Non-surgical Help For Your Ribcage and Chest Wall Pain!
Rita Hancock MD
Rib cage muscle tension can make your neck, shoulders, chest wall, hips, and back hurt and even cause numbness down your arms and legs! The good news? There are effective, non-surgical treatments available. At OSSO, we use Osteopathic Manipulation and Trigger Point Injections to help patients find relief and get back to their normal lives. Ask your provider for more information and read the blog post below to hear real stories.
Suzanne’s story:
Suzanne was understandably frustrated when I first met her. She had chest wall pain and shoulder blade pain that could have left a different team of doctors scratching their heads, since her heart and lungs were deemed normal and her x-rays and MRIs showed obvious cause for her pain. However, thanks to the wisdom of my OSSO doctor-colleagues, it was decided that Suzanne was not a surgical candidate for her pain.
Instead, she was referred to me, and I diagnosed her with soft tissue disorders called Somatic Dysfunction and Myofascial Pain. After only a few visits where I rendered hands-on treatments called Osteopathic Manipulation and Trigger Point Injections, Suzanne was back to her usual activities and almost entirely pain-free. That is exactly why I’m so proud to be part of the OSSO group of doctors. As great as our surgeons and affiliated hospitals are, we know when not to operate.
Why did Suzanne have neck, shoulder, and chest wall pain in the first place?
Since her teen years, Suzanne’s chest wall muscles have been strained to a degree by her mild scoliosis, her tendency toward joint hypermobility (loose ligaments), the weight of her breasts pulling her forward, and all the coughing and sneezing from our lovely Oklahoma City allergens.
However, what pushed her into a pain crisis recently was lifting and reaching to install her new, heavy, wall-mounted TV. She had a bad habit of holding her breath while lifting, and that made the muscles of her chest wall, neck, and shoulders even more vulnerable than usual. Not surprisingly, Suzanne developed significant shoulder and neck pain and chest wall discomfort on deep breathing, leaving her with a sense that she wasn’t getting enough air. She even ended up in the ER because of it.
What exactly was wrong with Suzanne’s ribcage muscles?
First, let’s cover how the ribcage is supposed to move. When the muscles are working correctly during inhalation, the upper ribs are supposed to move up (“pump handle” movements), and the lower ribs are supposed to move out to the side (“bucket-handle” movements). Then, when you exhale, the upper ribs are supposed to fall back down to their resting position, and the lower ribs are supposed to relax inward. But in Suzanne’s case, because of her scoliosis and hypermobile joints plus her recent lifting injury, her ribcage muscles had seized up in places, pulling abnormally on the ribs and preventing their normal movement.
The tightness of the scalene and pectoralis minor muscles on the left side of her chest pulled her ribcage upward so that the ribs of her upper chest couldn’t fall back to their resting position when she exhaled. I.e., the ribs on the left were “stuck up in inhalation.” And the tightness of the little muscles between the ribs on the right side of the ribcage wouldn’t let that side of her chest rise when she inhaled, i.e. those ribs on the right side were “stuck down in exhalation.”
The result of this muscular tug of war on the bones was decreased shoulder, neck, and chest wall range of motion, plus pain and knots in the muscles, which, in turn, sent numbness and tingling down her arms. It also caused the feeling of not getting enough air and feelings of fatigue.
How Osteopathic Manipulation and Trigger Point Injections helped her:
Osteopathic Manipulation (OMT) can help to normalize tissue tension, improve blood flow, and facilitate pain-free range of motion by helping the body function as an integrated whole again. There are many approaches, but I prefer to use only the gentlest non-popping techniques. I.e. I don’t pop the spine like chiropractors might.
Rather, I tend to utilize Muscle Energy Technique, where the patient is positioned in such a way that very little force is needed to loosen the soft tissues, then the patient gently pushes against me in a controlled manner until the target muscle relaxes. Another style of manipulation involves figuring out which way the joint “prefers” to be situated for optimal relaxation, then using that information to help the muscles and connective tissue around the joint relax further (Counterstrain or Functional Indirect).
Another soft tissue relaxation technique is Trigger Point Injection, where I locate knots in the muscles that are causing numbness, tingling, and pain and inject those knots with numbing medicine like you get at the dentist’s office. Even though that numbing medicine that I inject washes away quickly, the relief can last for weeks, months, or even years. Sometimes, the injection fixes the problem altogether in a “one and done” fashion. But keep in mind that new injuries from daily life can cause those knots to recur. So, some people who are prone to injury might need the shots periodically.
Trigger Point Injections are like a procedure that some physical therapists perform “Dry Needling,” except that medicine is injected, so the relief can be much more profound and long-lasting than dry needling, especially when coupled with the manipulation.
What other problems can Osteopathic Manipulation and Trigger Point Injections help?
Many other symptoms besides spine, shoulder, hip, and chest wall pain can potentially be eased through these treatments. Examples include certain types of headaches, TMJ or jaw pain, numbness and/or tingling in the arms and legs, some types of small and medium joint pains (elbows, wrists, knees, ankles) and sometimes even vertigo (dizziness).
The only way to know for sure if you can be helped with Osteopathic Manipulation and Trigger Point Injections is to let an experienced pair of hands evaluate you. For more information, visit RitaHancockMD.com.
