Always feeling tight in the upper back, shoulders and neck? Headaches? The problem may be in your ribs

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January 14, 2022

How can I tell if ribs are the cause of my upper back, shoulder, headaches and neck pain?

It can be difficult as a patient to understand where the problem is coming from, that's where finding a trained doctor in rib injuries is important. Often, where we have pain or tightness is not necessarily the source of the problem. If you answer yes to any of these questions, you may have a rib problem. 

  • When you breathe, do your ribs expand outward, or do you breathe in an upwards direction? 
  • Do you have pain or discomfort along the shoulder blades, underneath the shoulder blades, or pain that wraps around your sides
  • Pinpoint pain along the sternum on either side (not to be confused with cardiac symptoms, please check with your PCP if you have any discomfort in this area prior to assumption of a rib)
  • Pain when breathing
  • Do you have chronic neck, shoulder, or upper back pain that's not responding to treatments
  • Do you have headaches that start at the base of your skull and travel forward to your temple, forehead, or eye regions
  • Do you have tingling/numbness down your arm, specifically in the pinky or ring finger (this could be a 1st rib issue - your top rib that is located behind your clavicle)

Try wrapping a measuring tape, or string around your chest along your nipple line and exhale deeply, tightening the string and marking the amount of rib circumference. Now take a deep breath and remeasure the circumference, subtract the difference and if that number is below 2-2.5", you may have reduced rib expansion, depending on body size. 


Why would they cause tightness and pain in my upper back, shoulders, or neck?

It is common to experience rib restrictions. We observe them in patients quite often. Rib restriction represents a lack of proper movement in the joint, reducing inhalation, thus limiting gas exchange of oxygen and carbon dioxide. If we cannot expand our ribs, then we will breathe upwards using accessory muscles of breathing, which are typically the upper traps, levator scapulae and neck muscles. These muscles attach from the upper back to the neck and back of the head/base of the skull and become chronically tight, cause pain, and possibly headaches. 

Why do I hold my stress in the upper back and shoulders?

Chronic tightness in the upper back often has its source in the ribs. Many people claim to hold their stress in their upper back as we become more slumped forward, allowing our shoulders to roll inward, head to travel forward, restricting rib expansion, forcing us to breathe upwards. In order to breathe upwards we use our upper shoulder and neck muscles that are not meant to work that much and become very problematic over time if we do not correct the source of our problem - ribs. 

Can this be corrected?

Yes, through proper evaluation at Portland Chiropractic Neurology, we can completely evaluate your rib function and correct your problem through a comprehensive appraoch using chiropractic, physical therapy, and neurological treatments that retrain normal breathing mechanics.