rib sprain

Posted On: March 6, 2020

One of my favorite things to treat is a postural rib sprain. Younger to middle aged adult patients present with a sharp pain in the middle of their back. It typically gets sharper when they take a deep breath or rotate their thorax towards the side of the pain.

These patients can have a lot of different causes of their pain. I have seen patients who have had cardiac work ups and imaging of their chest to rule out more ominous causes of the pain. Medicine in general is particular and always seeks to rule out more morbid causes of this pain so as not to miss something that may be causing it.

After having seen a lot of these over my career. Most are more painful with deep breathing and trunk rotation. Palpation reveals muscular splinting of the thoracic para-spinals on the symptomatic side. On deeper palpation there is point tenderness over where one the rib joins the thoracic spine. This joint the costo-transverse articulation typically the culprit.

The cool part about this condition is that it responds to a brief intervention with manual mobilization either by a chiropractor or a knowledgeable physical therapist. In fact a lot of manual medicine providers feel so comfortable treating this condition that it obviates the need for more expensive testing.

If all of these patients saw providers versed in this problem the public would save a lot of money. Imaging and more involved testing could be reserved for those that don’t respond or have other comorbidities or abnormal findings on exam (like abnormal auscultation findings over the chest).

Treating these problems is one of the most gratifying areas of practice as people are surprised at how fast this problem resolves.

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