5 Things to Do When a Rib “Goes Out”

Rib HeadsRib pain can be miserable. I cannot tell you how many patients have come in to see me after visiting the Emergency Department because they suspected a heart attack or something serious. Pain in the chest, shortness of breath, radiating pain down the arm, nausea, etc. Sounds like a heart attack but all of the tests are negative. So what do you when the emergency docs send you home and tell you it is nothing? Most likely you are dealing with a rib that is either stuck or not moving in the way it is supposed to. Here are five things to do, and not to do, to help.

  1. Heat and Ice. One of the biggest complaints, when a rib is out, is muscle spasming. Heat will help you endure a muscle spasm. There is a caveat, however. Heat brings blood to an area and if that blood is not flushed out, it will cause more inflammation. So, use heat for 20 minutes and then walk around for a while or ice it. Ice drives away inflammation. Ice for 20 minutes maximum. Always end with icing. For more information on heating and icing, go here.
  2. Massage, but be careful. As mentioned, muscles are often tight when a rib is not functioning properly. massage can really help to calm down the muscles. Here again, a word of warning. Often times, the person giving the massage will feel a good sized bump and mistake what is really the head of the rib for a muscle knot. Rubbing this bump will not only be painful but can increase symptoms. Working on the areas around it can be quite helpful. Massaging after the rib is moving again is great.
  3. TENS or Electric Stimulation. A great, non-drug option for killing a spasm and managing pain is to use e-stim, TENS or something similar. These are basically devices that send electrical pulses through wires and patches over muscles. There are several options of machines and can be purchased at various locations or from Amazon. Price and quality range drastically but I have found that the inexpensive units work pretty well.
  4. Get it adjusted! At the end of the day, until the rib starts moving properly it will cause problems. Not all chiropractors are great at adjusting ribs as they can be difficult. Likewise, you really need to have the specific rib adjusted and not just do a general spine adjustment. Even after you get it adjusted it may still feel out. Remember that the muscles have most likely tightened around it and formed a knot. Symptoms can take a while to settle down.
  5. Mind your posture and quit trying to stretch it. Typically, ribs go out because of a forward head and shoulder posture. So, why do we always try and stretch that same way to get it to feel better? Likewise, stretching spasming muscles does not really work. It drives me crazy when I adjust a rib and the first things my patient does is check to see if stretching forward still hurts. That is like separating a wound to see if it has healed yet. If you keep doing it, it will never heal. Instead, look straight ahead and pull your shoulder blades down and back. Here is the vintage YouTube video I created to demonstrate. If you do this exercise and it is still really painful, chances are the rib is out again.

Ribs can definitely be tricky. Sometimes they stay in after one adjustment and sometimes they take several adjustments. Usually, the longer it is out the more adjustments it will take. The rib joints at the front where it connects to the sternum can go out, too. These are also very painful and can be adjusted, although it is a different method. Please remember that although rib pain is brutal, it is not that damaging. Stressing about it will only complicate the healing process. If you have pain to one side of the spine by the shoulder blades, in the front next to the sternum, radiating along the ribs, or all of the above, just come in and we can either help you or, at least, point you in the proper directions.

50 Comments

  1. Thanks for this write up! I’m dealing with this right now and I had a chiropractor adjust me but he didn’t explain exactly what causes this type of pain. Now I know. Thanks again, I’m going to try the ice and heat method now to see if I can get some relief.

  2. Thanks for the tips sir! But if I had to take a massage what kind of a massage I need to take and I am going to gym does that increase the muscle spasm and cause more pain?

      1. I have a rib out in the front number 4 right at the sternum.
        I have tried to have several chiropractors in the Philippines put it in but has not worked had exray camscan with no luck. But there is a lump at my sternum and the ribs sticking up little. Any info I can pass on to them as to fixing this problem would be very much appreciated.

        1. I usually use an activator to adjust the front ribs. With guys, I might stand behind them and pull on it. It looks like the Heimlich maneuver. I am not sure that helps you very much. I hope you find someone who can adjust it soon.

    1. I have a question. I pop my rib a year ago and I never got it corrected. My muscles have formed around to prevent pain. I have hip popping issues as well as popping knees and pain in my knees.

      Do you think these things are linked?

      1. Not necessarily linked but certainly appears to be a more common issue with you. A chiropractor should be able to help even now, though.

  3. I’m not sure if this applies to me or not;

    The pain I’m feeling feels like a crushing cramp at the top of my lung; it strikes whenever I take a breath, especially a deep breath and when I breathe out. There is a tender spot on the right side of my sternum. Is this a rib out of place?

    I’ve had chest cramps like this for over 2 years, but it has always gone away after taking a deep breath with my arms raised, until today. Today it has been persistent for the past 9 hours.

    1. I have had my own share of these problems and found out I have asthma. I would ask your doctor to run a test cause that may very well be your problem and an inhaler should help.

  4. Thank you! I think my rib has been out for 3 yrs. I had an xray in my Primary care office. They said they saw nothing. Now 3 or 3.5 yrs later… I have the same pain..not worse or better. Wish they would have looked further, such as MRI but they said I could not have an MRI until I went to PT. Hmmm. I ,was concerred that if it was a kidney issue or something such as a cyst on an organ. That PT could miss it and do further damage. Well ,anyway..I did not do PT. I had no insurance . Now I will see a chiropractor. I did do that also and to no solution. Guess I’ll try again with a different one. Deborah. (thanks!)

    1. I spent 3 years trying to out of this terrible stabbing pain. So much money spent on chiropractors & massage & acupuncture!! I Had X-rays & finally an MRI both which did not show cause of pain. I finally says to my chiropractor that it felt like my neck needed to be adjusted a different way. He put me on my stomach and straightened my neck out with my head turned to the side. The adjustment was like stretching the neck into straight position & adjusting that way. It worked. Took 2 adjustments but I knew right away that rib was FINALLY back in place. Don’t give up. The answer/key to help is somewhere. Best of luck to you xx

  5. So I’ve had my ribs pop out for as long as I can remember. Since I was a kid my ribs popped out but my parents thought it was normal and so did so of my doctors. I honestly don’t like how my ribs pop out. I really want to have a stomach where my ribs aren’t popping out. But, I don’t have any pain at all. I don’t know what to do so that they don’t pop out. I hate how they pop out so much. Please reply if you have an idea on how you can help me, thank you !

    1. I’ve had a problem with I believe 2 ribs for years. It seems like I have to go to the chiropractor forever. 2 years now I’ve been getting alignment. I have middle back pressure where I have to crack my back and I have the pain in my lower sternum from this rib slipping thing. I’m wondering if I will be able to ever get long term relief. When I let it go it’s hard for me to breath. I have scoliosis also along with bulging disc’s.

      1. With scoliosis and bulging discs, you will probably always need consistent chiropractic help. However, you can help yourself out by working on your posture and strengthening the muscles.

    1. Ice, in general, is safest. Ice when inflamed. Heat only when muscles need to loosen up and then only if you are going to keep moving.

  6. I have been experiencing pain on my right upper back which radiates to my chest, shoulder blades, neck and arm. I suspected rib misalignment but the CT Scan I did including d ECG said all is well. Pls I urgently need help

  7. The last 4 months or so, one of my right ribs on my shoulder keeps coming out of alignment. Ive been seeing a chiropractor for neck and overall adjusrments. I just had it fixed four days ago, and I’m having miserable pain again. I’m on a limited income so I’d like to know what I might be doing that is causing the misalignment. I feel like I have a small boulder under my right shoulder.
    I’m icing for 20 max, and trying not to stretch it as you suggest. I also have a right posterior shoulder modulation, same side. I sleep alternately on my right or left side.
    Thank you for any suggestions!
    Laurie

  8. Hi, so I had a rib go out about a year ago & had all kinds of tests done & no one could tell me what it was. Then I got a new doctor who does OMT & when she examined me she found that I had a rib out. So she did some stuff & it clicked back in, I even heard it. Well, it keeps going out & I have to keep going back to get it put back. The doc says I have a serious problem. What the heck is going on with this darned rib? Will it ever go back in for good? It is really painful for me to lay down, so sleeping is very difficult. Any help is greatly appreciated.

  9. Hi,
    This is a great article. Thank you for sharing. I have a subluxed rib for many years now. I keep getting it adjusted, but it frequently goes out due to my line of work.
    Interesting enough, I have gotten heart palpitations for several months now, and never connected them to my subluxed ribs. Went to the emergency room with nothing wrong according to them, went to see my Doctor and she told me that I needed my uterus removed and a cardiologist prescribed me beta blockers.
    I ended up doing non of the above, but went to my Chiropractor, had my ribs adjusted and that seems to make my palpitations 100 times better. I still have palpitations here and there but nothing even close to what I used to have. So, this article was great.

  10. Can anyone say ow eek oww oof

    Great article. For those that have stated they have had this a long time and can’t seem to get it into place. I understand they can surgically fuse your rib back? Is this true? Expensive, but it may put me out of some hefty misery.

    1. Thanks for the question. I have not heard of a rib fusion. If it exists, it may help or just irritate the area more. Ribs need to move or there are cascading consequences. Still, desperate measures sometimes work.

  11. Hi, my name is Lamiya and I am 16 I have a condition called Ehlers Danlos Syndrome. What that means is every joint that I have on my body has/ will dislocate. It’s been progressively getting worse, it is know to the point where my ribs dislocate. I came across your article and everything that you said makes it worse I’ve been doing. Your article was not only helpful to people who it ever so often happens to but helpful to me. Living the life that I have afraid to stand or sit because something my dislocate is hard. But, knowing that their is someone out there who can help me through the pain that is not one of my doctors is truest a blessing. If you’ve helped me you have help lots of others. God bless , and thanks ounce again.
    -Lamiya

  12. Thanks for explaining this so it makes sense, I’ve had this problem off and on for a year or so, lidocaine ointment and ice only relief I get
    Oddly enough I had a torn rotator cuff and when I’d get a cortisone shot in it,the rib (front breast center) would stop for a couple of months
    Two emergency visits for chest pain, still scares the heck out of me when it pulls out
    Thanks again

  13. I have had this stabbing pain for over 10 years. It used to be a couple times a year now it is everyday. My whole life revolves around it. Feels like I’m being stabbed. I can only work for about half an hour at a time then sit til the pain subsides. I have been adjusted several times through the years . Recently more often. Nothing is really working. I’m desperate to get some relief. This is not the way I want to live the rest of my life.

    1. Sorry to hear and sorry it took me so long to respond, Fay! I understand. Even if the chiropractor is adjusting it can take a long time. Most of the time, however, the chiropractor is not getting it to move. Other times, the patient is not going in often enough to make a difference. And, sometimes, it is just going to take a long time before it settles down. Hang in there!

  14. I think I may have slipping rib syndrome. It’s popping and clicking (in front and back) and aching (with a periodic sharp pain) in my lower rib (a floating one) around to my back. Sitting aggravates it and certain movements. I understand this is caused by a separation of cartilage and rib. It doesn’t seem like this would be helped by adjustments as its already separated. Is that your understanding?

    1. Lisa, the answer to your question is it depends. I have seen cases like this that we have been able to help and some that we cannot help. I would have to see it and give it a shot to really know. Sorry for a fairly vague answer.

  15. Great article and good info. I’ve popped ribs out several times. I cannot wait to see my chiropractor tomorrow (being Sunday today) seems this always happens on Sunday or Thursday (his day off) anyway I know what a popped out rib feels like, again really great article!!

  16. I’m dealing with a rib issue at the moment. No pain when breathing only when I sit up.”feels like a popping and clicking or something is out of place” chiro hasn’t adjusted me just heat and ice as well as light treatments. All of which has not helped. What to do? I just want to get back to training BJJ. Grrrrrr.

  17. Thank you, all I needed to know and handle myself. This sort of thing used to happen to my arm and then wore a sling for a week, it’s just what dr.’s called loosey goosey..it is joint hypermobility

  18. How do you sleep when ribs are out in your upper back. I have not been getting any sleep because every positions hurts and my ribs just ache all night

    1. It can be really tough. I don’t have a great answer for you other than to try and find a position where it is less painful. This is where medication might be needed.

  19. While skiing 3 weeks ago, I was blindsided by a snowboarder. I had X-rays in the ER, but nothing is broken. I’m feeling much better and have no pain or any of the symptoms you list in the article, really, but more of just an uncomfortable feeling and now feeling like a rib is popping in and out of place constantly. I had a chiropractic adjustment last week, but he didn’t do anything with the rib. This popping in and out is driving me crazy. Any suggestions?

    1. Often with ribs, it takes several adjustments before they start moving properly, consistently. Be patient. You have to take time to heal. Also, if you actually feel a popping, besides the adjustment, you may have still fractured the cartilage which will not show up on an x-ray. Be careful, if that is the case. You have to wait until that heals before adjusting manually.

  20. I had pain in the upper back/shoulder blade area for the past few months, in that same spot that is highlighted in your image on the left side. A few weeks ago I did have 2 appointments with a chiropractor where he adjusted my rib. I felt better after my first appointment, but after my second my pain came back. I have been trying to ice and not slouch, gently roll on a foam roller, I also got a TENS machine to see if that would help. The pain isn’t unbearable, but definite uncomfortable when I breath deeply or when I’m sleeping, especially on my side. Currently it is obviously really hard to get another appointment, so I was wondering if you had any exercises or recommendations/things to avoid in the meantime? Thanks, this was a really helpful article!

    1. Hopefully, you are doing much better by now. I should get into the habit of checking this on a more regular basis. If the rib is out, getting it adjusted is where you have to start. Icing and heating can help ease the pain but until that rib is moving it is brutal. If getting an appointment with your chiropractor is hard, Find another one. I appreciate the feedback. Again, sorry for the late reply.

  21. Great article. I have 5 acute/subacute rib fractures to the L chest wall Ribs 2-5. the first 2 ribs are slightly displaced @ the outer aspect of the clavicular line. the first rib is pretty much out of place. What can I do to help re-align this. will it realign on its own after callous formation? thanking you in advance

    1. Fractured ribs change the game quite a lot. It can take weeks to months for those to heal. When they are fully healed, your chiropractor may have to be very gentle so as to not fracture them again. Hard to say what the long term issues will be. You can’t do anything while the callous is forming in terms of adjusting. I hope you heal soon and well!

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