Many people who experience chest wall pain eventually receive a diagnosis of costochondritis, a common, self-limiting condition. This discomfort often leads individuals to seek non-invasive forms of treatment, looking for options beyond medication. Chiropractic care focuses on the musculoskeletal system, offering a way to address the mechanical factors that may be contributing to the pain. Understanding the nature of costochondritis and the rationale behind chiropractic methods provides a clearer picture of how this manual therapy can be part of the management strategy.
What Is Costochondritis?
Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone, specifically at the costosternal joints on the front of the chest. The primary symptom is localized chest pain that can be sharp, aching, or pressure-like, often affecting the second through fifth ribs on one side of the body. This pain is typically reproducible, meaning it can be triggered by pressing directly on the affected joints. Activities like taking a deep breath, coughing, or sneezing can also exacerbate the discomfort because they involve movement of the rib cage.
While costochondritis is a benign condition, its symptoms can closely mimic those of more serious cardiac or pulmonary issues. Any new or severe chest pain must be assessed by a medical doctor to rule out life-threatening causes, such as a heart attack. The diagnosis of costochondritis is one of exclusion, reached only after other concerning conditions have been eliminated through examination and testing. A person should only consider conservative treatments like chiropractic care after receiving medical clearance.
How Chiropractic Care Addresses Rib and Spinal Alignment
Chiropractic care for costochondritis operates on the principle that mechanical dysfunction in surrounding structures can place undue stress on the inflamed costosternal joints. The ribs form joints with the sternum at the front and with the vertebrae of the thoracic spine at the back (costovertebral and costotransverse joints). Restricted movement in these posterior rib and spinal joints can alter the biomechanics of the entire rib cage.
When the thoracic spine or the rear rib joints are stiff, the normal expansion and contraction of the rib cage during breathing is impaired. This restriction forces the less flexible costosternal joints at the front of the chest to compensate with excessive movement. The resulting strain on the already inflamed cartilage can worsen the pain. By addressing the underlying joint restriction in the mid-back, a chiropractor aims to restore normal mobility.
The goal is to reduce the mechanical strain on the anterior, inflamed tissues by improving the function of the posterior structures. Restoring proper movement in the thoracic spine and the costovertebral joints helps the entire rib cage move more freely and symmetrically. This reduction in compensatory stress may allow the inflamed costal cartilage to heal more effectively.
Expected Treatment Procedures
A patient seeking chiropractic care for costochondritis can expect a treatment plan focused on mobilizing the rib cage and the thoracic spine. A chiropractor will first perform a detailed physical examination to locate specific areas of joint restriction and tenderness. Treatment sessions typically involve gentle adjustments or manipulation techniques tailored to the delicate nature of the ribs and the inflamed tissue.
One common procedure is specific, low-force thoracic spine adjustment. This aims to improve the mobility of the vertebrae and the rib joints where they connect to the spine. These adjustments may be performed by hand or with the assistance of an instrument, such as an Activator, to deliver a precise, controlled force. The intent is to unlock stiff joints and reduce nerve irritation without aggravating the front of the chest.
Soft tissue therapy is also frequently incorporated to address muscle tension surrounding the painful area. Techniques like myofascial release or trigger point therapy are applied to the intercostal muscles between the ribs and the muscles of the chest and upper back. This helps to alleviate muscular guarding and tension that contributes to chest wall restriction.
Supportive Measures
Supportive measures are usually recommended to maintain improved mobility between sessions. These may include:
- Application of ice or heat to the painful area.
- Specific stretches.
- Postural exercises.
When Chiropractic Treatment Is Not Appropriate
While chiropractic care is generally considered safe for musculoskeletal conditions, certain circumstances require caution. A thorough medical history and physical examination must be performed before any treatment to ensure the patient is a suitable candidate for manual therapy. Adjustments are typically contraindicated in cases involving severe osteoporosis, as bone fragility increases the risk of fracture from manual manipulation.
Other absolute contraindications include active bone or spinal infections, tumors or cancers affecting the bones, and acute fractures or dislocations. For costochondritis, a patient should never receive chiropractic care for chest pain until a medical doctor has definitively ruled out serious cardiac or pulmonary conditions.
If the pain is accompanied by systemic symptoms, the patient must seek immediate medical attention. These symptoms include fever, unexplained weight loss, shortness of breath, or radiating pain into the arm or jaw. If a patient’s symptoms significantly worsen during a course of chiropractic treatment, they should stop the therapy and consult their primary care physician without delay.