Question
I started seeing a chiropractor after my lower back pain became severe enough to immobilize me.  I have been diagnosised with degenerative disk disease and my L4 & L5 have started touching.  I also had a straight condition in my neck.  I have finally accepted I will probably live with the pain as this is common, but am now concerned about another problem: Pain in my ribs.  I have mentioned it to my Chiropractor and he started adjusting the middle of my back with no results.  The pain only hits me when sitting.  It feels like a straights line from the back to the front, right through me.  The muscles, fat, or skin right under my chest muscles feel tight. The muscle between my shoulder blade and my spine feel tight.  If I stretch the pain does not increase but instead goes away, unlike a sore muscle (only while being stretched, only to return when relaxed.  Do I need to see a physcian.  I am afraid that my Chiropractor will shy away if I mention something like broken ribs?

Answer
Jeff,

Manipulation to the middle back can cause rib sprain and in some cases rib fracture.  It also is common to get sprains to the front of the ribs, along the margin where the rib bones meet the cartilage of your chest (along the nipple line and down).  Rib fracture is often dramatic, causing an unmistakable pain immediately after the joint manipulation.  Mild sprains are not always noticable immediately, but can become painful minutes after treatment.  You may not have any of this going on at all.  You may simply be feeling pain in the rib areas, but the pain can be generated from the spine or from your lungs.  I don't know what your age is, if you are osteopenic, if you are in ill health, are frail, etc etc.  If you are a 40 year old and athletic, then the odds of the above issues is nil.  If you are in your early 70's then I'd be more concerned.  The questions you have to ask your DC are these: Where is the pain coming from?   Is there a chance of rib fracture or rib sprain?   If the pain is coming from muscles or other soft tissues, then what is the most logical form of treatment?   Your chiropractor is a doctor that is trained to diagnose your ribs and spine, and if your condition warrants referral to some other kind of specialist or for tests/imaging, then he has the duty to order the tests or make the referrals.  

'Hope this helps.

Dr. G