Conditions We Treat
RIB & THORACIC JOINT IRRITATION
A sharp catch when you breathe in. A deep ache between the shoulder blades. Pain that wraps around the rib cage to the front of the chest. These are some of the most common, and most alarming, complaints we see at our Sandton practice. Many patients come to us after an ER visit that ruled out a heart problem, relieved but still in pain.
The mid-back has 12 vertebrae, each connected to a pair of ribs through small joints that move subtly with every breath. When one or more of these joints becomes stiff or inflamed, it produces localised pain, referred pain around the chest wall or that sharp catching sensation. Research estimates that 15 to 45% of non-cardiac chest pain is musculoskeletal in origin. Once serious causes are ruled out, this is exactly what we treat.
Costochondritis (inflammation where the ribs attach to the breastbone) is another common source of chest wall pain. It typically resolves with conservative care, and research supports manual therapy directed at the rib cage and thoracic spine for reducing pain.
A randomised controlled trial of 115 patients with acute musculoskeletal chest pain found that chiropractic treatment, including thoracic and rib manipulation, produced significantly better outcomes at 4 and 12 weeks compared to self-management alone. In practice, we also find that thoracic treatment often improves neck comfort and shoulder mobility.
Assessment includes a thorough history, orthopaedic testing, palpation of the thoracic and rib joints and screening to rule out non-musculoskeletal causes. Treatment typically involves gentle manipulation of the restricted joints, soft tissue work, postural advice and exercises to prevent recurrence. Most patients notice a clear improvement within the first few visits.
COMMON SYMPTOMS OF RIB & THORACIC PAIN
- A sharp catch or stabbing pain when taking a deep breath
- Pain between the shoulder blades
- Aching or stiffness in the mid-back after sitting for long periods
- Pain that wraps around the rib cage to the front of the chest
- Tenderness where the ribs meet the spine or breastbone
- Pain with twisting, turning or reaching
- A feeling of tightness or pressure across the chest wall
- Difficulty finding a comfortable sleeping position
- Pain that worsens with coughing, sneezing or laughing
- Restricted movement in the upper and mid-back
Rib and thoracic joint irritation can be painful and concerning, but it generally responds very well to hands-on treatment. Most patients experience noticeable improvement within the first few visits. The key is identifying which joints are involved and restoring their normal movement.
We regularly see patients from Sandton, Morningside, Rosebank, Parktown, Houghton and across the greater Johannesburg area.
Book an appointment at our Sandton practice and let us help you breathe, move and feel better.
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Frequently Asked Questions
Yes. Rib and costovertebral joint irritation is one of the most common conditions we treat. A randomised controlled trial found that chiropractic treatment including thoracic and rib manipulation produced significantly better outcomes compared to self-management alone.
A sharp catch when breathing in is often caused by a stiff or inflamed costovertebral joint, where the rib connects to the spine. These small joints move subtly with every breath, and when one becomes restricted, it produces pain with deep breathing, coughing or sneezing.
Research estimates that 15 to 45% of non-cardiac chest pain is musculoskeletal in origin. If cardiac and other serious causes have been ruled out, the pain is likely coming from the rib joints, chest wall muscles or thoracic spine. A thorough chiropractic assessment can identify the source.
Costochondritis is inflammation where the ribs attach to the breastbone (sternum). It causes tenderness and chest wall pain that can mimic cardiac symptoms. It typically responds well to conservative care including manual therapy directed at the rib cage and thoracic spine.
Most patients with rib and thoracic joint irritation notice clear improvement within the first few visits. The key is identifying which joints are involved and restoring their normal movement through gentle manipulation and soft tissue work.
References
- Stochkendahl MJ, et al. Chiropractic treatment vs self-management in patients with acute chest pain: a randomized controlled trial. Journal of Manipulative and Physiological Therapeutics. 2012;35(1):7-17.
- Southerst D, et al. Noninvasive interventions for musculoskeletal thoracic spine and chest wall pain: a systematic review. Journal of Manipulative and Physiological Therapeutics. 2015;38(7):521-531.