Expert: Dr. Victor Dolan, DC, DACBSP - 4/25/2009

Question
I have been receiving treatment from a resected chiropractor for sciatic pain. On my fourth visit after some improvement from prior sessions, the doctor did some agressive adjustments using the drop table.  When I left the clinic, I felt some pain in the bottom rib on the right side.  It has become much worse over the next 36 hours. Could the adjustment have cracked or dislodged a rib?  What should I do?

Answer
Rib injury



Hello Randy,

Sorry to hear of your pain, possible rib problem.

"....resected chiropractor ...."; I do not know what a resected chiropractor is.  I do not think it has much bearing on the question,
but if it does- please re-contact me here at AllExperts.com

"....I  felt some pain in the bottom rib on the right side.  It has become much worse over the next 36 hours. ....", pain after an adjustment is unusual, pain growing worse after any treatment requires investigation.  

You should return to this Doctor, explain the situation, and get adequate answers.  Certainly an Xray of the area of complaint should be performed.

Adverse events associated with Chiropractic Adjustment is rare.  However, if an injury occurs- a common one is fracturing a rib.
A crack in the rib is usually a self-limiting, self healing situation.
Years ago they used to tape, brace, support a fractured rib.  This was found to be counterproductive- sometimes resulting in pneumonia from the treatment (not the cracked rib).  Rib fractures that are not also dislocated or malaligned are now left alone to heal on their own.
So- you should return for an examination.  Examination should reveal IF there is a fracture/ dislocation/ malalignment/ sprain/ strain/ bruise; or if it just 'soreness' after  "....some agressive adjustments using the drop table".

If you have a fracture, nondisplaced; it will take several weeks to heal on its own (possibility).

If you have a fracture, displaced; a visit to an orthopedist would be in order to re-place the misalignment (not likely necessary).

If you have a rib head mal-aligned, the DC should be able to re-place it.

If it is sprained/ strained/ bruised/ sore; it will take a little time to heal, and I would certainly avoid that aggressive a treatment in the future.

Fractured ribs can occur from a Chiropractic adjustment.  It is possible.  

Soreness can occur with a Chiropractic Adjustment, it is possible and much more common then any significant adverse event.

I would  return to the doctor, get an exam, have an Xray, and then treat as indicated.

I know you are in pain- first thing to do is to evaluate that pain, get to the cause of it.

I know you are in pain- and platitudes will not comfort you.  This does not happen too often in chiropractic, but a fractured rib (of all chiropractic adverse events, a fractured rib is a more common one).  There was a bizarre but true 'joke' in chiropractic school:  Medical doctors bury their mistakes- there is no one around to complain;  Chiropractic doctors make people sore- and there are people left to complain.

If you do not feel comfortable returning to your initial Doctor, I still recommend going to some Doctor, some licensed health professional to evaluate (and probably Xray) your area of complaint.
There may be nothing to do (no treatment other then time), but you want to make sure it is not more complicated then that.

I think I would return to the initial doctor, complain, get an Xray, and definitely get treated a different way.

I hope this helps-
do not hesitate to re-contact me here at AllExperts.com:
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

Good Luck


Dr. Victor Dolan, DC, DACBSP
http://drvictordolan.chiroweb.com