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Posted on 04-24-2014

Is it Really Shoulder Pain?

When patients come in complaining of shoulder pain, I ask them to point to where it hurts. More often than not, they point to a spot on their back between the shoulder and the base of their neck.  Often, patients will say that their pain feels like a knife or ice pick stabbing them in the back. They will also report that it hurts to take a deep breath. This condition is one of the more common conditions I see and the diagnosis is actually a rib that has moved slightly out of position. The name of this rib is the costotransverse joint and we have twelve of them on each side of our spine. The word “costo” means rib and the " transverse" is for the transverse process of the vertebrae. Patients can also have pain in the front of their chest where the ribs attach to the sternum.
When we breathe, the ribs rotate, elevate and depress. Muscles are used to draw air into the lungs and then gravity along with some muscles exhale the air out. The reason it hurts to take a deep breath in is that the rib head pinches tissue inside the joint capsule when it elevates and rotates. When the joint isn’t functioning properly, it requires more muscle involvement to breathe, especially in exhaling. We can feel tired more easily because we are burning more of our fuel (ATP) to breathe, instead of gravity doing most of the work. This is one reason people say that they feel more energy following a chiropractic adjustment.
CAUSES: These joints get irritated and weakened by the constant stresses of life and day- to- day activities. People accumulate injuries as they age and the joints don't stay as strong as they were when we were teenagers. Falling on our side, sleeping on our side, and lifting heavy objects can also cause a rib to not function properly inside the joint. The muscles that hold us upright attach to the ribs and sometimes just the act of standing up can cause a joint to move out of place.The constant turning over and laying on one's side during restless sleep can cause ribs to move out of place, as well.
TREATMENT: Medically there isn’t much that can be done to correct this type of condition A typical course of treatment is for the patient to be prescribed muscle relaxers, NSAIDS, pain medications, and sometimes, prednisone. These can temporarily reduce the symptoms, but don’t actually correct the problem.
A chiropractor will use their hands to move the bone back into place to actually correct the condition This condition can be frustrating to the patient because normal day-to-day can cause the rib to move out of place again. Using icepacks can also help reduce the swelling and help hold the adjusted bone in place.
If you or someone you know has this condition, please have them call 252-441-1585 to make an appointment for an evaluation to see if that shoulder is really a rib condition.

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