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Not All Pain In the Back Is Back Pain – It Could Be Rib Pain

We had a patient recently how came in with mid-back pain just off to the side of the spine. He thought he strained a back muscle from heavy lifting over the weekend but it turned out that he strained his rib (intercostals) muscles instead. These are muscles between your ribs.

The patient of ours had gone for a massage earlier but it did not help relieve the pain. It hard to move – bending forwards, sideways and breathing deeply elicited the pain. Once we had diagnosed the problem, physiotherapy techniques of releasing the tight muscles and mobilising the affect stiff ribs (yes, we can mobilise the ribs) quickly helped relieved the pain. The pain disappeared by the next day.

A strain commonly occurs when a muscle or its tendon is stretched or torn causing symptoms. Similarly, you strain your intercostals muscles if you perform exaggerated or forceful twisting of your body or swinging of your arms. Sports activities at risk for rib strains include golf, tennis, and squash. A direct blow to your ribcage such as that occurs in a tackle in rugby may also cause stretching of your intercostals resulting in strain.

The symptoms are usually a dull soreness that may increase to a constant ache and/or sharp stabbing pain with deep inhalation, twists or bending.

If the pain is mild, stretching and breathing exercises to keep the intercostals, as well as the muscles attached to and surrounding the ribs, loose.

If these gentler methods are not working, physiotherapy techniques such as postural assessment, manual manipulation (as in the case with our patient) and massage therapy may be effective in cases where pain is increasing or consistent. Massage therapy had not worked for our patient earlier as the initial diagnosis was wrong and the masseuse worked on the wrong muscles.

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