Ribs and the assorted soft tissues
that surround them can be a source of a variety of different types of pain and
A rib sprain is usually described
as a sharp, stabbing pain in the back or chest. Frequently this pain is greater
when taking a breath.
As other structures become involved
there can also be pain that radiates down an arm. People are often rushed to
hospital thinking something very serious has happened to their heart.
If you have had a fall and actually
sustained a fracture, it is easy to understand and accept why the pain is
there. However, injury to the rib joints often does not appear to be related to
any major trauma.
In fact, the most common presentation
is that someone wakes up with sharp pain in the back of the shoulder area. Sometimes
it is caused by an awkward sleeping position or something that happened the day
before but was too mild to cause significant pain right away.
Many ‘kinks’ in the neck are really
sprains affecting the upper ribs, which are at the base of the neck.
Each rib connects to the body of
the vertebra 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 breastbone (sternum) along the course
of the rib. This inflamed rib nerve will cause pain (intercostals neuritis)
that travels along the course of the rib from the back to the chest.
All of these tissues can be damaged
by a rib injury.
Frequently, the joint between the
rib and the breast bone is also affected with this injury. The cartilage in the
chest becomes inflamed leading to pain in the chest. Medical textbooks describe
this as costochondritis. It literally means inflammation of the rib cartilage.
A disc herniation in the thoracic
spine can also cause back pain with nerve pain that radiates to the chest.
However, the ribs provide a tremendous amount of support to the spine. As a
result, it is very rare to suffer a disc herniation in those parts of the spine
where we have ribs (thoracic spine).
Sometimes, arm and shoulder pain is
caused by a rib problem. Full shoulder movement requires the shoulder blade to
glide over the ribs. A rib sprain can cause restricted shoulder blade mobility
with pain on shoulder movements. Over time, the altered shoulder movements can
lead to rotator cuff injuries and other shoulder issues.
Some of the neck muscles attach
into the upper three ribs, which are at shoulder height. Upper rib injury and
associated muscle spasm can have a huge affect on the cervical spine.
This can cause neck pain and loss
of neck mobility creating a ‘kink’. The muscle spasm can further impair the
blood flow and irritate the nerves travelling down the arm causing numbness in
the arm and hand.
Chronic rib pain and rib dysfunction
For some people, the pain of a rib
sprain can become an ongoing problem. In such a situation, this injury can be a
source of great frustration. Usually, there is a history of a number of rib
sprain incidents treated with a variety of pain medications, anti-inflammatory
and muscle relaxants.
Over time the repetitive spraining
of the joint leads to a biomechanical issue: rib dysfunction, a term used by
chiropractors to describe a mechanical problem affecting the joint between the
rib and the thoracic spine.
Rather than the joint being
sprained, it has lost the ability to move correctly. Rib dysfunction is a loss
of the proper biomechanics of the joint. There is a loss of the normal smooth
gliding motion of the joint leading to jamming of the joint and pain.
The pain may be so severe that you
can hardly breathe and sleeping may be next to impossible.
The surrounding muscles go into
spasm and become very tender. Usually, the pain is localised to the affected
rib and is described as sharp or stabbing, which is aggravated by movement and
There are many possible risk
factors for developing chronic rib pain, such as:
hunched posture, poor thoracic core
muscles, sedentary occupations, women with large breasts, people who carry
loads for prolonged times, and scoliosis of the mid-back.
There is a very long list of
medical conditions that can cause chest pain other than angina and rib
The most common medical conditions
with chest pain include pleurisy (inflammation of the lining of the lungs),
fractured rib, infection of a rib, rheumatoid arthritis, tuberculosis, and lung
cancer. For this reason it is important to not to ignore your chest wall pain,
but to seek out a diagnosis from a health professional.