Slipping Rib Syndrome

What is slipping rib syndrome?

Slipping rib syndrome occurs when ribs slip away sporadically from its position due to pulling of the ligaments which help to hold the ribs in their position.

slipping rib syndrome

The usual location of slipping is on eighth, ninth or tenth rib as they are not directly connected to the mid bone of chest i.e. sternum from anterior direction. These three ribs adjoin with each other with the help of fibrous tissues and provide flexibility of the lower chest region. These fibrous tissues are loosely connected and very much susceptible area during any type of accidental trauma. This symptom is more predominant in female rather than male.

Symptoms of Slipping Rib Syndrome

  • Back pain
  • Intermittent acute sharp pain in abdominal and/or thoracic region and gradually turned to a dull ache though out the day or more
  • “Popping” or “clicking” feelings
  • Some activities or  hooking maneuver such as deep breathing, bending, lifting, coughing, climbing stairs, stretching during yawning, getting up from the chair, and  rolling in bed worsen the pain symptom

Ignorance or untreated condition may create several serious thoracho-abdominal organ disorders which include pleuritic chest soreness, swelling of the chondral cartilage, cholecystitis, hepatosplenic disorder, esophagitis, gastric ulcer and stress fracture.

Causes of Slipping Rib Syndrome

The exact reason of slipping rib is not known, it can be happened with other associated chest associated ailments. The swimmer used to develop this type of disorder as continuous hypermobility of the eighth, ninth and tenth ribs causes weakness of the associated chest muscles and ligament weakness. The reasons of slipping ribs are:

  • Fragility of stern costal, costochondral and costovertebra ligaments (ligaments which assist in holding of ribs in their position).
  • Degeneration of the muscular tissue, which attached with the sternocostal ligaments.
  • Continuous severe coughing
  • Operative procedures of  lymph nodes associated with chest, heart, lungs and breast
  • Bronchitis
  • Cold allergy
  • Asthma
  • Sinusitis
  • Injuries in the chest wall

Treatment of Slipping Rib Syndrome

Mild to moderate slipping rib syndrome can be treated in the following traditional methods:


Skilled professionals help to reduce the pain due to slipping rib by providing hot and cold alternative compression.


Non –steroidal anti-inflammatory drugs temporarily help to reduce the pain.  But the long term benefits are not usually achieved and followed other associated ailments like gastritis due to their side effects.

Recent medical advancement try to invent new methods which help in reduction of pain due to slip ribs these are:

Botulinum Toxin Treatment

In this process clinician gives incobotulinumtoxin A intramuscular injection at the muscles of the rib cage. Injection is inserted into the lower end of the rib cage muscle and helps to attain a total relief from pain.


By providing Prolotherapy to patients, enhance the natural healing process of the body by stimulating the nerve endings. This therapy influences mild swelling reactivity in the affected ligaments or cartilages and stimulates the sensory nerve endings present on that site and promotes natural healing.

Ultrasound Therapy

By providing ultrasound therapy, the affected nerve is blocked. Correct nerve blocks assist to promote the rib mobilization and lessen the swelling of the muscles which are present between ribs

Some natural treatment processes which include exercise which may beneficial for the condition, but it is advisable that before starting the exercise first consult with doctor. Some wrong exercise technique may worsen the condition. It is also recommended that when pain is subsided then only start to do following exercises, otherwise these techniques will not give any benefits rather than worsen the condition.

Breathing Exercise

Controlling the breathing is help full to reduction of the further deterioration. During breathing exercise expand your chest and take deep breath and hold the air for10-15 sec and then gradually release the air. Repeat this exercise for 5 to 10 times. This helps to increase the rib mobilization.

Pressure exercise

For doing this exercise, you need a medical assistant. Careful pressure in the chest wall is required to continue this exercise. During the pressure generate against the chest wall, that time inhale air and spread out chest muscles and when pressure is released exhale air slowly.

Expansion of Chest Muscles

To commence the exercise stands or sits straight and expands your shoulder towards backward direction and then squeezes the shoulders and expand the chest muscles. And then squeeze your shoulder in forward direction and compress the chest muscles. Alternatively, repeat this for 5 times and then relax.

Slipping Rib Syndrome Surgery

If the above mentioned therapies do not work and the patient is complaining severe pain, then surgical intervention is the only option.  Surgical resection at the affected rib or ligaments successfully relieves the pain and provides permanent relief. Surgical intervention helps to correct the abnormality associated with ligament attachment or the affected rib placement. After surgery, rehabilitation required 6 weeks rest with mild exercise. The outcome of the surgical intervention is quite satisfactory.



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