Chiropractors/Ribs: Painful popping

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On the lower right portion of my ribs I tend to get a pressure that builds up. This has probably been going on for a few months the frustrating part is this pressure builds up every day and more than once now, before it only happened once in the blue moon. Each time I get this pressure at the edge of my ribs and close to my sternum I have found that pushing down on that area causes it to pop and thus the pain is relieved. Before that worked and now that only helps for a few seconds. I have also found that leaning down, twisting or movements of my body immediately cause a sharp pain and then it feels like it's burning. The pain just stays there. I have a chiropractic appointment but my question is if you believe this might be "slipping rib syndrome?" What questions should I ask and beware of when I see my chiropracticor?

Answer
Hi Krys,

Yes, this could be a slipping rib syndrome.   Here's a great review article on it:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1150226/pdf/i1062-6050-40-2-120.pdf
First, avoid taking x-rays.    Unless you are looking for a fracture or big tumor or dislocation (e.g. you fell off you ladder), then do not waste your time and money on x-rays.    You chiropractic treatment should focus on the combination of joint manipulation to the thoracic spine and maybe the ribs in an effort to reduce areas that are stiff and/or fixated, and thus improve movement.   The hypothesis is that by improving movement of stiff/stuck regions, it takes the mechanical excess movement away from the rib.   Nobody's proven this, however.  Also, I would recommend that you see a DC that has undergone the Graston Technique program, or, better the FAKTR program (each a .com).    With athletes, I would also use tape procedures to try and take stress off the ribs.   There are a variety of tape procedures available, from the classic PT strapping  tape to the current fashion of proprioceptive tape (see:  www.KTtape.com).     Pressure is one thing, and sharp jags of pain is something else.   If you do not get alleviation within about three to four weeks or 6-12 treatment sessions, with the combination of joint manipulation and thorough soft tissue mobilization (with or without tape), then you might want to consider an MD Physiatrist for consultation regarding injection "blocks" to the rib area.    Some MD's are comfortable with this and some aren't.   Other things that surely don't work to fix this include ice/heat/electric stimulation.   

'Hope this was helpful.

Dr. G

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Scott F. Gillman, DC, DACBSP

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21 Years in practice: I can answer any question regarding chiropractic and sports medicine treatment. Mostly, I can help the unknowing public understand what is safe, valid, reasonable and evidence-based, and what kinds of unscrupulous chiropractors and fraudulent methods to stay away from. I have an advanced specialty degree in Chiropractic Sports Medicine. I have experience treating elite and Olympic athletes.

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