Somatic Rib Dysfunction/Malalingment

I had chronic costochondritis for decades. I had to be so careful with stretching, upper body exercise, sports, etc. to not cause a flair up. It’s soooo painful!

The only thing that ever made it better for me other than time was osteopathic manipulation — very hands on. That was the first time I’d been pain free in years and it lasted 2 years before the next flair up. A chiropractor with a very hands on technique might work, but the chiropractor I saw just did TENS, hot packs, neck cracking, etc. and I did not feel that worked at all. The osteopath also took away my two long years of whiplash pain that six months of chiropractic didn’t help. The osteopath fixed my whiplash in 10 visits and said it would have been 4 if I saw him when it first happened. He fixed my costochondritis in 4 visits. This was 36 years ago so maybe chiropractic techniques have changed.

I was 30 and so was my osteopath (my primary physician). He was still building his practice and said once an osteopath has a full practice they don’t have time to do osteopathic manipulation anymore. He was more expensive than chiropractor but priceless! It also helped that he had costochondritis in medical school so he could relate. I hope you find someone, maybe a young osteopath still building a practice? He told me costochondritis is not usually chronic. He only had it once due to stress. I have a rare nerve disorder that I believe is the trigger. My issues with it have greatly improved in the past 20 years but I’m 66 now — much less active and I’m careful with triggers. My heart goes out to you.

What were you doing when the pain started? If the ribs are loose, wouldn’t that show up on an xray? My bet is inflammation. Have you tried the 6 day prednisone or medrol pack to reduce inflammation? My doctor told me that would be overkill but nothing was too extreme for the pain I was in. He suggested NSAIDs to reduce inflammation but I’m allergic. I did try a single injection of cortisone once and that didn’t help.

@californiazebra I am so thankful for your response. It makes me feel more hopeful.

I was smoking cigarettes and weed when it started. I would smoke and then it would hurt. I then quit smoking and the pain went away except when I would tap my ribs. I figured it would heal eventually and it didn't bug me day to day. However. a few years later I got a virus and all of a sudden the ribs started to hurt daily.

I have never tried prednisone or medrol. All I have used are tylenol, lidocaine, biofreeze, and muscle relaxers. I am given Nortriptyline daily and that did not help at all, and now that's yet another med I am on. I was just given tramadol due to my extreme flare I am going through. I ended up in the hospital last week from this. Today is my 2nd day taking Tramadol and it scares me especially because I already take a daily benzo. It feels like I am spiraling out of control.

I was referred to a chiropractor and it felt like he was useless despite him being highly respected and my amazing doctor could not recommend him enough. But he does the "activator" method which feels like it's not a fit for me. It doesn't go for my ribs, he just says my leg length is wrong and that my pelvis is misaligned.

However, I did just find someone who is a chiropractor and his website actually mentions helping with rib subluxation. I am hopeful but I have weeks to wait and cannot afford to take tramadol nightly for several weeks.

I take so many meds and I am only in my early 30s. It is scaring the shit out of me. I deal with many mental health disorders, gut disorders, pain, and breathing issues.

Anyways, I really relate to your story. I tried an injection, and it did nothing. Also issues with the chiropractor we share in common and just general frustration trying to figure this out.

Your story does give me hope though. I just hope I can find a proper osteopath through my insurance that knows what they're doing.

This feels so mysterious. My body always feels like it presents in weird ways doctors can't figure out!!!! I feel like this is something so small and random that itll take forever to figure out!!!!

I had chronic costochondritis for decades. I had to be so careful with stretching, upper body exercise, sports, etc. to not cause a flair up. It’s soooo painful!

The only thing that ever made it better for me other than time was osteopathic manipulation — very hands on. That was the first time I’d been pain free in years and it lasted 2 years before the next flair up. A chiropractor with a very hands on technique might work, but the chiropractor I saw just did TENS, hot packs, neck cracking, etc. and I did not feel that worked at all. The osteopath also took away my two long years of whiplash pain that six months of chiropractic didn’t help. The osteopath fixed my whiplash in 10 visits and said it would have been 4 if I saw him when it first happened. He fixed my costochondritis in 4 visits. This was 36 years ago so maybe chiropractic techniques have changed.

I was 30 and so was my osteopath (my primary physician). He was still building his practice and said once an osteopath has a full practice they don’t have time to do osteopathic manipulation anymore. He was more expensive than chiropractor but priceless! It also helped that he had costochondritis in medical school so he could relate. I hope you find someone, maybe a young osteopath still building a practice? He told me costochondritis is not usually chronic. He only had it once due to stress. I have a rare nerve disorder that I believe is the trigger. My issues with it have greatly improved in the past 20 years but I’m 66 now — much less active and I’m careful with triggers. My heart goes out to you.

What were you doing when the pain started? If the ribs are loose, wouldn’t that show up on an xray? My bet is inflammation. Have you tried the 6 day prednisone or medrol pack to reduce inflammation? My doctor told me that would be overkill but nothing was too extreme for the pain I was in. He suggested NSAIDs to reduce inflammation but I’m allergic. I did try a single injection of cortisone once and that didn’t help.

What does your pain feel like and where is your pain ? I have Post-thoracotomy Pain Syndrome from nerve damage in my left intercostal nerves that run under ribs on my left chest. I have had it for 24 years and had to take a complete disability in 2005. The pain from this is 24/7 and is intractable and unrelenting.

@jdbarr1
Deep breaths and coughing certainly aggravate costochondritis so that may be where the smoking and virus played a part.

I was 18 when it hit the first time. It was my third karate class in college PE when I thought I pulled a muscle. Horrible pain for 2 months. A few years later it flaired up again and I was diagnosed with costochondritis. Avoid major stretching, even when reaching for something on a high shelf. Gentle upper body exercise that doesn’t strain your ribs.

A physical therapist would also be a good option if you get one that is very hands on. Again, it’s the manual manipulation that helps. I didn’t do PT for costochondritis , but in recent years I’ve used PT for post-op issues and found it very valuable with some therapists more hands on than others. PT may be easier to get than osteopathic manipulation. I think you are spot on that with either one you want to find someone who has successfully treated costochondritis. Most doctors don’t understand just how painful it is. I can’t even take any meds for pain except Tylenol that does nothing for any pain I have. You don’t want to get hooked on anything though.

Michael Jackson got costochondritis in the middle of his intense dance routine and went to the hospital by ambulance believing he was having a heart attack. His heart was fine, but he stayed in the hospital for a week demanding more tests to figure it out because he was scared by the pain and thought surely he was dying. We get that, right? It’s soooo painful!!!

I was in my late 20s before I discovered that it doesn’t hurt other people when they touch their ribs. I was stunned to learn that. When my son was about 10 he gave me his tightest bear hug with his arms around my lower ribs. I thought I was going to pass out from the paralyzing pain. I couldn’t even speak to tell him to stop.
I hope you can find the right hands on therapy to fix this and then be aware of what triggers it for you to minimize episodes. I also have a lot of rare physical diagnoses so I get that frustration too. So does my son and so did my aunt. Lots of genetic mutations. Such is life. You’ll be okay. Practice good health habits. Get involved in fun healthy activities with happy people that bring you joy to reduce stress. We have to do our part too.