Question
I'm a 25 y/o female, 5'3 and 108 lbs. I've been experiencing right side pain for the last 4 months now. I actually first noticed it about 9 months ago while jumping up and down on a mini trampoline during an aerobics class. I've practiced the same aerobics routine for 2 years, so I'm unsure as to why the pain all of a sudden occurred during this particular session. I wasn't doing anything strenuous or anything like that, but anyway. I'm fairly athletic and exercise 4-5 days per week, or used to... I haven't been able to since I've had this side pain... During the last 15 minutes of my aerobics class, I started noticing a sharp pain below my right ribcage. Since I only had 15 minutes left, I decided to keep going. As I kept moving, I felt moderate discomfort. After the class was over, the pain throbbed for about a day but went away. A few days later, I did an aerobics class and was fine. A few days after that, I performed the same aerobics routine and noticed the pain again. I worked through it and after the class was over, the pain throbbed for about a day or two but again, went away. I noticed it again about a week later while out dancing with friends. But, the pain subsided after the dancing was done. A few days later, I performed my normal aerobics routine, and again felt the pain, but continued with the class. This time, I was forced to take it really easy because of increased pain, but after the class was finished, the pain throbbed and ached, and it never went away! This pain has stayed with me every single day for the last 4 months. It gets worse when I sit down. It's no longer a sharp stabbing pain like when I felt when I was doing aerobics, it's more of a severe ache. It feels like a warm/burning/pressure/almost tingly sensation on my right side. The pain is generated from my abdomen/right flank, just under my rib cage, but above my hip and it radiates over to the right side of my back, all the way up the right side of my spine near my shoulder blade. It's almost like my whole right torso is affected. I feel a lot of pressure and a pulling sensation underneath my right rib cage. I have a very hard time sitting at my desk at work, leaning back in my chair, and leaning forward to write. When I wake up in the morning, the pain is pretty much gone! But of course within the first 5-10 minutes I start walking around a little bit and sitting down to eat my breakfast, it starts. It progresses throughout the day. I cannot do aerobic activity anymore. All I can do is walk at a slow pace, and even that irritates it. What I eat doesn't bother it. Nobody can figure out what I have, but it seems to be getting worse. I've had many different types of blood tests, I've had a CT scan of my right side, an MRI of my T spine, a bone scan, an X RAY of my ribs, an ultrasound of my right side, an ultrasound of my heart (echo) and everything has shown up normal. I've been checked for kidney stones, gallstones, kidney problems, liver problems, gallbladder problems, but so far, everything is normal! I also went to an OB and he checked my ovaries and uterus and said everything feels normal. He also did a quick rectal exam and he said things feel normal. The doctors are stumped. One doctor suggested, 搒lipping rib syndrome? Are you familiar with this and does this sound like the symptoms? I've researched it on the internet and the symptoms I've read on it and the symptoms that I am experiencing seem to be right on! What do you think? Have you dealt with this before and have your patients reported feeling better afterwards?

Answer
Dear Kristy,

Thank you for your question about your therapeutic diagnostic findings of 搒lipping rib syndrome.? Your question to me may be based on misconceptions or incomplete information about chiropractic and, since I have no information on your familiarity with chiropractic, in order to answer properly, I'll first need to give you some background on the chiropractic profession.    

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.  

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation.  This is not the same as the findings you mention in your question, though they may exist together with vertebral subluxations.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign, or subluxate, in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential, whatever that may be.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as exercise routines, perhaps, or sports, in general, but also such things as sleeping posture and mattress condition, the birth process, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, food additives, etc.), which are, unfortunately, uncontrollable and regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.
 
Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms whatsoever.  The reason is that most of what goes on inside you happens without your awareness.  As an example, try to "feel" your liver.  What's it doing right now?  You can't know, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  The branching of the nerve pathways is complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  For this reason alone, it is impossible for anyone to give you reliable answers as to a connection between the spine and specific symptoms of any kind, including the kind of pain you describe.  Certainly, every part of the body must have connections to the nerve system so that vital information may be transmitted between the brain and the cells.  There are some who would attempt to review the possible nerve connections between a nerve root and specific organs or tissues, but this ignores the multitude of variables that determine the expression of function.  The question of how your individual body carries out the myriad of activities just to maintain life is enormous and would require your Creator's (or creator's, for the agnostic) knowledge, or at least far more than our educated knowledge of the complexities of life.

The only way to know if someone has a vertebral subluxation is to have that person's spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible.  The term for this procedure is 揳djustment.? 

Notably, since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  You need to understand very clearly that the practice objectives of therapeutic mixed chiropractic and non-therapeutic straight chiropractic are quite different, as described above.  What I can tell you must not be interpreted from the mixed viewpoint.  So far, from what you related to me, you had visited only offices or practitioners of the therapeutic viewpoint.  It is quite understandable, then, why they would rely on therapeutically intended procedures or tests and not check you for vertebral subluxations.  

A key question to ask for your purposes, then, would be, Is someone with rib joint issues, assuming this conclusion is correct, better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.  So, having your spine checked for vertebral subluxation will be of tremendous value, but it's not for the purpose of dealing with the things you mentioned.  It's about something much larger.  In other words, non-therapeutic straight chiropractic can be of benefit to you (or any spine-owner, for that matter), but perhaps in ways that you may not have considered.  It's not that you should visit a non-therapeutic straight chiropractor FOR your rib issues or symptoms ?you should visit one in an effort to be free of vertebral subluxations, even WITH such things.  Non-therapeutic straight chiropractic is not about diagnosing and/or treating these or any therapeutic-model or medical condition.  It is entirely separate in its goal.  

I cannot comment, then, A key question to ask for your purposes, then, would be, Is someone with neck curve or rib joint issues better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.  So, having your spine checked for vertebral subluxation will be of tremendous value, but it's not for the purpose of dealing with a the things you mentioned.  It's about something much larger.  In other words, non-therapeutic straight chiropractic can be of benefit to you (or any spine-owner, for that matter), but perhaps in ways that you may not have considered.  It's not that you should visit a non-therapeutic straight chiropractor FOR your rib concerns ?you should visit one in an effort to be free of vertebral subluxations, even WITH such things.  Non-therapeutic straight chiropractic is not about diagnosing and/or treating these or any therapeutic-model or medical condition.  It is entirely separate in its goal.  

I'll not comment on your therapeutically-oriented diagnostic findings.  That doesn't mean I've never encountered people with similar findings.  It's just that the objectives are not the same.  The non-therpaeutic straight chiropractor will use methods of analysis, as I mentioned, to determine whether you have any vertebral subluxations, and effect necessary adjustments.  Therapeutic procedures or tests are not within the realm of appropriate non-therapeutic straight chiropractic.  

Incidentally, it would be wise to have your spine checked for subluxations by a non-therapeutic straight chiropractor even if you still elect to have therapeutic attention for your therapeutic concerns with another provider, whether that is with a therapeutic mixing chiropractor or some other provider to do so.  

If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area, please contact me at this site again or at [email protected].  You may also visit www.gschiro.com, a site that represents non-therapeutic straight chiropractic organizations on a state level.

Kristy, I wish you the best in understanding what non-therapeutic straight chiropractic has to offer.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.