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?

Rib subluxation, or a misaligned rib, is a common condition seen in the chiropractic clinic and experienced by many patients.  Rib subluxations or having a "rib out" can be extremely painful and at times can be so severe it may even mimic symptoms of a heart attack.  We often see people with this condition that first went the ER because they were having sharp and severe chest pains as well as shortness of breath.  Not to downplay these symptoms, as it possibly could be a much more severe condition, but many people spend thousands of dollars on medical visits and diagnostic tests in an effort to resolve rib conditions without ever getting an appropriate diagnosis.

Rib subluxation can present with symptoms that range from a mild dull and achy pain to a severe stabbing and 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.  It may also be associated with 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)



Lets first find out a little bit about the anatomy of ribs and how they function.  There are 12 ribs on each side of the body which 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 8 ribs are referred to as "true ribs"; they connect in front to the sternum directly through cartilage.  Ribs 9 and 10 are referred to as "false ribs" because they connect to the sternum, indirectly, through inter chondral 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 foramina (openings where nerves exit and enter the spinal cord). Each rib has a nerve that is situated directly 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

A rib subluxation often times goes hand in hand with muscle tension.  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. 0438506001706631493.jpg

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". 

There is also a condition known as rib dislocation which is different from rib subluxation.  A dislocated rib has no relationship with the joint that it dislocated from, while subluxated rib still has a relationship with that joint, but it is not aligned properly.  True rib dislocations are almost always result of severe physical trauma such as a car accident and at times can involve the spinal canal directly.  For more on this read: Post-Traumatic thoracic scoliosis with rib head dislocation and inclusion into the spinal canal here

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:0115102001706631521.jpg

  •  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 elliptical machine can often times be helpful.  Check out our blog: What am I doing to cause my ribs to come out of alignment?

  •  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

  • 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.


Are you feeling sore after a rib adjustment?  Check out our blog I feel like my ribs were sore after a chiropractic adjustment blog here.


Call for an appointment!  406-551-2177 or go online to GallatinValleyChiropractic.com

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