Question
QUESTION: Hello Dr. Gillman, I have had an UNDIAGNOSED pain in my right side (under my rib cage)since May,2006. I have sought every type of doctor you can think of for medical advice. In 2007, I was told that my gallbladder was not functioning correctly, thus I had it removed. My pain continued exactly as it had before the surgery. The only injury I can think of that may have contributed to my problem was a very bad fall in January, 2006..in which I landed on my tailbone while skating.

Recently, I went to a pain-management facility. The doctor suspected that my 11th and/or 12th rib had been injured and had been sticking into my tissue/ muscles or ligaments since 2006. Thus, I was given intercostal injections of a novocaine type drug into the nerves or areas around the 11th and 12th ribs. The pain stopped. Thus, the pain management doctor is now certain that what he assumed is correct and has advised me to have my floating rib or ribs surgically removed.

Some months ago, I had gone to a deep tissue massage person and he believed that I had ribs out of place. The deep tissue massage was extremely painful. It did not fix my problem.
 
My Questions: After the novocaine injections, can I now be sure that my floating ribs are the culprit? If so, can they be manually adjusted and removed from my tissue (which may have formed scar tissue by now, If not, would you recommend surgery, or is there something else that I can do?

ANSWER: Hi Sherry,

I have to agree that the pain is related to the 11-12 rib if an anesthetic block injection made the pain go away.   My only concern is that you have not had any other manual or physical therapy besides a deep tissue massage.   Have you gone to the chiropractor?   It would be good to try a few sessions of joint manipulation before having a major surgery.   Has MRI been done?  Any signs of compression fracture to the lower thoracic vertebrae from your fall in 2006?   Does MRI reveal any thoracic spine disc protrustion or bone spur formation that could cause nerve irritation into the rib area?    You may want these to be tested before surgery.  A well skilled chiropractic doctor can guide you through this.  See if you can find anyone on this list:  www.westhartfordgroup.com   Feel free to correspond again on this web site.

Dr. G

---------- FOLLOW-UP ----------

QUESTION: Dear Doctor Gillman,

Thank you so very much for your prompt reply.
Yes, I have had various MRI's and a host of other imaging
services. I retired from a major medical center,thus I also
saw and/or was treated by every medical specialty area..even
Orthopedic doctors.

Over the years, I have been treated by 5-6Chiripractors.
They have all been stumped. Do you think that steroids injections
would be a viable solution for the longterm? I don't relish the
thought of surgery....especially after having my gallbladder removed
because of this pain. Also, the pain management doctor
stated that I could experience ghost pain after having my rib
removed. He also stated that I would have to undergo therapy
because tissue may also have to be removed.

Thank you very much.

Answer
Hi Sherry,

Wow. You've really been through it.   What haven't you tried?  Forget about the title of the specialist/provider.   What method or procedure have you not tried?  Acupuncture?  Graston Technique?   FAKTR?   Exercise Evaluation and Training?  Rolfing?  etc...    Beyond this, I'm also afraid I have no magic answers for you.

Best of luck with this.  

Dr. G