The Slipped Rib Syndrome

The Slipped Rib Syndrome

The Slipped Rib Syndrome

It was great to post my first blog yesterday!  I would like to thank all those who have spent the time to read my first posting.  Today, I would like to start by discussing a very common, yet in my opinion, misdiagnosed and under diagnosed condition that I see quite frequently in practice.

Have you ever felt a sharp pain in the upper back or middle of your back? Right between the shoulder blades? Moreover, have you ever experienced a sharp localized pain in the back while taking a deep breath? Has this pain ever gone from being localized in the back to referring to the side and front aspect of the torso? These are all symptoms of what has been referred to as a ‘slipped rib’ or ‘slipped rib syndrome’.

What is a slipped rib?

I have experienced many patients who have come to me with these symptoms without knowing exactly what was going on. They explain that the pain they experience is “annoying” and “feels as if a knife is digging in their back”. Whether it be by twisting, bending , lifting, getting in and out of the car, sitting at a desk all day or constant repetitive strain, slipped ribs occur and do so at a frequent rate. Often gone misdiagnosed, slipped rib syndrome can be a very frustrating condition to deal with.  What do you do?  Before explaining what I do for patients, I will describe more about what a slipped rib is.

What is slipped rib syndrome?

Slipped rib syndrome was first described in the early 1900’s.  Cases have been reported in children as young as 12 years and much higher in females than males.  We have 2 sets of 12 ribs which create the rib cage.  The ribs attach to each thoracic vertebrae in the back.  Sometimes the ligament connection (called costovertebral/costotransverse ligaments) linking the vertebrae of the back and the rib can cause symptoms and discomfort.  If this connection is slightly lax or loose, it may cause something known as hypermobility.  Let’s break up this word – hyper – and – mobile.  Hyper meaning excessive or beyond.  Mobile meaning capable of moving or being moved. Hypermobility may result in stretching of the ligament, misplacement of the bones, and thus an irritation in the back over the attachment location.  Sometimes the nerve in the area can become irritated from this stretching and as a result sends a sharp pain around the torso from the back to the front.  Furthermore, the muscles around the area become taut and irritable as well.   Hope I did not lose you!  If I have, think of it this way…your rib and vertebrae bones are connected together by a ligament (in this case, think of the ligament as an elastic band).  If the elastic band stretches too much, it may cause the bones to shift out of there normal position.  If the bones shift, they feel out-of-place and thus cause our bodies discomfort.  Hope this explanation makes things more clearer.

How to treat a slipped rib?

Slipped ribs can be treated by various techniques.  One technique is to relax the musculature with heat, interferential current (electromodality that assists in pain reduction), and registered massage therapy.  These techniques will assist in realigning the rib(s) and vertebrae.  A second technique is to adjust the rib(s).  This will also assist in realigning the rib and vertebrae into a ‘normal’ or more comfortable position.

What is an adjustment?

The Ontario Chiropractic Association defines an adjustment as a highly skilled and precise movement usually applied by hand to a joint of the body.  Adjustment loosens the joint to restore proper movement and optimize function. When a joint is adjusted, a gas bubble escapes causing the popping noise you may have heard about. Chiropractic adjustment techniques have been researched extensively. Complications are rare and side-effects, such as temporary soreness, are usually minor.    

How is a slipped rib adjusted by a Chiropractor?

One technique is to have the patient lie on his/her stomach on a chiropractic table.  The adjustment is applied by the chiropractor to the area where the slipped rib(s) is/are irritated.  The adjustment to the area is very quick.  Following the adjustment, the patient usually knows whether or not that rib(s) is/are still irritating them.  Most of the time the pain goes away.  Sometimes, the muscles around the slipped rib remain tender to the touch.  Another techniques is to have the patient sit at the end of the chiropractic table.  The patient sits facing away from the table.  The patient is lowered onto the table and will usually feel the pop or click once he/she reaches the table.  Trained Chiropractors and other trained practitioners can perform this rib adjustment procedure in various ways.  Always consult a trained health practitioner when contemplating treatment.

From my experience, a combination of techniques, modalities (IFC, Cryotherapy, Heat Therapy), registered massage therapy and adjustment, work extremely well to help with the discomfort of a slipped rib. Furthermore, I find that adding mid back strengthening exercises (such as wall angel exercises) to the mix, helps to prevent future episodes of slipped rib syndrome.

Please note that I have not exhausted and discussed all the options for dealing with a slipped rib.  I have only touched on a few that I find work for my patient’s.  Do your  own research and if you have any questions, please send them along and I will do my best to address them.  Look forward to comments.

Hope you found this information on the slipped rib syndrome interesting. To make an appointment to see Dr. Luciano Di Loreto, please contact the office at 647.873.4490. 


Dr. Luciano Di Loreto, HBSc., D.C. & Associates

Chiropractor & Acupuncture Provider


Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada, Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports.

Fit for Life Wellness & Rehabilitation Centre is a health clinic located in Vaughan, Ontario, just north of Major Mackenzie on Weston Road (Located in the Vellore Medical Centre & Walk In Clinic). If you have questions for Dr. Luciano Di Loreto, please comment and we will get right back to you promptly with information on your conditions/concerns.


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Dr. Luciano Di Loreto