– Rib pain, specifically the lower part can be felt in three areas; on the side, posterior (back) and anterior (chest). Lower rib pain is felt usually as a sharp pain in the upper low back, upper abdomen (stomach), and side regions. Sometimes people may also have accompanying numbness and pain that wraps around the side.
– Rib pain in the lower region has a few main causes, similar to the upper region, that I see on a regular basis which includes: Excessive twisting, doing activities that require a pulling motion especially one side dominant, sleeping all the time on the same side, or in some cases of a bad cough. In all these cases there is some degree of the rib being dislodge and subluxate (go out of place).
– There are a number of methods used at preventing, reducing and eliminating lower rib pain.
1) Avoid always sleeping on the same side- When sleeping all the time on the same side, the joints of the ribs become chronically stretched and loosen due to the weight of the other half of the body. Ideally sleeping on the back would be the best position since it would equally distribute the weight. However, alternating sides can be a good alternative by allowing each side to get equal rest.
2) Avoid excessive twisting and one sided pulling- Day to to activities such as vacuuming, or work and exercise activities that involve repeated one sided pulling and twisting increase stress on the rib joints and can lead to the rib going out of place.
3) Ice/heat– Ice in the first day or two helps to numb pain and reduce some muscle spasming. Using either a bag of ice, gel pack or even a bag of frozen vegetables for 10-15 minutes can help reduce pain. Allow for at least an hour break in between icing sessions.
Heat after the first couple days provides a better method for healing and relaxing the muscles around the area. Using a hot pack, hot water bottle or heating pad for 10 minutes will help decrease muscle tension and spasms. It is important to remember to wrap multiple layers of towel to prevent skin burns. Even if the heat source does not feel hot, long sustained heat can cause damage to the tissue
4) Compression– A good way for people to deal with pain associated with breathing and coughing is to apply a light compression to the ribs using a tensor bandage (Ace wrap). This helps prevent excess movement of the rib which can cause irritation and sharp pain when taking deep breaths. Apply very lightly to avoid restricting breathing.
5) Stretching– Stretching the Quadratus Lumborum (QL) muscles by lying on your back and pulling your knee to your chest can help alleviate tension caused by tight muscles. These muscles are attached to the lower ribs.
6) Chiropractic adjustment– the quickest way to alleviate rib pain, is an adjustment to put the rib back into place. While this treatment can be quite intense and painful, the adjustment only lasts a split second. Most people will feel some relief of the area after treatment. However, lower ribs tend to be more difficult to treat than upper ribs and usually a few adjustments are required to keep the rib in place.
7) Massage– Treating the muscles and tissue surrounding the rib will help reduce pain and prevent future episodes.
Dr. Alex Murray
Spring Medical Centre