Expert: Scott F. Gillman, DC, DACBSP - 3/24/2009

Question
I went to a chiropractor for two mildly herniated discs.  After about the second adjustment I noticed a strong sense of what felt like a tightened muscle just under my left shoulder blade.  Now after about the 3rd week of adjustments there is a pronounced pain whenever I inhale deeply where the rib meets my spine.  It feels like there's something jabbing into my lung.  But the bold pronounced pain goes away if I don't inhale deeply.  I am then left with a dull ache in the general region.  I think it's a huge knot in my muscle that seems to be constantly contracting.  He's tried to adjust the rib area, and treat the swelling and inflamation.

So my question is two fold.  

1. Am I dealing with a subluxed rib, and is he treating it properly.

2. Did his adjustments directly lead to the subluxation, or was it through the course of treatment and spinal/muscular reallignment that lead to the rib problem.

Answer
John,

If you are talking about herniated cervical discs, then please note that the herniated cervical disc, especially C6 (more than C5 or C7) will refer pain to the inside border of the shoulder blade and under the shoulder blade and ribs...  Many have been duped into thinking they have a muscle pull in their back or popped out rib when, in fact, they have a herniated cervical disc.  The chiropractor should know this.  Is there really swelling in the ribs?  Or does it just feel like swelling?   People with angina of the heart will also swear they have shoulder pain, when, in fact, it's their heart... just to give you another example of how pain is referred and how the brain perceives pain...   I bet your rib pain is referred pain from a cervical disc.  If he is manually adjusting the cervical spine, it is possible to further irritate the disc (just as much as it is possible to improve the area). If the adjustments are irritating the disc, he must stop.   If you bend your head to the rib side and extend it back, and it caused rib pain, then it's your neck causing the rib pain...

'Hope this helps.

Dr.G