While “dislocated rib” is a common phrase, a true dislocation of a rib from its connection to the spine is exceptionally rare and severe. More often, what people call a “dislocated rib” involves other forms of displacement or separation. This occurs when a rib shifts from its normal position, particularly where it connects to the sternum or its associated cartilage, leading to pain and discomfort.
Understanding Rib Displacement
The human rib cage consists of 12 pairs of ribs. They articulate posteriorly with the thoracic vertebrae of the spine and, for most ribs, connect anteriorly to the sternum (breastbone) via costal cartilage. The first seven pairs are “true ribs” because their costal cartilages connect directly to the sternum. Ribs 8, 9, and 10 are “false ribs,” as their cartilages attach indirectly to the sternum by connecting to the cartilage of the rib above them. The last two pairs, ribs 11 and 12, are “floating ribs” and do not connect to the sternum.
Common forms of rib displacement include costochondral separation, where a rib detaches or tears away from the cartilage connecting it to the breastbone. Another type is costovertebral or costotransverse joint subluxation, which involves a partial displacement of the rib from its connection to the vertebrae in the back. This minor misalignment is often called a “rib out of place.” Slipping rib syndrome occurs when the cartilage of a lower rib (typically 8th, 9th, or 10th) becomes hypermobile and can “slip” under an adjacent rib, irritating nerves and causing pain.
Causes and Symptoms
Rib displacement can result from direct trauma like falls, car accidents, or sports injuries. Repetitive strain also contributes, with actions such as severe coughing, sneezing, poor posture, or specific exercises potentially causing displacement. Underlying conditions like hypermobility or severe osteoporosis can also increase susceptibility.
Individuals with rib displacement often report sharp, localized pain that worsens with movement, deep breaths, coughing, or sneezing. The affected area is tender to the touch. With slipping rib syndrome, a “popping” or “clicking” sensation may be felt in the lower ribs. Swelling or bruising can occur, and difficulty breathing deeply is a frequent complaint, as chest expansion intensifies the pain.
Diagnosis and Treatment
Diagnosis of rib displacement begins with a physical examination. A healthcare professional will palpate (gently press on) the ribs to identify tender spots and observe rib cage movement during breathing. While X-rays rule out fractures, they often don’t show rib displacements or cartilage injuries. MRI or CT scans may assess soft tissue damage, and a dynamic ultrasound can sometimes show a slipping rib in motion. In some cases, diagnostic injections of local anesthetic help confirm the diagnosis if physical findings are unclear.
Treatment for rib displacement is often conservative. Rest and activity modification are recommended to prevent further irritation and allow healing. Pain management involves over-the-counter pain relievers like NSAIDs, and ice or heat application to reduce inflammation and discomfort. Physical therapy is important for recovery, incorporating gentle exercises, stretching, and posture correction to improve mobility and support the rib cage. In rare and severe cases, or when conservative treatments are ineffective, surgery might be considered.
Recovery and Prevention
Recovery from rib displacement varies based on severity and injury type, generally ranging from a few weeks to several months. Most simple rib injuries heal within 6 to 12 weeks with conservative management. Adhering to medical advice and prescribed physical therapy exercises is important for recovery.
Preventative measures focus on minimizing strain and maintaining proper body mechanics. This includes practicing good posture (especially when sitting or standing) and using proper lifting techniques to avoid undue stress on the ribs. Strengthening core and back muscles provides better support for the spine and rib cage. Using correct form during exercise or sports and avoiding repetitive movements that strain the rib cage can help prevent recurrence. Addressing chronic coughs or sneezes promptly also reduces the risk of rib displacement.