The slipping rib syndrome, which is also called Tietze’s syndrome, develops due to having one of the ribs slip out of place. This scenario causes the ligaments that support the back and front of the rib to stretch unusually and cause pain in the chest. While this isn’t always the case, the tenth rib is usually involved in the development of this problem. This is because, unlike ribs from one to seven, the tenth, ninth, and eights ribs aren’t attached to the sternum, but anteriorly to each other with a loose and fibrous tissue.

In most cases of the development of the slipping rib syndrome, the ribs slip out of their positions because the ligaments that hold them become weak. The loose ligaments allow ribs to easily slip out of place, after which they stretch more and cause pain in the chest. In fact, even a coughing attack or excessive laughter may cause a rib to slip out of position. Moreover, conditions such as emphysema, bronchitis, asthma, and various other allergies can offer additional stress to the involved structures, further increasing the chances of the slipping rib syndrome.

What is Slipping Rib Syndrome?

Slipping rib syndrome can also occur due to heart, breast, lung, and chest surgeries, which are also likely to result in a lot of stress to rib attachments.

What is Slipping Rib Syndrome?

Like we mentioned earlier, the slipping rib syndrome occurs when one of the ribs; usually the tenth; slips out of its place due to loss or lack of sufficient strength in the ligaments that are supposed to hold them together in place.

The eighth, ninth, and tenth ribs are the likeliest to end up slipping out of their places, are they are not attached directly to the sternum like the other seven. Due to the same reason, these are called ‘floating ribs’. These floating ribs, instead of being attached directly to the sternum like the rest, are attached to each other anteriorly with a fibrous and loose tissue. Usually, the rib slips out of its place due to the weakening of the sternocoastal ligaments that attach them to the sternum. Due to this, slipping of the ribs out of their places becomes much likelier than would have been otherwise.

When a rib manages to slip out of its usual place, the initial symptoms feel somewhat like a heart attack, with its pain shifting from side to side of the chest, and sometimes even to the arms and the neck area. Some of the people who experience the slipping rib syndrome or Tietze’s syndrome find it really hard to breathe; however, such symptoms do not signify the seriousness of the issue.

Causes of Slipping Rib Syndrome

The exact cause of the slipping rib syndrome is currently unknown, but it has been observed as well as confirmed that certain situations and activities like trauma to rib cage, an inflammatory disease, viral infections, excessive coughing, sneezing, laughing, and other activities that may turn out to be highly stressful to the rib cage or the chest area.

In most cases, the tenth rib is the source of the pain caused by the slipping rib syndrome, as the last three ‘floating ribs’ are attached to each other at the back with the loose fibrous tissue, which is what mostly causes the pain by stretching due to rib dislocation. Moreover, the symptoms are likelier to target the lower ribs, as the blood supply they receive is poor and injuries caused to the cartilaginous tissues in the lower ribs do not heal completely by themselves.

Symptoms of Slipping Rib Syndrome

The most common symptom that develops due to the slipping rib syndrome is chest pain. This pain in the chest is much more intense in the acute phase of the syndrome, and usually becomes worse with every activity that stresses the chest area in some way. This includes breathing stressfully (for example, breathing deep), coughing, sneezing, swallowing, making sudden movements, experiencing pressure on the chest, wearing bras, etc. If you have been experiencing any of these symptoms, you may be affected by the slipping rib syndrome.

However, while you can predict the likeliness of you suffering with slipping rib syndrome, you should always go to a health professional for final diagnosis.

Treatment of Slipping Rib Syndrome

Treatment for the slipping rib syndrome exists in various forms, from physical exercise to consuming medicines. The following are some types of treatments used to improve upon the slipping rib syndrome:

  • Anti-inflammatory Drugs to Treat Slipping Rib Syndrome: Because it is also believed that the slipping rib syndrome is caused due to factors and conditions like inflammation in the constochondral junction, treatment can often include non steroidal anti inflammatory drugs, also known as NSAIDs.
  • Chiropractic Treatment for Slipping Rib Syndrome: Chiropractic treatment methods are known to restore any slipped ribs to their original locations. Chiropractic treatment involves the manipulation of the spine for the treatment of mechanical health issues. Massage and other manipulation techniques can be used to treat the slipping rib syndrome and help it back to where it should be.
  • Physical Therapy for Slipping Rib Syndrome: Physical therapy is one of the most useful treatment methods for curing the slipping rib syndrome, as these therapies tend to strengthen the muscles that are supposed to hold ribs together. Physical therapy, when used to treat the slipping rib syndrome, involves exercises like segmental breathing that can help the dislocated ribs fall back to their original places. You can perform various stretching exercises, segmental breathing exercises, alternative chest expansion and compression exercises, and seated rotation exercises to quickly cure your slipped rib.
  • Altering lifestyle: Making various alterations in lifestyle can also help sufferers treat their slipping rib syndromes. Incorporating mild and momentary activities can help people improve upon their syndromes, as well as prevent the occurrence of slipping rib syndrome. Making certain necessary lifestyle changes like avoiding activities that are stressful to the chest area, avoiding laughing, sneezing, or coughing way too hard, keeping yourself supplied with necessary nutrients, and building your muscle strength can help you avoid the slipping rib syndrome.
  • Surgery: Though only in extreme cases, surgery is also used to treat the slipping rib syndrome by placing it back to the original place by manipulating is physically- well, a bit too physically.
  • Home Remedies for Slipping Rib Syndrome: While the slipping rib syndrome doesn’t have many treatments that could be performed at home, you can still try to perform regular exercises or try to treat yourself chiropractically by pushing your ribs back to the right place. Moreover, you can try to alter your diet to keep your muscles and ligaments in shape good enough to hold your ribs in place.

What is the Recovery Period for Slipping Rib Syndrome?

The time taken by the treatment for slipping rib syndrome to end up in complete recovery can take anywhere from a day to a year, depending on the methods. Usually, exercises should show effect in a few weeks or months, recovery period following chiropractic methods to treat slipping rib syndrome can take few weeks. Surgery to treat slipping rib syndrome can take couple of weeks to months for complete recovery.

Written, Edited or Reviewed By:


Last Modified On: June 16, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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