Recurring "rib adjustment" question

[Michael Ray]

Sounds like I've been abnormally fortunate in my experience with the chiropractor. I've always suspected as much.

Thank you for the information. Since I wrote my original post, I've trained two times, and I'm realizing right now that the pain, while still there, is significantly diminished. Awesome. Looks like it's on its way out.

I appreciate the response! Thank you for the help!

Glad to hear this is feeling better as well. Great input JHG.

The only addition I have is regarding this statement: "I have a Chiropractor that I have used for many years, and he has always identified it as a "rib" that needs "an adjustment". With no exceptions, his adjustment, which is always the same procedure (stand behind me, take my left elbow in hand as I bend my left arm, and abruptly yank my left arm toward my left shoulder), cause the pain to completely disappear by two days later, no matter how intense it is when I go to him for an adjustment."

The contextual effects of treatment are a major factor in such situations. We usually call such situations placebo-like contextual effects but there's a push to move away from the term placebo. Also, what you are describing is conditioning based on prior experiences and held beliefs about the perceived issue and required intervention to "fix" the issue. This is a common line of thinking. As JHG stated, there is high probability for self-resolution with time and minimizing awareness to the issue, while maintaining activity. Often when we experience pain our thought process is something is wrong that necessitates fixing - which elicits seeking a provider to find and fix the perceived problem. Not to go too far down this rabbit hole, but this can play a major role in perpetuating scenarios you are presenting (persistent, re-occurring pain). Ultimately this gets to the core of the issue - a false premise pain = bad = tissue damage. Happy to discuss further.

[JHG]

Glad to hear you're feeling better!

[DorianStarbuck]

Sounds like I've been abnormally fortunate in my experience with the chiropractor. I've always suspected as much.

Thank you for the information. Since I wrote my original post, I've trained two times, and I'm realizing right now that the pain, while still there, is significantly diminished. Awesome. Looks like it's on its way out.

I appreciate the response! Thank you for the help!

[JHG]

Hi, this is a very common complaint.

There is no good evidence that rib subluxation occurs as frequently as some providers may lead you to believe, and the process of reducing such a subluxation manually is typically not as pleasant as what you’ve experienced with your chiropractor. In other words, it’s unlikely that your rib is “out”.

We don’t have conclusive evidence to ascertain the cause of this common complaint. Local ligamentous sprain appears to be the general consensus at this time. This may occur with movement or even sneezing, resulting in the secondary muscle spasms you described.

If you give it time, the discomfort you are experiencing will dissipate on its own.

[DorianStarbuck]

Hello, I've got a question about a recurring condition that has menaced me on and off for almost two decades now. I'm hoping you can shed some light on it for me, and maybe even help me identify what I might be doing to cause it, or how I might deal with it when it occurs.

A couple of times a year, I experience a sudden fairly intense muscle spasm in my back, on the left side, close to my spine, right at the edge of my scapula. I've attached a picture that shows where the pain occurs, though mine feels like it's just fractionally lower than shown in the picture. The onset seems to be almost completely random...at times, it'll happen when I'm lifting something, but other times it'll happen when I'm brushing my teeth, or just turning my head. I've even woken up in the morning with it happening, after having gone to bed without having any symptoms.

I always feel a mild pop when it happens, and the spams comes on immediately, becoming more intense over the next 30-60 minutes. Once it happens, I can no longer take a full breath without a tremendous amount of pain, and certain movements exacerbate the pain.

I have a Chiropractor that I have used for many years, and he has always identified it as a "rib" that needs "an adjustment". With no exceptions, his adjustment, which is always the same procedure (stand behind me, take my left elbow in hand as I bend my left arm, and abruptly yank my left arm toward my left shoulder), cause the pain to completely disappear by two days later, no matter how intense it is when I go to him for an adjustment.

For the last couple of years, I have been doing a good deal of reading about pain, specifically as it applies to "back tweaks", because I've always been really terrified of them. In the last year or so, I've had several opportunities to "train through" a low-back tweak, and have had tremendous success in dealing with (and not catastrophizing) the various aches and pains that are endemic to our species. In short, the stuff I've been reading has really worked for me, and I no longer feel anxiety about tweaking my back...it happens on occasion, and I push through it.

This specific pain, though, is an exception. I had this "rib" thing happen about three weeks ago, and I've done everything I can think of to deal with it, but no matter what I do, it simply isn't going away. And, what's weirder, it's actually starting to creep up into my neck. I still, even three weeks later, can't take a full breath without extreme pain. I'm able to lift normally, though taking a breath for the valsalva maneuver is extremely difficult.

I know, with complete certainty, that if I go see my chiropractor, he'll tell me "oh, it's a rib again", then will yank my arm and it will be gone within 48 hours. But this is at odds with most of the stuff that I've been coming to understand about how pain and injury works. I'd really like to find a way to manage this situation without having to go see the chiropractor, in part because he's very near retirement, but also because I really believe that it's something that I can manage without turning to a chiropractic adjustment.

Do you have any information or advice to offer me? Thanks very much in advance for this, and for all of the time and effort you've put into helping people in this forum, and elsewhere!