Rib Sprain
(Costo-Vertebral Sprain)
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Rib sprain is one of the most common conditions seen by osteopaths. It is often a sprain of the joint capsule due to repetitive postural strain but may also present as a thoracic facet (joint) sprain or localised pain due to repetitive use of muscles in that rib joint region.

  • Can caused by chronic mechanical overloading of the supportive structures of the upper back and neck (including muscle, fascia, ligaments and facet joints). This can lead to muscle fatigue and micro-trauma of these tissues causing low or high grade inflammation in areas of strain (in this case the joint where the rib inserts into the spine).
  • Most commonly caused by poor and sustained poor postures.
  • Commonly presents in those spending extended periods of sitting and working on desks and computers.
  • It is theorised that drooping of shoulders, head and neck as a result of stress and other psychological issues may also contribute
  • Pregnancy and recent weight gain.
  • Sedentary lifestyle and obesity
  • Poor bra support.
  • Long history of general poor posture
  • A history of other conditions or injuries that may have been poorly managed which can cause compensatory postural changes
  • Trauma such as sleeping awkwardly, a fall, heavy lifting, or whiplash may also cause the sprain
  • Pre-existing conditions such as some arthritic conditions or degenerative diseases.
  • Generally there will be a slow onset of upper back/shoulder pain.
  • In some cases there may be a sudden acute and sharp pain in the upper back which can cause some shortness of breath.
  • Pain may be exacerbated by deep breathing.
  • The ache will commonly be constant and become worse with certain movements or sustained shoulder use.
  • The pain is often worse towards the end of the day (when the tissues become fatigued).
  • You may also experience an increased regularity of headaches (mainly due to postural strain through the neck).
Your osteopath will take a past medical history and perform a through physical examination to determine the cause of the postural strain. Your osteopath will also screen for other potential causes that may require referral to a specialist.

Generally the cause is multi-factoral and requires a dynamic treatment based on the patient. An important aspect of treatment is to work through causative factors with the patient and devise a management plan to reduce repeat incidences.