Costochondritis is a commonly under and misdiagnosed condition that involves your ribs. The ribs of which there are twelve pairs attach to the front and back of your body. The first seven attach in the front at the breast bone (sternum) and in the back at two locations along your spinal column. The other five pairs attach to the spinal column (in your back) on both sides of it at two locations each and in the front they are connected to each other by a network of cartilage. Now the two main functions of your ribs are to protect your lungs and to move to allow the lungs to fully expand. The ribs are essentially hinged at the front and back so that they may raise and lower to allow for the movement of your lungs. Well I have a little saying, anything that moves in a mechanical way can get STUCK. That’s right, your joints, which are places where bones meet and glide one upon the other can essentially get locked and cannot always unlock without help. Now when ribs get locked they are especially painful. Why? Because if a rib or ribs become locked then your lungs cannot fully expand and you cannot get the full load of air you need. Because of this important function, your brain will send a very strong pain signal letting you know it is not getting its proper level of oxygen. Now a locking of the upper front ribs can also mimic a heart attack exactly and has sent many people to the emergency room. The best way to tell it is not a heart attack is that if you press on the area and it hurts then we have a locked rib or ribs on our hands. What causes this condition? Well most commonly it occurs when the arms are out in front of you holding a load or for an extending period or at an odd angle. It occurs more commonly in women. It can also occur as the result of trauma or surgery such as open-heart surgery.

A true patient story:

A 49 year old woman presented to me with debilitating rib pain. She did not know it was her ribs of course. She described it as chest pain that had been going on for years. She had to work from home because driving had become to painful, her activities were limited and she felt best lying down. Years before this pain took over her life she had undergone a necessary open heart procedure. Everything went well with the surgery but the ensuing pain was alarming. On follow up visits to her cardiologist they concluded it was pericarditis, some inflammation around the heart. These symptoms initially came an went so it may have been reasonable at that time to conclude it was a post operative reaction. But one day the pain came and stayed and at that point some one should have put their thinking cap on. This went on for a number of years until she was referred to a pain management doctor who had his thinking cap on. He concluded it was costochondritis, a very severe case of it and then referred her to me. She is now much more stable, able to drive, walk for much longer periods of time and engaged in life more fully. She is not cured but under much better control primarily due to a combination of intensive dry needling of her rib joints front and back, myofascial release and spinal manipulation. She is thankful and I now treat her husband for a very chronic case of plantar fascitis that is now responding well to treatment as well with Dry Needling.

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