Rib locking
What is a rib lock?
Pain between the shoulder blades.
The thoracic spine, which is located below the neck, is also called the thoracic spine and consists of twelve vertebrae. In these vertebrae, all twelve of the body's ribs (also called costae, costa) also attach to each side of the respective vertebra. Together, they form the most stable part of the back. The function of the ribs is to protect the internal organs, as well as to make room for the lungs and facilitate breathing. The ribs also attach to the front of the chest. They then move a little like bucket handles and expand the chest when they move upwards/outwards and compress when they move downwards/inwards. Between the ribs and around the attachment to each vertebra are muscles that help with this movement. Having good posture and mobility in the thoracic spine and ribs enables good breathing.
To control all the muscles in the thoracic spine, good coordination/control is required. The name rib locking or rib hooking, as it is also called, is a bit misleading. It is more about a spasm in the muscles around the rib's attachment to the vertebra. It can occur, for example, in a sudden movement, sneezing, coughing or sometimes without a clear cause. It is suspected that the coordination did not keep up with the movement and that the muscles then responded with a spasm to protect the area. The result is that the rib in the area cannot move as it should during movement and breathing, with pain as a result.
Symptoms of rib locking
Patients usually describe that they have pain in the thoracic spine/pain between the shoulder blades and that it can be stabbing in the area in certain positions. It is common for there to be constant pain that is provoked by deeper breathing, certain movements or if you lie on the affected side. The pain can be local or radiate along the rib towards the chest. A rib lock can be located at one or more levels, on one side or both sides, although it is most common for only one side to be affected. It is easy to end up in a vicious circle where it hurts to breathe deeply and move, which leads to the spasm getting worse further, with increased pain as a result.
Treatment for rib hooking
By asking about the progress of our patient and then carrying out an examination, we can in most cases confidently conclude that this is precisely the diagnosis. If the posture is not optimal, we discuss the importance of optimizing it. In terms of treatment, shock wave therapy often has a good effect on muscular spasm. In combination with this, manual treatment is performed in the form of mobilization and manipulation to restore/improve mobility in the area. A gradual exercise rehabilitation is also started to take advantage of the increased mobility and to optimize coordination in the area. We also check the ergonomics when working at home and in the workplace.
Forecast
The prognosis for hooking one or more rib joints is very good. Often, a clear improvement can be experienced after just one treatment. However, it is common for several treatments to be needed before the symptoms go away. This is a condition that often resolves on its own in one or two weeks. Treatment can definitely shorten the time with symptoms. Rehabilitation training helps to minimize the recurrence of symptoms.
In cases where we are not successful with the treatment, it may be because there is osteoarthritis in the rib joint (costotransverse joint osteoarthritis). In these cases, the symptoms are sometimes very similar to those of a rib lock. There are also rheumatic diseases that in their infancy can cause similar symptoms. Regardless, if we are not successful in treatment, we refer the patient to a doctor for further investigation, such as plain X-rays, MRI scans and possible anti-inflammatory treatment.
