What Type of Treatment is Rib Raising?

A Guide to Rib Raising: What You Need to Know

Rib raising is a hands-on technique used in osteopathic manipulative treatment to improve rib cage movement and influence the activity of the sympathetic nervous system (SNS). It is designed to ease rib restrictions and manage issues linked to increased SNS activity.

It is often used to enhance movement in the thoracic region and help reduce pain caused by different rib-related problems. During the procedure, the practitioner gently applies rhythmic pressure to the rib angles to help loosen the ribs and enhance their range of motion.

This method aims to relieve muscle tightness, support better breathing, and reduce irritation of the intercostal nerves. However, it is essential to understand how this treatment is performed and how it helps. Keep reading for a detailed insight.

How Do You Treat Lower Rib Syndrome?

Lower rib syndrome, also known as slipping rib syndrome, is treated in the following way:

• Rest and Activity Modification: Avoid activities that trigger or worsen pain, such as heavy lifting, twisting, or strenuous exercise.
• Pain Management: Use over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen for mild pain relief.
• Local Treatments: Application of heat or ice packs to the affected area can help manage pain. Ice should be wrapped in a cloth to avoid direct skin contact.
• Physical Therapy: Gentle stretching, rotation exercises, and manipulative physical therapy techniques may provide relief and improve mobility.
• Supportive Devices: Wearing a chest binder may stabilize the ribs and reduce discomfort.
• Injections: For persistent or severe pain, local corticosteroid or anesthetic injections, and intercostal nerve blocks can provide symptomatic relief.
• Manual Manipulation: Techniques such as manipulation of the costovertebral joint or Mulligan’s mobilization with movement (MWM) may help in some cases, though long-term relief is not always achieved.

Is Surgery Ever Needed for Lower Rib Syndrome?

In cases where symptoms of lower rib syndrome persist and do not respond to conservative treatments over time, surgery may become necessary. Surgeons often opt for minimally invasive techniques, such as video-assisted thoracic surgery (VATS), to reduce recovery time and minimise complications.

Surgical options for lower rib syndrome may include:

• Stabilization: This involves securing the loose cartilage or ligaments with sutures to hold the rib in place.
• Partial Rib Resection: In this procedure, the surgeon removes the damaged or excessively mobile portion of the rib cartilage to stop it from slipping.
• Rib Plating: Small metal plates may be used to keep the affected ribs properly aligned and prevent them from rubbing or shifting against each other.

Surgery is typically considered only after non-surgical approaches, such as rest, pain management, or physical therapy, have failed to provide lasting relief.

What Causes Lower Rib Syndrome?

The exact cause of lower rib syndrome (also known as slipping rib syndrome) is not fully understood. It often develops after an injury, trauma, or surgery, though it can also occur without any clear cause.

The condition is thought to result from excessive mobility or looseness in the cartilage or ligaments of the lower ribs, specifically ribs 8, 9, and 10. These ribs, also known as ‘false ribs’, are not attached directly to the sternum but are instead connected to one another by flexible fibrous tissue.

This loose connection makes them more vulnerable to movement or ‘slipping’, which can irritate nearby nerves and strain muscles in the area. The result is inflammation, discomfort, and sharp or aching pain in the lower chest or upper abdomen.

How is Lower Rib Syndrome Diagnosed?

Identifying lower rib syndrome can be difficult because its symptoms are similar to those of many other medical issues. The process usually begins with your doctor taking a detailed medical history and asking specific questions about your symptoms, such as when they started, what makes them worse, and whether any particular activities triggered the pain.

Your doctor will also want to know what you were doing at the time the discomfort began. A key diagnostic tool for lower rib syndrome is the hooking maneuver. During this exam, the doctor uses their fingers to hook underneath the lower rib margins and gently lifts them upward and backwards.

If this movement reproduces your pain, it is a strong indication of lower rib syndrome, and additional imaging like X-rays or MRIs (magnetic resonance imaging) is often unnecessary. This approach is part of a broader method called differential diagnosis, which aims to rule out other possible causes.

Lower rib syndrome, though often overlooked, can cause significant discomfort and impact daily activities. With accurate diagnosis and appropriate treatment, many individuals can find effective relief. Techniques like rib raising and manual therapy may support recovery, especially when integrated into a broader care plan.

At Star Health, we recognise the value of prompt and thorough medical attention. Our health insurance policies offer wide-ranging coverage for numerous health conditions. With a strong hospital network of over 14,000 facilities across India and a quick, hassle-free claim process, we aim to ensure you receive the care you need without added stress.

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