Rib Pain, Costochondritis

Symptoms by body part:

Chest (Upper-Ribs)
Acute Pain
Thoracic Paraspinal (Mid-Side-Back)
Acute Pain
Scapular/Interscapular region (Shoulder Blade)
Acute/Chronic Pain

Who we are 

What sets our rib pain treatments apart from so many others is the incorporation of our deep understanding of the nervous system and how that translates into healing- it's not just about changing the structure but also changing the pathways that connect the structure to the brain. And it's this reconnection and reintegration that serve as the backbone of what we do. We are New England's premier center for chiropractic neurology. 

We understand that everything in the body is conected. From the spine to the brain, the nervous system is the engine of feeling. And when a connection is broken, you feel it. The connection and reintegration is the inspiration behind our care, demonstrating the core of who we are: restoring connections in our patients. 

A person's pain is a result of a combination of factors involving muscle, joint, nerve and brain. Thereby, a diagnostic and treatment approach that involves all of those structures will create the best possible, long-term outcome. That's what the Portland Chiropractic Neurology model incorporates, reconnecting all of these structures through a multi-modal appraoch that combines chiropractic, physical therapy, occupational therapy, neurology and hyperbaric oxygen therapy. Our analysis allows us to determine which therapies are right for you and then applied over a certain treatment plan we achieve long-lasting, permanent results if possible. 

Rib Pain 

Rib pain occurs as the result of restrictions associated with the costosternal and costovertebral articulations, or joints.  In the upper to mid back region, each rib forms two joints with the thoracic spine, as well as an additional joint in the anterior, or front, portion where they form a connection with the sternum/breastbone.   If one or both of these joints becomes restricted you may experience pain in the chest or back, often experiencing radiating pain along the rib cage in a specific distribution.  Between each rib is a muscle known as the intercostal muscle, and when the joints become restricted, it begins to tighten, leading to radiating pain that may wrap around the side of the chest as previously described.  This may occur as the result of injury (whiplash from a motor vehicle,  athletic injury, or a fall), prolonged positioning (such as sitting in front of a computer, television, reading, etc.), or may come on without warning. 

Rib structures cannot be ignored as a source of pain. These can generate headaches, migraines, back pain, neck pain, shoulder/rotator cuff dysfunction, breathing difficulties and costochondritis.


  • Pain in the back (often underneath the scapula, or shoulderblade)
  • Pain in the neck/shoulder region
  • Pain slightly lateral to the spine
  • Pain when breathing, either in the chest, side or back (FIRST rule out cardiovascular involvement)
  • Pain that wraps around from the chest to the back, or vice versa
  • Pain with breathing or the feeling of having difficulty breathing
  • Tingling or burning type pain in the back or chest
  • Shoulder/Rotator cuff problems
  • Tingling/pain down one, or both of the upper extremities (arms/hands).  This is most commonly felt in the pinky and ring finger of the hand. 

Why do we have ribs?

Most importantly they act as a source of protection for our vital organs and aid in the breathing mechanism with some help from the diaphragm.  Secondarily, they are extremely important as a source of muscle attachment, allowing for multiple biomechanical processes to occur during trunk, upper limb and lower limb movement. When affected, they can cause multiple areas of pain that may appear as muscular strains.  As for oxygenation, they allow us to breathe deeply, with the help of the diaphragm and the many accessory muscles that attach to the ribs. When affected, they can greatly reduce the oxygen content of our blood, causing fatigue, anxiety, lack of mental clarity, migraines and headaches.

 How can we fix it?

Through careful examination by Maine’s premier Chiropractic Neurology team, we are able to determine the cause(s) of your presenting symptoms.  We then create a treatment plan to resore normal joint motion, retrain muscles by reducing tension and improving strength and stability, restore posture and reduce inflammation.  This is accomplished through a comprehensive treatment consisting of chiropractic care, physical rehabilitation and neurological retraining.   

PCN core spinal treatments (may include one, two or many within the list below, depending on your particular condition)

  • Specific Corrective Spinal Chiropractic Neurological Manipulations (SCSCNM)
  • Disc Decompression Therapy (traction therapy) (DDT)
  • Electrical Muscle Stimulation (EMS)
  • Active Muscle Release Therapy (ART)
  • Percussor Muscle Therapy (PMT)
  • Graston Soft Tissue Technique (GSTT)
  • Postural Restoration (PR)
  • Specific Corrective Chiropractic Neurological Manipulations for Oxygenation L/S/T (SCCNM-O)
  • Gait protocol Non-Invasive Nerve Stimulation (NINS-gait)
  • Vestibular Rehabilitation (VR)
  • Occuptational Therapy (OT)
  • Physical Therapy (PT)
  • Co-treatment (CT)
  • Functional Neurological Rehabilitation/Neuroplasticity Retraining Exercises (FNR/NRE)