Thoracic (Mid Back) Pain Slipped Rib Syndrome

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Is Slipped Rib Syndrome Causing Your Thoracic Back Pain?

Slipped rib syndrome can cause a very uncomfortable, deep, continuous pain that is felt in the bottom of the chest and the top of the abdomen. The cause of the pain is a rib that has become detached from the cartilage at the rib facet joint. It is also known as the lost rib syndrome.

Understanding How Slipped Rib Syndrome Can Cause Thoracic Pain

In order to understand how slipped rib syndrome can cause pain in this region, it can be helpful to understand the basic structure of the thoracic spine. The middle back is made up of 12 vertebrae (T1-T12) with each vertebra supporting two ribs which curve around connecting to the sternum. There are 24 facet joints with each rib having an upper and lower joint. There are 12 pairs of spinal nerve roots. Problems with facet joints resulting in a slipped rib usually occur to the Xth facet joint with the XIth facet joint riding over it, initiating the deep pain.

This condition can be an inherited anomaly that has gone unnoticed. More typically it is caused by trauma such as a boxing injury, car crash, fall, bike accident or any event that stresses the rib cage and damages the ligaments and nerves in the facet joints of the rib. The unusual pain signal is believed to be caused by the rubbing of the end of the free cartilage on adjacent structures such as nerves, bones, or ligaments. To give you an idea of how complicated this region is, slipped rib syndrome can also cause bile duct disorders.

To diagnose slipped rib syndrome, your back doctor will perform a physical exam, looking for a rib that is not aligned with the other ribs. He or she may also perform the Hook maneuver, gently pulling on the suspect rib to listen for a clicking sound.  Rest and analgesic medications may help relieve pain caused by this unusual condition.

Tips for Preventing and Managing Mid-Back Pain at Home

  • Regular stretching and exercise can help prevent and ease low back pain.
  • Maintain a healthy weight.
  • When lifting heavy objects, use your legs for leverage, not your back.
  • Walk cautiously and wear shoes with good traction when walking on slippery surfaces.
  • When carrying something, be sure to distribute its weight evenly, not favoring one side.

Consult a spine specialist for severe mid-back pain that hasn’t resolved with conservative methods in a few weeks

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