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Slipping Rib Syndrome - Symptoms, Causes, Diagnosis, and Treatments

Written by
Dr. Vasantha K S
and medically reviewed by iCliniq medical review team.

Published on Sep 19, 2018 and last reviewed on Mar 28, 2020   -  3 min read

Abstract

Abstract

Slipping rib syndrome, otherwise called slipped rib syndrome, is a painful condition where the lower ribs slip away from their normal position and move up and down causing a sensation of 'rib slipping.' Read the article to know more.

Slipping Rib Syndrome - Symptoms, Causes, Diagnosis, and Treatments

What Is Slipping Rib Syndrome?

Slipping rib syndrome, also referred to as slipped rib syndrome, clicking rib syndrome, displaced ribs, painful rib syndrome, rib tip syndrome, intercostal subluxation, etc., is a rare condition where the ribs slip from their normal position due to the movement of the ligaments causing abdominal pain or back pain.

This condition affects women slightly more than men. It is a rare syndrome and can affect persons of any age group following a trauma or surgery. The ribs involved are the eighth, ninth, and tenth ribs as they are not connected to the central chest bone but to each other by loose tissues and ligaments. Although this allows for more flexibility and movement, it also makes these ribs more prone to slipping in case of an injury or blow.

What Are the Signs and Symptoms of Slipping Rib Syndrome?

Slipping rib syndrome can result in symptoms that vary from one person to another. The common symptoms include:

  • Sharp and intermittent stabbing type of pain in the upper abdomen or back. This pain is followed by a dull and achy feeling.

  • Sensations of the lower ribs slipping or popping.

  • Breathing difficulties.

These symptoms worsen on bending, coughing, lifting heavy objects, sneezing, stretching, deep breathing, etc. In most cases, only one side gets affected, but it can affect both sides. Consult a doctor immediately if you experience breathing problems or chest pain, as these are also signs of a heart attack.

What Are the Causes of Slipping Rib Syndrome?

There are various causes of slipping rib syndrome, which includes:

  1. Weakness in chest muscles or ligaments - this is because of hypermobility of the eighth, ninth, and tenth ribs.

  2. Trauma or injury to the ribs.

  3. Sinusitis.

  4. Asthma.

  5. Bronchitis.

  6. Degeneration of muscle tissue that are attached to the ligaments.

  7. Severe and persistent cough.

How Does a Doctor Diagnose Slipped Rib Syndrome?

The doctor, after taking a thorough history, will perform the 'hooking maneuver' test to confirm the slipping rib syndrome. In this test, the doctor will hook his fingers under the patient's last rib and make an upwards and backward movement. If this action causes pain, then a diagnosis is made.

As many other conditions can result in similar symptoms, the doctor will try to rule out these conditions with the help of some tests.

Differential Diagnosis:

Some other conditions that result in similar symptoms are:

  1. Problems in the sleep and liver.

  2. Cholecystitis (inflammation of the gallbladder).

  3. Costochondritis (inflammation of the chondral cartilage).

  4. Esophagitis (inflammation of the esophagus).

  5. Stress fractures.

  6. Muscular tears.

  7. Stomach ulcers.

  8. Some heart problems.

  9. Bone cancer.

  10. Bronchitis.

  11. Asthma.

  12. Appendicitis.

What Are the Treatment Options for Slipping Rib Syndrome?

There are various treatment options depending on the severity of pain and discomfort. For mild to moderate symptoms, the treatment options include:

  • Hot and cold compression - Apply hot and cold compressions alternatively for 3 to 4 times a day. This will help relieve pain.

  • Stretch and rotation exercises.

  • Physiotherapy - Consult a trained physiotherapist to learn proper physical therapy methods.

  • Painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs).

  • Take plenty of rest.

  • Avoid all strenuous activities.

The treatment options for severe cases include:

  • Corticosteroid injections - Corticosteroids are injected in the site of pain, which helps reduce swelling.

  • Botulinum toxin (Botox) - Botox is injected into the muscles surrounding the rib cage. This relieves pain.

  • Ultrasound therapy - The nerve endings are blocked in order to reduce swelling and promote rib mobilization.

  • Prolotherapy - Here, nerve endings are stimulated, which promotes the natural healing process of the body.

Alternative Treatments:

  1. Taking a deep breath and then releasing your breath slowly after holding it for 10 to 15 seconds will increase rib mobilization.

  2. A doctor will carefully apply pressure on your chest wall and ask you to take deep breaths.

  3. The patient sits or stands straight and pushes his or her shoulder back. This expands the chest muscles. They then bring the shoulders forward to compress the chest muscles.

All these exercises need to be done under strict medical supervision, as they can worsen your symptoms.

In some severe cases, where no other treatment option helped, a surgery called costal cartilage excision might be required.

As the symptoms of slipping rib syndrome are general and nonspecific, they can be confused to be due to a different condition. Hence it is important to address the concern at the earliest and get treated soon.

What Are the Possible Complications of Slipping Rib Syndrome?

There are no long term complications. The possible complications include:

  1. Breathing difficulties.

  2. Corticosteroid injection can result in lung collapse (pneumothorax).

How Is the Prognosis?

Pain, in most cases of slipped rib syndrome, gets better with medications over time. In some rare cases, the pain becomes chronic, which requires injections or surgery.

For more information on slipping rib syndrome, talk to an orthopedician and traumatologist online through phone or video consultation.

 

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Frequently Asked Questions


1.

How does a slipped rib syndrome feel like?

A person with slipped rib syndrome might suffer from back pain, stomach pain, popping or clicking sensation in the ribs, and breathing problems.

2.

What can I do at home for slipped rib syndrome?

With proper rest, applying heat and cold, painkillers (Ibuprofen, Naproxen), stretching, rotation exercises, and avoiding strenuous activities, most cases of slipped rib syndrome resolves on its own.

3.

How long does it usually take for slipped rib syndrome to get better?

It usually takes around a week or 7 days for the symptoms of slipped rib syndrome to get better.

4.

Can slipping rib syndrome be diagnosed with an X-ray?

No, an X-ray will not help in diagnosing this condition. Slipped rib syndrome is usually diagnosed with the hooking maneuver. X-rays or MRI scan is done for differential diagnoses, which means to rule out other conditions that can result in similar symptoms.

5.

Is slipping rib syndrome a dangerous condition?

This syndrome does not lead to any internal damage or severe complications. But in a few, it can cause longterm pain, which might make doing day to day activities such as turning while lying down or buttoning you bra painful.

6.

Can slipping rib syndrome get better on its own?

Slipping rib syndrome has been reported to go away on its own without treatment in some. In case of severe and chronic pain, consider getting an intercostal nerve block.

7.

When to consult a doctor for rib pain?

If you experience chest pain, breathing difficulties, and shortness of breath, it is wise to consult a doctor immediately, as it can be signs of a heart attack or some other life-threatening conditions.

8.

How to sleep if you have rib pain?

Avoid sleeping on the side where the ribs are sore or slipped. If possible, sleep in a supine position, that is lying flat with your face and torso facing up.

Last reviewed at:
28 Mar 2020  -  3 min read

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