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

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. 

Many practitioners ignore the rib structures as a source of pain, yet they are extremely important as a source of dysfunction and are involved in many processes.   Often, 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 only Chiropractic Neurology team, we are able to determine the cause(s) of your presenting symptoms.   We then create a treatment plan to restore 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.