Question
I have been having severe pain in my right chest area for over 10 years.  It is getting worse.  Every time I breathe, turn, cough, or do anything it hurts.  Also, I have spasms going from the lower part of my spine all the way to the base of my skull which radiates over my head.  They will last for a minute or two minutes.  My doctor says that a rib is out of place, but I don't know how to get it back into place.  What could be the problem?

Answer
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Hello A.,

It sounds like there may be something more than just a rib out of place.  As always, it's impossible for me to truly know what is going on through an email alone.  But typically, ribs out of place do not cause that much pain for ten years.  And if your rib is really out of place, and if that is what is causing the pain, then you should feel a lot better after it is adjusted.  But the fact that it is getting worse is always an indication for a referral.  It doesn't necessarily mean it is serious or an emergency, but at the same time, it could be more than a simple rib misalignment.  It is best to stay on top of the matter if it continues to get worse.  If the doctor you are seeing is a chiropractor, you can ask him/her for a referral to a medical doctor or chiropractic orthopedist.  Sometimes special imaging may be needed to determine the root cause of the pain.  Again, I don't know enough about your health history, signs, or symptoms to really know what the problem is.  But some things that can cause the pain you describe can come from the viscera of your chest, such as your lungs.  

In chiropractic, the standard of care is generally to treat a patient for a couple weeks for their pain.  If the pain does not improve or respond to treatment, the doctor should try a different technique for a couple more weeks.  If after four weeks of treatment the pain is still present with no improvement (especially if it's getting worse) then it is time to refer the patient to a specialist or for special studies.  I hope this helps provide you with a bit of guidance.  Best of luck!

Dr. J.R. Strecker