A close friend rushes to the emergency room complaining of severe chest pain which turns out to be related to the joints in his chest, not his heart. A woman suffers from excruciating pain in her shoulder which runs down her left arm that no one can diagnose or help. Another woman suffers for years from a mysterious pain in her shoulder blade without recourse – medical tests are negative. All of these have in common the same root cause: rib pain.
These are some of the most extreme examples I’ve seen in my practice. And yet, I see this issue crop up to lesser degrees on a daily basis. People come in all the time complaining of shoulder blade pain or upper back pain. Very often the pain is not in the spine or the shoulder joint but rather next to the spine were the ribs form joints with the spine. Most people don’t realize that the rib cage runs between the spine in back and the sternum (chest bone) in front. As we breathe, the rib cage expands and contracts. It also accommodates the motion of our body as it moves. This is another example of the balance that the human body has to strike between support while still allowing for mobility.
In addition to direct traumas to this area, such as auto accidents or falls, pain can also come from a forward head posture. I call this The Posture of the 21st Century because so much of our lives now entail hours spent hunched over the computer, smart phone, desk or steering wheel. This position puts stress on the back of the spine and the ribs as the head and shoulders rotate forward.
From my point of view, these are very rewarding patients to work on. When the exact cause of their issues hasn’t been determined and I can put my finger right on the origin of their pain, it is as if a light bulb goes on in their head. “That’s it!” they will so often exclaim.
Gently adjusting the ribs back into place tends to provide great relief. At the same time, it’s important for me to give the patient stretches and exercises they can do at home to address the forward head posture that is predisposing them to have that pain.
Interestingly, I’ve found that even if a patient comes in who does not have direct complaints of rib pain, they seem to feel better and their spines stabilize better if I address any misalignments of the ribs. So for years now, as a matter of course, I address the rib alignment of all my patients.