....these comments do not address the possibility of infection or other soft tissue complications, so by all means talk with your surgeon.
We should all be aware of the mechanical aspect of proper joint function in our spine and rib motion. As a patient, I too had sharp mid-back and rib cx that kept me from taking a deep breath, which worsened over a week or so post op.
As a chiropractor, I was aware of the cause of MY problem, which was a sprain/strain to the mid-thoracic spine between the shoulder blades where they place the device that lifted me into position with extended cervical spine that allowed easier placement of the various trachial tubes.
It is a common problem to have a partial dislocation of one or more ribs due to such a position. The effects of deep sedation produces a complete relaxation of the spinal musculature, which normally maintain a certain tonicity even during deep sleep. This means the only structural protection of the costovertebral joint and associated ligamental groups is put in a bind during that procedure.
During normal inspiration, the rib heads MUST move a certain way, and the opposite in expiration. The rib joint is composed of small facetal contacts on to vertebra, and MUST rotate and extend a certain amount, or there is limitation to chest wall expansion and deep breathing is compromised by the pain of dysfunctional joint mechanics. This is similar to a 'sprained ankle' in some aspects.
Add the effects of the musculature of the head, neck, shoulders, scapula, and regional spinal movement, along with demands of the muscles of respiration--it is not just the diaphragm that helps us breathe-- and you have a complex mechanism that requires precise timing of joint movement.
Symptoms of rib subluxation ('mechanical dislocation') typically include:
inability to take a deep breath IN--often patients are able to take slow breath about 50% of their normal, but rapid breathing or forced inhale beyond that limited amount is accompanyied by a sharp pain....many times feeling similar to an ice pick jabbed into the back an inch or to one side of the spinous process.
Commonly lateral bending is painful to the affected side. Forward bending is not usually so limited yet still painful. Backward bending is usually affected also.
Usually, at the begining of this problem the origin of pain is in the back. As time goes on, it can travel around under the arm. Eventually there can be pain at the costosternal junction as well.
If you have a rib displacement, there are a lot of intercostal muscles that will become spasmotic and hypertonic, and there can be a progressive and increasing amount of pain and loss of normal movement.
It is not usually recognized by PCPs who are not trained in spinal mechanics.
The longer you have a rib subluxation, the less likely it will resolve by itself. Chiropractors understand this and have an easy fix for the problem.
My experience is if the problem is only a few days old, usually ONE adjustment fixes it; if it is a week or two, it may take several adjustments. If it is a month or more, it may take 5 or 10 adjustments over a couple weeks to restore normal movement.
Again, this is mechanical disorder. See someone who understands this kind of problem.
And yes, I am a licensed Doctor of Chiropractic. Body mechanics is my field of expertise.
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Last edited by Jack; 04-19-2006 at 08:33 AM.
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