of affected ribs to restore normal movement
• Massage of intercostals muscles to reduce muscle spasm
• Reducing mechanical loading on affected rib by
  • Improving movement and flexibility in adjacent areas
  • Improving posture and body alignment

Tags: back pain, mid back pain, rib pain