Rib Pain is often particularly nasty and can be extremely disruptive.
Your ribs attach to your middle back (thoracic spine) and at the front at the breast-bone (sternum). The thoracic spine is made up of 12 thoracic vertebrae with 12 ribs on each side.
Each rib has two joints at the back connecting to the spine and the top seven ribs have a joint at the front attaching to the breast-bone (sternum). The last two ribs do not attach to anything at the front and are called “floating ribs”.
All ribs connect to the body of the vertebra and to a bone on the side of the vertebrae called the transverse process, and sometimes to the disks. The joints are stabilised by ligaments and muscles. There are muscles found between the ribs and there are many muscles overlaying the ribs. There is also a nerve between each rib, which extends from the spine to the sternum along the course of the rib. All of these tissues can be damaged by a rib injury.
Rib pain has been given many names, costochondritis, intercostal neuritis, inter-costal muscle injury or costo-transverse sprain to mention a few.
Chronic, longstanding Rib Pain
In most cases rib pain can be corrected with swift diagnosis and treatment. However, for some people the pain can become recurring and ongoing, and for these people the problem can be a source of great frustration. Sometimes, when we see them they have often had a number of chronic pain interventions such as long term anti-inflammatories and painkillers, spinal facet and rib joint injections (cortico-steroids), which often gives only short-term relief.
People who have had rib pain for a long time there are other indicators such as a slouched posture with forward drawn shoulders. In our experience we often find that the pain is located at the apex of the curvature of the mid back (kyphosis) or if you have a scoliosis. It makes sense for us since that is the point under most load and strain, making the muscles fatigue resulting in chronic strain of the supporting ligaments. This is often seen in people who are generally unfit with:
- poor thoracic core muscles
- increased thoracic curvature (kyphosis)
- sedentary occupations
- women with large breasts
- people who carry loads for prolonged times
To help these patients in the long term, apart from treating the underlying spinal problem with specific mobilisation and manipulation, it is extremely important to address the postural problem and core muscle weakness.
Our Physiotherapy team are very experienced at accurately treating rib and thoracic spine pain, give them a call today to fight your pain and ensure best possible future management.