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I have a rib out of place! What do you do?!






Do You Have Ribs Out Of Place?

How do I know if I have a Rib out of place?

This blog is about rib joint restriction or subluxation, a common condition seen in the chiropractic clinic and experienced by many people.   Some people with this condition go to the ER or medical doctor first, thinking they are having a heart attack or a serious condition within the chest. Many people spend thousands of dollars on medical visits, diagnostic tests and pain medications in an effort to resolve rib conditions with no results or appropriate diagnosis.

Rib subluxation can present with symptoms that range from a mild, dull, achy pain to severe, stabbing, sharp pain that becomes more intense with deep breaths, coughing, sneezing or laughing. It may follow an injury or may manifest for seemingly no reason at all...postural stresses may contribute to  or cause symptoms.  Most often, a doctor of chiropractic or medical doctor will diagnose a rib subluxation.

Some quick anatomy:




(Left: The back part of a rib attaches on to the vertebrae at the vertebral body and transverse process of the vertebrae)

(Right: The front of the rib attaches onto the sternum/chest bone or its surrounding cartilage)




All 12 ribs on each side of the body connect to the spine at 3 joints each (1 joint at the transverse process of the lower vertebrae and joints to both the upper and lower vertebrae at the vertebral bodies at the intercostal facet joints). The top 7 ribs are referred to as "true ribs"; they connect in front to the sternum directly through cartilage.  Ribs 8 through 10 are referred to as "false ribs" because they connect to the sternum, indirectly, through interchondral joints (cartilage to cartilage connections).  Ribs 11 and 12 are "floating ribs"; they do not connect in front at all. Women and men have the same number of ribs on both sides of the body; there are no significant gender differences.

All three of the joints between the ribs and the spine are very close to the intervertebral foraminae (openings where nerves exit and enter the spinal cord). Each rib has a nerve that is situated direcly underneath (intercostal nerves). These nerves are responsible for sensations to the skin and innervation to the parietal pleura (the tissue that surrounds the lungs and provides glide between the lungs and rib cage).

Ribs have many muscular attachments to large muscles of the back and shoulder girdle but also have small muscle attachments between them creating intercostal muscles (muscles between the ribs).
Ribs provide stability to the spine, create protection for organs and, while providing more stability, allow for body motion and  expansion and contraction of the chest with breath.

Rib Subluxation/Misalignment/Rib Out of Place

Subluxation  and muscle tension often go hand in hand with both being present.  One can cause the other; though pain and muscle tension may ease or resolve over time, joint restrictions/subluxations, typically, require intervention to restore proper health and motion. When ribs do not move appropriately and/or are out of proper alignment many sensitive tissues in the body may feel irritated and extremely painful. Misaligned ribs can easily put pressure on nerves or the parietal pleura, especially with motion or breathing. 

When a rib pops out of alignment, it can also cause the surrounding muscles and tissues to get inflamed.  When the nerves in between the ribs get inflamed and irritated (often from rib subluxation), it is a condition that is called Intercostal Neuritis or Intercostal Neuralgia.  Additionally, what can happen when the rib comes out of place is the cartilage where the ribs attach to the sternum (or breastbone) get inflamed and irritated which causes the condition "costochondritis", which translates to "inflammation of the rib cartilage". 

How to treat a Subluxated rib?

Rib subluxation can be a very frustrating condition to treat and have heal properly.  The most important thing to do is get your rib ADJUSTED by a chiropractor.   This will keep further damage to the rib from happening and further inflammation from developing.  They can often times take multiple adjustments to properly have the rib set in place, but it is well worth it vs. having a chronic rib issue.  

There are some things that you can do on your own to get the inflammation down which can help a lot wit pain as well.  Here are a few at home things that you can do:

  •  Apply ice over the painful areas in both the front and back for 20 minutes at a time up to once every hour.

  • After getting it adjusted, cardiovascular exercise can sometime be helpful as it can help keep the rib muscles from tightening up, and prevent it from "popping out" again. Please talk to your doctor of chiropractor first about this, and avoid any twisting or bending exercise which can further injure the rib.  Running/brisk walking or exercise on an ellipitical machine can often times be helpful.

  •  Also there are some rib braces that can help with pain that provide some compression for the rib joint and  help the joint stabilize a bit more.  We want the rib muscles to move and stretch out gently, but we want the rib joints in the front and back to be stable.  The rib belt shown below is affordable and can be effective in helping rib injuries heal.
    -Here is the link to the rib brace on Amazon.com
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  • Stretching lightly after the rib has been properly adjusted can help a lot also.  A great stretch to do is have your thumbs down and knuckles at your temples, and press your elbows together (or as close as you can get them) in the front of your chest, hold for 8 seconds, and then reverse the stretch and bring your elbows out to the side (still knuckles at your temples) and gently squeeze the shoulder blades together in the back.


A combination of chiropractic care, stretching and exercises is the most effective method of dealing with rib conditions.

Your doctors at Gallatin Valley Chiropractic provide safe and effective care for rib complaints.  If you are experiencing back pain, rib area pain and/or pain with breathing (especially a deep breath), give Gallatin Valley Chiropractic a call for a consultation, exam and care for your condition.   If you have a condition that is more serious requiring medical intervention please call 911, or the doctors will refer you to the appropriate care provider for your condition. Save yourself money, time and pain by allowing your doctor at Gallatin Valley Chiropractic be your first point of contact for rib and back pain.

Call for an appointment!  406-551-2177

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