Orthopedics-Online

Rib block

Synonyms

Rib blockage, rib blockage, blocked rib joint

introduction

The term rib blockage refers to the blockage, i.e. the restriction of mobility, of a rib joint. The rib joints are located between the ribs and the thoracic spine.

The joints are secured by various straps that severely restrict the freedom of movement of the joints. However, this restriction is necessary to give the chest the necessary stability and to ensure the upright posture of the body. Nonetheless, there is little room for maneuver, which allows, among other things, rotating movements of the upper body or bending movements. With a rib block, as the name suggests, the joint between the thoracic spine and the affected ribs is blocked. The restriction of mobility results in a feeling of stiffness and pain with various movements.

causes

The causes of a rib block can be found in two main groups subdivide. Cause for rib blocks namely Injuries (Trauma) different ways or Signs of wear be. While with injuries causes like Falls, Car accidents or that Lifting heavy loads are in the foreground, diseases such as arthrosis a major role. Falls, accidents or lifting heavy loads can displace the Joint lead into a position from which the joint cannot "go back", resulting in a rib blockage.

Degenerative diseases, i.e. diseases caused by wear and tear, for example the arthrosis, promote the development of bony changes in the joint. When moving, the joint can become wedged, resulting in restricted mobility. Also congenital deformities of the joints can block the ribs, but they are extremely rare.

Rib blockage from coughing

Rib blockages can be caused by coughing.

This is because the ribs are part of the bony protection of the chest and thus the lungs and must move synchronously with every breathing movement. The fine movement is only possible through the joint between the respective ribs and the spine. If the pressure or tension on the ribs changes enormously, as in the case of a coughing blow, it may be that one or more rib joints are released from their original anchoring position. If the joint parts are then slightly offset from one another, there is a blockage of the ribs.

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Blockage after a fall

Rib blockage can also be caused by a fall.

It is unimportant how the person concerned falls or at what speed or from what height he falls. The intensity of the force acting on the body only needs to be so great that a shock is exerted on the spine and the ribs, which exceeds the holding function of the surrounding ligamentous apparatus and thus causes a displacement of the bony joint partners. The more violent the fall, the more likely it is that the joint-forming parts of the ribs are further displaced and the rib may even break.

Symptoms

Pain

Blocking the joint between the rib and thoracic spine results in restricted freedom of movement, as the joint normally allows a small amount of freedom of movement. This also leads to pain at the level of the blocked joint. The pain follows the rib in a belt shape from the spine to the sternum once around the chest.
Those affected often feel pain between the shoulder blades and in the back. The pain can have a dull, pulling character.

Typical of a rib block is that the pain can improve or worsen through certain movements and changes of position. The pain also depends on the breathing mechanics, as the entire chest is moved here. When you breathe in, the lungs fill with air and expand along with the bony chest. At this moment, the affected person feels particularly severe pain and has the feeling that they can no longer breathe properly as a result. This can trigger a feeling of fear in the person affected, which increases the problem.

Also read the article on the topic: Rib blockage symptoms and Pinched nerve on the rib

Neck pain with a rib block

A rib block is when one or more of the small joints that connect the ribs to the thoracic spine have become wedged. In this respect, a rib block is an orthopedic phenomenon and has nothing to do with the heart. In this sense, a rib block is not a dangerous emergency like a heart attack.
However, rib blockage, especially on the left side, can easily be mistaken for heart problems. The symptoms of a blockage in the ribs are similar to those of a heart attack with a stinging sensation in the chest, a tightness in the chest area and painful breathing. Fear of a heart attack can lead to downright panic conditions with shortness of breath and a racing heart, which in turn makes it difficult to differentiate. A doctor should be consulted immediately, especially if such an attack occurs for the first time, in order to rule out a heart attack or other serious heart disease.

shortness of breath

In the presence of a rib block, the mobility of the affected rib is limited. So if the person inhales and the chest normally expands, it cannot rise like the other ribs. As a result, when you inhale, a blockage arises at some point, which those affected perceive as pain.

Inhalation is stopped reactively. Depending on the point in time of this "stop feeling" when breathing in, those affected breathe more or less shallowly and try to compensate for this by increasing the breathing rate. The oxygen uptake cannot be increased as a result, it only leads to increased exhalation of carbon dioxide. This in turn leads to shortness of breath.

Palpitations from a blockage in the ribs

Palpitations occur primarily reactively with a blockage of the ribs, as those affected feel acute pain and then, understandably, are usually afraid.

The racing heart is a physiological response to the pain and not caused by the rib block itself.The more affected people are influenced by the symptoms of a rib block, the more palpitations they perceive. Conversely, this means that those affected should remain calm if possible in order to be able to address the cause of the pain causally and to protect their cardiovascular system.

Localization of the rib block

Right rib block

Rib blockages on the right side are usually expressed through right-sided, sharp painwho sometimes even seizure can occur. The To breathe difficult; activities such as pressing (for example, defecating) or sneezing make the pain worse.

Rib block on the left side

Left-sided rib blocks cause pain that is easy with the Symptoms of a heart attack can be confused. This includes Chest pain, especially on the left, one Feeling of tightness due to the restricted mobility and the Painful breathing such as radiating pain in the left arm or the left shoulder.

Patients suffering from such pain quickly become restless and anxious. This restlessness or fear can also be misinterpreted as symptoms of a heart attack. If such signs occur, a quick medical evaluation should be carried out to get one Heart attack safely to exclude.

How can you tell the difference between a blockage and a heart attack?

For laypeople it can be very difficult or even impossible to distinguish a rib block from a heart attack. In the case of increasing symptoms in the chest area in the form of pain, shortness of breath or a racing heart, those affected should definitely consult a doctor.

In general, however, there are symptoms that are more specific to a heart attack. A typical symptom is, for example, the radiation of pain to the lower jaw or the left shoulder, whereby the pain often has a destructive character and is accompanied by a clear feeling of tightness in the chest. Those affected often describe this as "not comparable" with otherwise known complaints. Those affected are therefore often cold sweaty, pale and panicked.

Nevertheless, a subjective description of the symptoms is not sufficient for the diagnosis of "heart attack". The only conclusive or exclusive is an EKG. For a rib block, on the other hand, it is typical that it usually occurs after movement and suddenly pain occurs when inhaling. From the localization of the pain, the pain is more in the back area than directly in front of the heart.

Important information on this topic:

Signs of a heart attack

therapy

The most important therapeutic goal in the case of a blockade of the rib joint is the patient's freedom from pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are the main drugs used. Acetylsalicylic acid or ibuprofen are active substances that can be found in NSAIDs. These substances prevent inflammatory reactions in the body by inhibiting inflammatory enzymes.

If the rib block is accompanied by strong muscular tension, muscle relaxants are often used. Medicines of this type loosen the hardened muscles and thus also help relieve pain. For example, suxamethonium chloride, a muscle relaxant that works in the peripheral nervous system, is used.

In addition to treatment with medication, heat therapy can be helpful. You can either use warm compresses, electric blankets, heating pads or heat lamps or take warm baths. However, especially with electric blankets or heating pads, it is advisable not to expose the skin to the heat unprotected or for too long, as in the worst case scenario, burns can occur. A warm bath relaxes tense muscles and improves general wellbeing.

Manual therapy

To solve a blockage of a rib joint one uses the manual (with the hand executed) therapy. The aim of this form of therapy is to release the blockage through the Use of targeted movements. The patient is first prepared, the blocked area is felt and examined, then a quick impulse is given to the blockage. Sometimes a loud crack can be heard, which is a sign that the joint is back in its proper position, so freedom of movement is restored. Once the blockage has been resolved, the patient is immediately symptom-free and no longer feels any pain, the full range of motion of the rib joint is restored and symptoms such as breathing difficulties are a thing of the past.

physical therapy

Physiotherapy with Massages and physiotherapy exercises is helpful to clear the blockage. It's all about the blocked joint to relieve. The so-called Traction therapy is often used here. The aim of this method is Relief of the affected jointto be reached by train.

Breathing difficulties in the context of a rib block can be resolved through targeted Breathing exercises to treat well. Are also important muscle strengthening exercises, because strong, well-developed muscles provide substantial protection against joint injuries by wrapping around the joint like a protective jacket. Fast movements, which would normally lead to damage to the joint, can be "intercepted" by the muscles to a certain extent. Various exercises that strengthen the muscles can then also be performed at home with expert guidance. Most of the time you don't need any equipment, you can do the gymnastics with your own body weight.

Loosen the rib block yourself

Especially if a rib block occurs for the first time, it is important to see a doctor to confirm the diagnosis. Serious internal diseases such as a heart attack or aortic dissection can cause similar symptoms and, if not treated, can be fatal. Those affected can have their orthopedic surgeon or physiotherapist show them how to get the blockage under control in an acute situation.
However, laypeople run the risk of pinching a nerve or damaging the articular cartilage if they are improperly reduced, so the corresponding exercises should be tried out well beforehand.

In any case, warmth in the form of a hot water bottle or a hot bath can help alleviate the discomfort. Pain medication such as ibuprofen or diclofenac can also provide relief in the first few days. However, since these can have side effects if taken for a long time, the intake should be discussed with the doctor if it is longer than a few days.
With a little warmth and patience, a blockage in the ribs often resolves itself within a few days. If the symptoms appear for the first time or if they last for a long time, a visit to the doctor is indicated.

Exercises for a rib block

There are a few exercises you can do at home that can help loosen up a rib block and ease the discomfort. In order not to worsen the symptoms by pinching a nerve or damaging the articular cartilage, it is advisable to first have a physical therapist or orthopedic surgeon show you the exercises so that they can be performed professionally.
The doctor or physical therapist uses certain moves to unblock the joint, which makes these exercises difficult to do on their own. There are no blanket instructions for unblocking, which is why advice from a professional is usually indispensable.
However, certain sports such as yoga, Pilates or a back school contain exercises that specifically strengthen the back muscles and thus prevent a reoccurrence of a rib block. In addition, this type of movement is essential during and after a rib block in order to prevent cramping of the muscles and the formation of blockages. Special breathing exercises are also very effective for a rib block, as those affected often have great pain while breathing and so only breathe superficially.

diagnosis

The cornerstone of the diagnostic procedure for a rib block is, as is often the case, that Anamnesis interview (Collection of the medical history) by the attending physician. The nature of the pain and the fact that the pain can be reduced by changing position are the first indications of a blockage of the rib joint. There follows one thorough physical examination, to rule out other possible diseases and assess the extent of the blockage. Neurological assessments like that Testing the reflexes on the arms, are also part of such an investigation. Finally there is the possibility with a Magnetic resonance imaging Also consult an imaging test.

forecast

A rib block can usually be treated well with physiotherapy or manual therapy, so that the symptoms subside quickly after successful therapy. Follow-up treatment or further medication are then no longer necessary.

Duration

In most cases, a rib block lasts only briefly and is released again by a random movement. The duration is therefore limited to seconds or a few minutes in the majority of cases.

In some cases, however, it may be that the rib blockage cannot be released by the person affected or that the patient adopts such an extreme relieving posture that the rib cannot reinsert itself in its original joint position. Here it pauses until therapy or a solution from a doctor, physiotherapist or chiropractor.

prophylaxis

Prophylactically, i.e. to prevent a blockage of a rib joint, it is extremely important Strengthen your back. The back school is the method of choice here. Various, strengthening exercisesperformed at home or under the guidance of a physiotherapist, help to strengthen all of the muscles in the back and maintain their protective function. In addition to strengthening exercises, also play Stretching exercises an important role. she keep the muscles flexible and allow more freedom of movement. Back-friendly lifting and carrying ensures that there is no blockage in the ribs when transporting heavy loads.

If you lift something heavy, you go into the back to relieve the strain knee and then straighten up with a straight back. If you put down your load, you also bend your knees with your back straight and then put the load down.

In general, you should always pay attention to to work ergonomically. In the office, too, it is important to avoid bad postures that result from long periods of sitting. Regular exercise and sporting activities are important, protective factors in preventing rib blocks.