Ask any chiropractor or doctor, and they will tell you that rib problems are pervasive in their clinics. Top of the list is rib dislocation. Anyone who has suffered a rib dislocation can attest to how painful it can be. Breathing can be excruciating, and so can laughing and any slight movement. But how exactly does a dislocated rib come about, and how is it diagnosed? Additionally, what are the possible treatments and preventative options? In this article, we will offer you insights into the condition.
Several reasons can result in rib dislocation. The cause may be elementary for some people, like performing daily activities, e.g., loading the dishwasher. Other complexities may also result in rib dislocation, but the prevalent causes are;
- Injury or trauma: Rib dislocation can occur due to a high impact on the rib cage. Athletes and people who engage in contact sports like wrestling, football, and gymnastics are prone to rib dislocation.
- Heredity: Those born with loose ligaments are prone to injury. Additionally to the muscles in the ribcage, ligaments also offer support. Those born with loser ribcage ligaments are susceptible to rib dislocation.
- Medical conditions: Conditions like asthma and bronchitis make one more susceptible to rib dislocation because of the weakened muscle state.
- Extreme or persistent coughing or sneezing: Whether due to a common cold or condition like pneumonia, severe coughs or sneezes can strain the ribcage, causing a rib to dislocate. Sneezing very hard can also cause a rib to dislocate.
- Exercise: For a person who works out and has an improper or poor form, if they excessively exercise with the arms extended to the front, the ribs can move out of place, especially where weights are involved. The muscles used may be unable to handle extra movement and weight combination.
- Excessive vomiting: Even though vomiting does not typically involve the lungs, its convulsive action may make a rib “pop.”
- Poor posture: Improper posture can put stress on one’s body, including the spine. This can add pressure on the posterior ribcage, which may cause a rib to dislocate with time.
- Pregnancy: Towards the end of a woman’s pregnancy, her weight mainly shifts to the front. Where it causes a continuous downward pull of the rib cage, it increases the risk of dislocation.
The symptoms may depend on how the rib dislocates. The main symptom will usually be a pain within the chest area or the back. The pain is sharp and intense and increases with breathing. The pain suffered is due to nerve and muscle irritation caused by abnormal rib movement. Other common symptoms include;
- Extreme difficulty and pain when breathing or sitting up.
- Pain when sneezing or coughing.
- Inflammation: A rib that pops out of alignment can inflame surrounding tissues and muscles. If the nerves between the ribs are inflamed or irritated, the condition is referred to as Intercostal Neuritis. Others may refer to it as Intercostal Neuralgia. The ribs that attach to the breastbone can also be inflamed and irritated to cause costochondritis– ribcage inflammation.
- The affected area may feel tender, and it can swell to form a lump over the affected joint.
- Numbness in the nearby ribs.
- Bruising on the affected area.
Symptoms may worsen with activities like bending, slight twisting, turning in the bed, or lifting.
Typically, the doctor will inquire about your symptoms, how long they have been going on and what worsens or makes them better. The “hooking maneuver” is the most reliable test, and it entails the doctor moving the affected rib gently. They look out for pain and a clicking sound that can confirm a misaligned rib. Additionally, the doctor may order an X-ray or an ultrasound.
Treatment of rib dislocation is crucial for pain prevention. Rib dislocation may heal independently without treatment, and the healing process will typically take about six weeks. The following treatments can be used;
- The administration of over-the-counter medicine to relieve pain. For example, ibuprofen.
- The administration of intercostal nerve injections that ease pain and any inflammation.
- Application of ice over the painful area in the front and back.
- Physical therapy and exercises can help prevent the ribcage muscles from tightening up and a rib from popping out of place. However, a physiotherapist should guide through any activities to avoid further damage. It would be best if you also talked to your doctor before embarking on any exercises.
- Chiropractic care- the chiropractor, determines which rib is out of place and uses various techniques to “loosen” the area and make the muscles more pliable. They may massage, stretch, or use a vibrator on the location, then use gentle but firm pressure to put the rib back in place. At times, stabilization may be used afterward to protect the area and allow it to heal.
- Rest may be recommended.
- Osteopathic manipulative treatment.
- Surgery- where the other treatments are not effective and the effects are severe, surgery may be conducted. For example, a closed reduction can be performed- it entails manually putting a rib that has dislocated back to its correct alignment.
Note; Treatments used to return a rib in place will usually be significantly less painful than the condition itself. Combining chiropractic care, exercises, and stretches are the best and most effective treatments for rib dislocation.
It is essential you avoid injury and trauma of the ribcage. Those who engage in sports that can cause injury or trauma to the ribs must always use the suggested protective gear. For those that may be taking drugs, confirm with the doctor if they can cause dizziness. This way you can take precautions to avoid falls that may impact the ribcage. It is also important to avoid tripping hazards too.
After the rib is adjusted, light stretches can be helpful. You can prevent recurrence by stretching and doing stability exercises after treatment to improve joint rib support; once your rib dislocates, you are more susceptible to future dislocation.
Rib dislocation and the ribcage structure
A dislocated rib is mainly an injury that occurs when one or more ribs move from their normal positioning within the chest cavity.
The ribs are a framework of bones within the thoracic cavity. They protect the thoracic organs but mainly aid in respiration- they allow for chest expansion and contraction when breathing. Additionally, they offer spine stability and enable body movement. They have multiple muscular attachments to the bigger muscles on the back and the shoulder girdle. They also have smaller muscle attachments in between that form the muscles between them, the intercostal muscles.
The ribs are a combination of 12 pairs of bones that are curved in nature. The “true ribs,” or the first seven pairs, are joined directly to the sternum or the breastbone. The “false ribs,” which are the eighth to the tenth pairs, are not directly attached to the sternum. They, however, are indirectly connected by cartilage to cartilage connections (interchondral joints). The “floating ribs” or the eleventh and twelfth pairs are the lower ribs and do not connect in front.
Every rib has a nerve connection located directly underneath it, the intercostal nerves. They give the skin sensation and provide the parietal pleura with innervation. The parietal pleura is the lung surrounding tissue that gives them and the ribcage glide.
Even though most people think of the ribcage as a stationary structure, it is somewhat flexible.
Ever noticed how, when inhaling, the chest expands? Every rib is joined to the spine by three back joints and joined to the breastbone by one front joint. These joints are small, but they also allow some movement. Due to that, the ribs do not cause breathing impairment. Instead, they rise and fall every time you breathe. Breathing is involuntary, and therefore avoiding such joint movement is impossible.
Rib dislocation can occur in any part of the ribcage- front, side, or back. It often may be confused with conditions such as heartburn, pleurisy, esophageal reflux disease, or even a heart condition. Because the “false ribs” are not directly attached to the sternum, they are more prone to excessive movement. The hypermobility gives them a higher risk of dislocation than the other ribs. Rib dislocation mainly occurs on one side of the rib cage, but rarely, it can occur on both sides.
A dislocated rib is a musculoskeletal condition that can be extremely painful within the chest, abdomen, or back. Ribs that shift out of place can also result in many sensitive issues such as pressure on nerves and difficulty maintaining physical activity. That is why you should visit a doctor immediately upon suspicion. They can help you diagnose your injury accurately and help fix your problem. Additionally, they can assist you by further advising for effective chiropractic care or physical therapy. Since some of the causes of rib dislocation are preventable, you must take any measures necessary to prevent occurrence and recurrence.
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