Chiropractors/rib pain

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Expert: Dr. J. Shawn Leatherman - 7/7/2008


Question
Dr:  After receiving an adjustment from my chiropractor, I immediately felt horrible rib pain on my left side under my breast.  It hurt terribly for about a week. After icing it for the next week, it felt better.  Then, a few weeks later, my chiropractor was not in the office, and his replacement did the same thing to me involving the same rib level, but on the right side of my sternum.  This was originally explained to me that I must have previously injured it and the adjustment to it caused this pain.  Is this true?  Deep in my gut, I find this hard to believe, since I have never injured my ribs before.
Thank you for your answer.

Answer
Dear Peggy,

Increased pain, even fracture, especially in the ribs after an adjustment is something that should have been included in your informed consent document.  All forms of care have associated risks, even chiropractic care.  

Vertebral adjustments to the mid back (thoracic spine) can affect the joint spaces of the rib and the vertebra and be responsible for localized rib pain or referred pain along the course of the rib.  Rib fractures, although very rare, can be a consequence of a forceful thoracic adjustment.  I have to admit that I have hurt a patient's rib before with a thoracic adjustment, however, these cases are usually not a big deal and are only due to increased inflammation around the joint space, the nerve root, or a bruise of the periosteum (outer covering of the bones) of the rib itself.

What I would do in your case is express your concern over the issue to your treating doctor as well as the fill in doctor.  I am sure that they did not mean to cause you any discomfort, but they need to be made aware that you are concerned about this and do not wish for it to occur again.  Adjustment techniques can be altered to lessen the amount of force utilized and this should reduce the likelihood of recurrence.  Your doctor should have owned up to the fact that he could have created a problem while treating you and then proceeded in correcting the issue.  I think that blaming it on a previous injury is just passing the buck.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net

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Dr. J. Shawn Leatherman

Expertise

I can answer questions on general chiropractic care, sports injury, whiplash and auto crash, mild traumatic brain injury, structural and functional rehabilitation of the spine, nutrition for inflammation and repair, fitness training, nutrition for sports performance and other general health and nutrition related inquiries. I currently lecture on automobile trauma, occupant kinematics, and forensic risk analysis to local EMS, Fire and Police, as well as nutrition and sports injury to community groups. Rest assured all answers are generated from my clinical experience, and scientific research.

Experience

I have accumulated over 1100 hours of post-doctoral training to include; Certifications in Spinal Trauma and Mild Traumatic Brain Injury from the Spine Research Institute of San Diego, Certification in Chiropractic Spinal Trauma from the International Chiropractic Association, Certification in Low Speed Auto Crash Reconstruction and Certification in Forensic Risk Analysis from The Center for Research Into Automotive Safety and Health, Certified Proficiency in spinal and extremity diagnostic procedures from The Motion Palpation Institute, Certified in Sports Injury and Rehabilitation from the National University of Health Sciences and The American Chiropractic Board of Sports Physicians, Nationally Certified Fellow of Structural Rehabilitation from The Chiropractic Biophysics Organization, and I have advanced training in manipulation under anesthesia and nutrition. Feel free to check out my website for course listings: www.suncoasthealthcare.net

Organizations
International Chiropractic Association, Florida Chiropractic Association, American Chiropractic Board of Sports Physicians, American Academy of Pain Management, Chiropractic Biophysics, Spine Research Institute of San Diego, Center for Research Into Automotive Safety and Health, Motion Palpation Organization, American Academy of Manual and Physical Medicine, Fort Walton Beach Chamber of Commerce

Education/Credentials
B.A. (Psychology)The University of Cincinnati B.S. (Human Biology)Cleveland Chiropractic College D.C. (Doctor of Chiropractic) Cleveland Chiropractic College C.C.S.T. (Certification in Chiropractic Spinal Trauma)The International Chiropractic Association C.C.S.P. (Certified Chiropractic Sports Physician)The American Chiropractic Board of Sports Physicians. *CCST and CCSP 120 hour certification courses are not recognized by the Florida Chiropractic Board due to the fact that they are not 300 hour diplomate level courses*

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