A common source of neck, shoulder and chest pain is injury to the joints of the upper rib cage.

This type of injury causes a guarding mechanism of the large flexors, extensors and rotators of the cervical spine and head, including the sternocleidomastoid muscle, the scalene muscles, and levator scapulae and trapezius. These are all muscles that traverse the region from the upper thoracic, and shoulder area to the cervical spine and head.In order to protect vital structures, these muscles will become rigid. The result is poor circulation in the tissues. This is felt as burning pain and loss of range of motion.

When people are asked to locate their neck pain, most will indicate the lateral (side) aspects of their necks. This points to an involvement of the scalenes muscles. The ribs are invariably subluxated when the scalenes are involved.

Common Causes of Displacement

Common displacement patterns are posterior and lateral, which has to do with outstretched hands, seat belts, and backpacks, pulling the ribs posteriorly away from the sternal joints. The way we fall, the way gravity interacts with our bodies, pushes the ribs in that direction as the impact is felt. These are the common causes of displacement — all bets are off when a person is thrown from a bike or a jet ski, flying through the air like a rag doll.

Effects of Rib Displacement

When the scalene muscles become rigid, they trap the neurological structures that extend to the arm, hand and fingers. In addition, this rigid muscular guarding will restrict the normal respiratory motion of the ribs themselves, which will produce a restricted breathing pattern.

Then a more subtle involvement occurs: the sympathetic chain resides on the costovertebral joints; a minor displacement of these joints will distress neurological structures affecting sleep, digestion, and other autonomic health conditions. I am suspicious that the cardiovascular system is also affected, causing a system-wide vasoconstriction– like being in fight or flight mode all the time. In this case coronary arterial structures would shunt blood to other structures, leaving a resident increase in pressure. Over time this could translate into systemic hypertension and would be a likely, though as yet unproven, neurological explanation for systemic cardiovascular problems.

The Body Has a Building Code

Structural chiropractic views the body as an integral, architectural system; impaired alignment features go against the Universal Building Code of the Body. Remedies for various sources of neck pain and accompanying neurological involvement need to address the body’s building code violations. The goal then of chiropractic treatment is to restore normal motion and function of the muscular, neurological, and vascular structures.

How to avoid further injury:

Avoid doing these things while you heal from your injury:

  • reaching into the back to the car from the front seat
  • reaching for the seat belt with your left hand
  • reaching behind you
  • push-ups, bench presses, butterfly exercises
  • yoga
  • Pilates
  • rowing machine
  • sleeping on your stomach or on your back with your arms above your head
  • leaning on your elbows

Recommended Actions

  • Laser therapy to stimulate the healing of damaged rib cage ligaments, and ease pain and inflammation.
  • Light to medium pressure massage therapy, but do not allow heavy pressure to be placed on back or chest. Do not allow the therapist to position or stretch your arm, especially over your head or behind your back.
  • Sleep on your side with a pillow underneath your waist (above your hipbone), leaving a space for your shoulder and two pillows for the head and neck. You may roll between your right and left sides, unless one side is painful or injured.

Essentially, you are cleared for typing and cutting vegetables, i.e. light activities directly in front of you.

There is a discrete window in which to have your arms and hands that is directly from your shoulder height as wide as your shoulders to your waist. If you go above the box, to the side of the box or behind the box, you are adding to the distress of your sternoclavicular joints and rib joints which have been pulled away from your sternum.

See one of our chiropractors at North Oakland Ciropractic Clinic and follow their recommendations. This condition is hard to resolve. With focused care and a few adjustments to your lifestyle, rib cage injuries can be overcome so you can live pain free.