Posts Tagged ‘rib pain’

First Rib Dysfunction

Monday, July 6th, 2009

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

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Rib Pain – Costovertebral Joint Pain

Wednesday, July 1st, 2009

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

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