Expert: Dr. J. Shawn Leatherman - 2/5/2009

Question
Hi,

I've recently had some complicated health problems. I am a 35 year old
female and have been in pretty good health until recently. About 5 months
ago I found out that I have quite high blood pressure and then soon after
found out that I have early stages of kidney failure. At the same time I began
to have a lot of chest pain which I have associated mostly with the high blood
pressure and with some acid reflux. I also saw my chiropractor at the same
time and she said that I probably had a rib out of alignment. The pain started
strongly when I did a six day meditation course where we were doing a lot of
"suspending" the breath or basically holding the breath in different patterns.
It has continued over months even though the blood pressure is now under
better control. I have been seeing an Integrative Medicine specialist (one who
is an MD but who practices a lot of naturopathic and alternative medicine) to
balance things out). I am in Hawaii for a little while to do this. I've also been
doing a lot of yoga lately, especially Ashtanga which can be quite vigorous.

The pain is basically a chest tightness and soreness that is pretty constant
and sometimes when I straighten up and tuck in my chin there is a little
"popping" or clicking sound in the upper left chest.

Do you think that this pain could be related to a rib sprain or fracture? Is
there any tests that I should get to determine this?

I am away from my regular doctors for a few weeks more...

Thanks so much,

Ong Kar

Answer
Dear Ong,

I do not think that the rib is fractured.  This sounds more like a joint problem where the rib connects with the sternum or vertebra...as the rib has to connect with both.  This can be very painful due to the joint capsule that surrounds the attachment surfaces.  Some people may refer to this as a rib sprain, however, it is more like a stretching of the joint capsule due to a rib head fixation of position within the joint structure.

So what is the fix...the chiropractor can easily mobilize the joint space and this should significantly reduce pain from the area.  Adjusting this rib articulations can be exquisitely tender though and you should expect some discomfort.  These issues can often be stabilized in just 3-4 adjustments.  You may also need some soft tissue techniques such as massage or stretching to assess tight musculature.

Now you should not need any special testing or imaging to correctly diagnose, address or correct this issue.  The examination is clinical and functional and does not require any advanced diagnostic techniques.

Hope this helps Ong.  Good luck with care.

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