Rib Out of Place: How to Treat Rib Subluxation (A Misaligned Rib)

Rib Out of Place: How to Treat Rib Subluxation (A Misaligned Rib)
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Popping a rib out of place can result in a lot of pain in your chest when breathing deeply or coughing. When a rib is out of place, you can feel sharp stabbing-like pains in the front of the chest or between the shoulder blades. The misaligned rib causing pain in your chest may intensify when you move your upper body or be worse in the morning when you wake up.

Your rib cage doesn’t just protect vital organs in your upper abdomen but also assists in breathing. Your ribs constantly move when you breathe and if a rib pops out of place, the pain can be unbearable. This is why a rib out of place can cause persistent upper abdominal agonizing pains under your ribs. Of course, there are other serious causes of intense, pressing chest pains that are related to your heart.

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Some of the reasons why a rib can come out of alignment include injury to one or more of your ribs, excessive sneezing, forcefully throwing an object, or lifting heavy items. In most cases, you should, first of all, see a doctor for any kind of intense chest pain that causes discomfort. If the reason for pain in your chest or upper back is due to a popped rib, physical therapy can often help to relieve the pain and put the rib back into place.

In this article, I will look at some of the reasons why a rib can pop out of place and what you can do about it. Knowing the symptoms of a rib out of place can also help to get the proper treatment. At the end of the article, you will find some helpful home remedies to relieve the pain as your popped rib heals.

Structure of the Ribcage

Your rib cage has 2 pairs of 12 ribs that are attached to the middle part of your spine (thoracic spine). Ten of your ribs on each side of your chest attach to the front of your breastbone (sternum). The other 2 ribs on each side of your spine are called floating ribs because they don’t attach to your sternum. In total, you have 24 ribs in your ribcage.

Doctors from PubMed Health say that your rib cage also comprises of intercostal muscles located between your ribs, as well as nerves and ligaments. The muscles and ligaments in your rib cage support your torso and also contract and expand when you breathe.1

What is Rib Out of Place (Rib Subluxation)?

A rib out of place describes a condition when one or more of your ribs gets partially separated from its normal position. This can happen either where the rib joins the thoracic spine at the back or where it joins the sternum at the front of your chest. This can cause pain that affects your ribs or middle back.

Doctors also refer to rib subluxation as a partial dislocation of a joint.2 This can cause tremendous pain especially if the rib presses on a nerve or if any muscle tissue is inflamed or damaged near the end of the rib.

An out of place rib is sometimes referred to as a rib misalignment, jamming a rib, popping a rib, or subluxated rib.

Rib out of place vs. dislocated or slipped rib

Sometimes, you may hear doctors talking about a slipped rib or dislocated rib when a person has agonizing rib pain. What is the difference between a rib out of place and a dislocated rib?

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Doctors from the Mayo Clinic say that a dislocation (luxation) is when the bone is forced apart from the joint. This means that the rib becomes completely displaced from its joint. This results in intense pain in the affected area, and the pain may radiate to other areas of the body.3

On the other hand, a rib out of place, or subluxation, is only a partial dislocation. A rib head subluxation will also cause intense and even debilitating pain, but it is not as serious as a complete rib dislocation.

Rib out of Place Symptoms

The main symptom if a rib is out of alignment or becomes partially dislocated is pain that will take a few weeks to heal. However, depending on the severity of the subluxation, you may have some other symptoms.

The journal Gut described many symptoms of various painful rib syndromes. Doctors say that there are 3 main symptoms of popping a rib out of place. These are:4

  • Varying degrees of pain in the upper abdomen or lower chest
  • Tenderness on the lower part of the rib cage
  • Pain when pressing on the affected area of the rib cage

Other symptoms of a rib out of place can include:5

  • A clicking noise when moving the upper body
  • Inflammation and possible swelling in the affected joint
  • Muscle spasms in the rib cage
  • Difficulty breathing
  • Increased chest pains when breathing deeply or sneezing

Sometimes patients with mild to severe chest pain caused by a displaced rib can mistake the pain for digestive problems or even a cardiac-related pain. You should never ignore any kind of chest pain. So, even if you assume that the sharp pains under one side of your ribs are due to a popped rib, you should still see your doctor.

Causes of Popped Rib (Rib out of Place)

Let’s look in more detail at what can cause subluxation of a rib and possible reasons why you are having pain under the ribs.

Excessive coughing or sneezing

Coughing or sneezing with extreme force can put so much pressure on your ribs that it can cause one of them to pop out. Your rib cage moves up and down with your diaphragm when breathing, and sharp movements or excessive repeated coughing can result in a rib out of place.

The journal Mayo Clinic Proceedings reported that extreme coughing can result in serious rib injuries and sharp shooting pains in your chest. In fact, chronic coughing can affect the ribs so much that it can even cause a rib fracture. Doctors also report that even a person with normal bone density can suffer a rib injury from excessive coughing or sneezing.6

Forceful vomiting

If you suffer from serious gastroenteritis or digestive upset, repeated forceful vomiting could also result in a rib becoming misaligned. The reasons for chronic vomiting making a rib pop are the same as for excessive coughing or sneezing.

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Sports injuries

Rib subluxation or a rib out of place is common among sports people and athletes. For example, sports that involve racquets or bats, swimming, or throwing items can put tremendous strain on the ribs, forcing one to become displaced or partially dislocated.

A study published in the Journal of Athletic Training found that rib subluxations are a common sports injury. For example, one swimmer experienced persistent pain in the left lower rib cage. Because rib subluxations are often undiagnosed, the pain lasted for many months. However, doctors discovered that the swimmer had suffered a subluxation in the rib cage.7

Also, the International Journal of Surgery Case Reports says that trauma to the rib attachments in the rib cage can cause the rib head to pop out of place. Because 20 of your 24 ribs in the rib cage are attached to the sternum, a rib out of place can cause chest pain that radiates to the back.8

Some other symptoms of a rib out of place can include:

  • Difficulty breathing
  • Increased intensity of pain when bending forward or crouching down
  • Tenderness at the place where the rib is out of place

Forcefully throwing an object

Throwing an object with great force or sudden jerking movements of your arm can partially dislocate a rib.

The journal Sports Medicine reported that musculoskeletal injuries to the rib cage are common among baseball players, golfers, and rowers. The reason for the rib becoming out of place or another rib injury could be due to a sudden jolt of the arm or stress injuries from repeated motions.9

Other symptoms could include:

  • Xiphoid process pain
  • A clicking noise when moving your arm
  • Breastbone pain due to costochondritis (inflammation in the joints of the rib cage)
  • Swelling of the costochondral joints

Poor posture

If you have to sit at a desk all day, poor posture can put pressure on your thoracic ribs and eventually lead to chronic middle back pain and cervical pain at the base of your skull.

Many chiropractors report that bad posture when sitting or standing can cause a rib misalignment. Although few studies have been done on the effects of posture and rib displacement, the journal BMJ reports that postural factors can lead to displacement of the lower ribs.10

Also, the researchers from the University of Michigan cite poor posture as a common cause of upper and middle back pain. The reason for this is that sitting or standing with a slouched back puts a lot of pressure on the vertebrae that attach your bones to your back.11

To find out how to relieve chronic back pain, please read my article on how to improve your posture with simple exercises or try these exercises to strengthen your back.

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Exercise

Vigorous physical activity or exercising too much can pop a rib out of place and sprain or tear your intercostal muscles. Sometimes, the reason for pushing a rib out of alignment when exercising could be due to failing to warm up properly or having weak core muscles.

To help reduce your risk of damaging your ribs or chest wall muscles when exercising, please read my article on how to strengthen your core muscles. You may also want to try a 10-minute workout to transform your body in a month.

Lifting heavy items

Lifting items the wrong way or trying to lift items that are too heavy can force a rib to become partially dislocated.

The Indian Journal of Anaesthesia reported that too much force on the middle or lower back can cause ligaments in the rib cage or spine to rupture. This could cause some of the rib heads to come out and lead to a lot of pain. Doctors report that this type of injury is more often than not causes the 10th, 11th, or 12th rib to come out of alignment.12

Other Causes of a Misaligned Rib (Rib out of Place)

Of course, falling, being in an automobile accident, or overstretching your arm can all result in rib injuries that cause a partial dislocation or even complete dislocation. What else can pop a rib out of place?

Pregnancy

Many pregnant women report that they suffer a rib popping out of place during their third trimester of pregnancy. This could happen because the weight of the growing baby puts extra pressure on the rib cage.

According to doctors from the National Health Service, there are a number of reasons why pregnant women can have rib pain during pregnancy. For example, the hormone relaxin can loosen ligaments in your ribs which can cause the ribs to become misaligned. When one or more of the ribs are out of place, you may feel pain in various different ways.13

Some of the types of pain related to a rib out of place that can affect pregnant women include:

How to Treat Rib out of Place (Subluxated Rib)

If you are experiencing the symptoms of a rib out of place, then there are some ways to help reduce the agonizing discomfort in your chest or middle back. Of course, because there is a risk of further injury, you shouldn’t try to put a rib back into place yourself. At the end of the article, I will discuss how a chiropractor pops a rib back into place.

Doctors from the National Health Service say that there are a few self-treatment methods for a rib out of alignment. Some ways to help heal a painful rib include:14

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  • Get plenty of rest to prevent further injuries to ligaments, muscles, or nerves in your rib cage
  • Try to breathe normally to prevent a buildup of mucus in your chest and chest infections
  • Hold a pillow against your chest to reduce pain if you need to sneeze or cough
  • Clear your lungs by taking 10 slow deep breaths every hour

Ice the affected area

Most doctors agree that putting a cold compress on a partially dislocated or fully dislocated rib can help to ease the sharp pain and reduce swelling.

Doctors from the Mayo Clinic advise that ice helps to reduce inflammation in the few days after the rib has come out of alignment. This is what they suggest to help ease the painful symptoms:3

  1. Fill a sealable bag of crushed ice or take a frozen bag of peas and wrap it in a thin towel.
  2. Place the ice compress on the painful rib for between 15 and 20 minutes to help reduce the aching pain.
  3. Repeat every 2 or 3 hours for the first 3 days to help improve your popped rib symptoms.

If your ribs are still sore after a few days, you could try switching to a heat compress to relax the sore ligaments or muscles around the popped rib.

Essential oils for pain and inflammation

As the displaced rib starts to heal, you can massage some of these pain-relieving essential oils to the sore rib to ease the intense discomfort. An essential oil blend containing essential oils like peppermint, eucalyptus, chamomile, lavender, or rosemary can help to bring down inflammation and get rid of joint pain.

How to make an oil blend to treat rib pain:

  1. Mix 4 drops of any of the above mentioned essential oils with a tablespoon of a carrier oil such as sweet almond oil or olive oil.
  2. Gently massage a little of the pain relief remedy to the area around the popped rib.
  3. Repeat 3 or 4 times a day to help speed up healing time.

How long does a rib out of place take to heal?

Dr. Colin Tidy on Patient.info says that minor rib injuries may take a few weeks to heal. During this time, you will have some pain in your chest as well as possibly feeling breathless.15

Doctors from the Mayo Clinic say that even after a complete rib dislocation, you should be able to return to normal activities after several weeks of rehabilitation.3

How to Put a Rib Back in Place

You should not attempt to do a self-adjustment on a rib that is out of place. Usually, you need to visit a chiropractor for a rib subluxation.

Your chiropractor will perform various manipulation techniques to help loosen the muscles and ligaments around the out of place rib. This will allow the chiropractor to gently pop the dislodged rib back into place. Most patients report that this type of procedure only causes a minimal amount of pain.

Yoga Poses to Self-Adjust Rib Out of Place

Some yoga poses can help to carry out a self-adjustment on a rib out of place if the misalignment is only minimal. Remember, do not continue with this method to pop your own rib if you have any pain at all.

Doctors from the NHS recommend the following stretching exercise to relieve rib pain:

  1. Sit on a chair, your back straight and your hands clasping the back of your head.
  2. Gently bend to one side so that you stretch the side of your chest wall where the pain is.
  3. Hold the position for a few seconds while you take 2 deep breaths.
  4. Return to the starting position.
  5. Repeat the exercise between 5 and 10 times.
  6. If you have pain on both sides of your chest, repeat the exercise on your other side.

When to See a Doctor

A rib that pops out of place can mimic the symptoms of a heart attack. Therefore, you should always see a doctor if you have intense chest pain, even if the pain is on the right side of your chest.

The journal Gut says that people visiting a doctor with chest pains should always be evaluated for cardiac problems or issues with their lungs.4

Another reason to visit your doctor in the case of a rib coming out of place is that there could be other life-threatening injuries. The journal Radiographics warns that injury that is serious enough to pop a rib or fracture it could also seriously damage an internal organ. Rib injuries have been known to cause a collapsed lung, internal bleeding, liver damage, or spleen damage.16

Read my other related articles:

Medical Sources

  1. NCBI. Rib cage.
  2. MedicineNet. Medical definition of subluxation.
  3. MayoClinic. Dislocation.
  4. Gut. 1993 Jul; 34(7): 1006–1008.
  5. BetterHealth. Rib injuries.
  6. Mayo Clin Proc.2005 Jul;80(7):879-82.
  7. J Athl Train. 2005 Apr-Jun; 40(2): 120–122.
  8. Int J Surg Case Rep. 2016; 23: 23–24.
  9. Sports Med.2002;32(4):235-50.
  10. BMJ. 2008; 336
  11. UOFMHealth. Upper and middle back pain.
  12. Indian J Anaesth. 2013 May-Jun; 57(3): 311–313.
  13. NHS. Rib pain during pregnancy.
  14. NHS. Broken or bruised ribs.
  15. PatientInfo. Rib injuries.
  16. Radiographics. 2017 Mar-Apr;37(2):628-651.
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