Expert: Gerald Anzalone, D.C. - 10/10/2009

Question
QUESTION:
Hello I do quite a lot of weight lifting and just for the past year , I have be getting a sharp pain under the right side of the floating rib, went to a phsio guy and he found a bit that click just where it hurts I feel it mostly when I do running 1st though it was a stich but is sharper.

Have you any idea what it may be ?

And if so do you think there is any treatment for it ?

Thanks


ANSWER: Darren,

Thank you for your question.

In 1975, an Italian medical journal published an article entitled "The painful floating rib syndrome."

The article described a painful syndrome in the front of the chest due to abnormal mobility of a rib that has lost the normal cartilaginous connection with that above it. The syndrome is common enough, though little understood. Deep, continuous, dull and aggravating pain is felt in the bottom of the chest and top of the abdomen. It is relieved by rest and exacerbated by effort and certain postures. One or more ribs on one or both sides may be affected, though the 10th rib is most commonly concerned. The condition may be the direct or indirect result of trauma, or congenital. Abnormal development of the 10th rib may result in its riding over that above it and so causing pain.

Treatment normally consists of pain medication and rest. Strangely, gall bladder abnormalities also seem to be associated with a painful floating rib syndrome.

Anecdotally, many patients with similar symptoms also respond to chiropractic manipulation. As with anything else, results are judged on a case by case basis.

I hope that this helps to answer your question.


---------- FOLLOW-UP ----------

QUESTION:
Hello , I was just wondering is a Orthopaedics specialist the same as a chiropractor ?
And can a Orthopaedics specialist do any thing for it ?
Just causes going to be going to see one soon.

Thanks


Answer
Thank you for your question.

No, an orthopedic surgeon is not the same as a doctor of chiropractic. An orthopedic surgeon specializes in the surgical management of musculoskeletal disorders; a chiropractor specializes in the non-surgical management of musculoskeletal disorders. A physical therapist predominantly is trained to use rehabilitative exercises for the treatment of musculoskeletal disorders.

An orthopedic surgeon might approach a painful rib syndrome by prescribing pain-reducing medication, anti-inflammatories, or in more severe cases, might recommend surgical intervention. A chiropractor would approach this problem from a structural standpoint and would most likely use manipulation techniques to effect a positive change.

As I indicated in my previous response, the causes of painful rib syndromes, especially those concerning the "floating" ribs, or the two lowermost ribs, is not completely understood. Therefore, successful management of this problem depends on an accurate diagnosis. It would be important to differentiate this problem from costochondritis, a painful inflammatory condition of the ribs or the connecting cartilage; costochondritis also produces chest pain.

If your symptoms are truly caused by inflammation of the rib, a combination of manipulation and anti-inflammatory medication might be most helpful.

I hope that this helps to answer your question.