Expert: Dr. J. Shawn Leatherman - 10/28/2006

Question
hi my ribs on my left side have been out of place for at least a year. i dont experience too much pain but when i do, it is just a very small cramp feeling in my ribs for less than a second and it varies where the pain is. if i feel my ribs, starting from the collar bone down, the ribs start to kind of cave inward about mid way. I have gone to my chiropractor consistently and really dont experience too much pain. my question is will my ribs ever go back to their normal position? they seem to just stay in the same spot no matter how frequently i go for treatment and it really bugs me. and if they will, what is the most effective way of moving them to the normal position? is there a certain type of specialist i should see that would give me better treatment than a chiropractor? thank you very much

Answer
Dear Nick,

Although technically your ribs cannot be out of place, that is called a dislocation, I understand what you mean...you have dysfunction within the normal function of the joint space.  You are seeing the right type of professional for the problem you have described, as chiropractors typically deal with these types of dysfunction.

Conversely, the fact that you say the ribs start to cave in about half way down the spine, does prompt me to ask a few questions.  Were you involved in a trauma?  Do you have a previous skeletal deformity in the rib cage?  There is a condition called PECTUS EXCAVATUM where the rib cage caves in, but this is congenital and is on the front of the body as you described?  If so, this problem will never get better from a structural standpoint and can only be treated to allow for joint biomechanics and pallative measures, unless you consider a surgical proceedure to correct the deformity.  Most of the time pectus excavatum has no symptoms unless it is beginning to progress.  If so you may experience minor discomfort, minor pain, decreased ability to take deep breaths, and ultimately a reduction in the amount of physical activity that you may be able to handle.

I would explore this diagnosis on the internet, there are a multitude of sites with information about it.  Just search on yahoo or google.  If this is the case, monitor it for any progress.  Many general practitioners will tell you that it is a benign condition and only has cosmetic implications, but orthopedic surgeons know better...they are the ones who surgically repair these types of problems when they become problematic.

Hope this helps Nick, after reviewing the information, you may want to get an Orthopedists opinion on your case.  If it is non-progressive then chiropractic is a good way to maintain the joint mechnics involved.