What is First Rib Syndrome
Many adults experience neck and shoulder pain throughout their lives. According to Mastromarchi et al., “First rib dysfunction is considered one condition that can cause neck and shoulder pain, upper limb paresthesia (numbness in the arms), and neurological symptoms.”
Anatomically, the first rib is located just below the clavicle a.k.a the collarbone. With first rib dysfunction, the rib does not move properly or is positioned incorrectly. Many important structures can become compromised, including the subclavian artery and the brachial plexus. The subclavian artery is responsible for blood flow to the limbs. Meanwhile, the brachial plexus is responsible for muscle innervation. When these structures are compromised, they can lead to various symptoms, such as numbness, tingling, and muscular weakness.
What Are Some Symptoms Related to First Rib Dysfunction?
Common symptoms are:
- Pain in the neck, shoulder, and/or upper back
- Tingling, numbness, or weakness in the arm or hand
- Restricted range of motion in the neck and/or shoulder
- Headaches
- Tightness or pressure in the upper chest
- Difficulty with full inhalation
What Causes First Rib Dysfunction?
Many causes can affect the first rib:
- Poor posture: Forward head posture and rounded shoulders can place stress on the muscles such as the anterior scalene pulling on the first rib. This can lead to faulty mechanics and joint dysfunction over time.
- Overuse injuries: Activities that involve repetitive shoulder and neck movements, such as lifting and sports like volleyball and tennis can strain the muscles and ligaments around the first rib.
- Trauma: Direct trauma to the neck, shoulder, or upper chest, such as a car accident, fall, or sports injury can put the first rib in misalignment
- Tight muscles: Tightness in the scalene muscles can pull on the first rib which restricts movement and causes pain
- Sleep: Improper sleeping positions and/or lack of neck support can cause joint restrictions and cause the first rib to go out of alignment
How Is First Rib Dysfunction Diagnosed?
Diagnosis of first rib dysfunction involves a combination of patient history, physical examination, and sometimes imaging studies. Imaging can help to differentiate between first rib dysfunction and a congenital cervical rib.
How Can Physical Therapy Help First Rib Dysfunction?
Physical therapy is the first line of defense and can be highly effective by addressing the underlying causes, alleviating symptoms, and preventing recurrence. Specifically, first rib dysfunction is best managed with manual therapy, dry needling, and WinBack therapy. All of these treatments are provided at Symmetry Physical Therapy. Come see us at Symmetry Physical Therapy, located in the Miami/Brickell downtown area, where we provide an in-depth assessment and treatment strategies so we can help you get back to living pain-free!
Manual Therapy:
- Mobilizing the first rib to improve the mobility of the first rib and surrounding joints.
- Manipulation is a more forceful technique to correct the position of the first rib if it is significantly out of alignment.
- Soft tissue techniques such as massage, cupping, and myofascial release can reduce muscular tension and improve flexibility in the musculature that is affecting the first rib.
Dry Needling:
- Assists in the healing of tissues and the removal of increased inflammation of the injured area.
- Electrical stimulation (E-stim) with needles helps to increase opioid production in the body, blocks pain in tissues, increases blood flow, and removes byproducts and waste from affected tissues.
- Can help to release the acetylcholine trapped in trigger points to allow for optimal movements of muscles.
To look more at the science involved in Dry Needling check out the link here.
WinBack Tecar Therapy:
- Increased blood flow will help to deliver oxygen and nutrients to the affected tissues while removing waste products and facilitating the healing process.
- The heat generated by the therapy can enhance blood flow, improve muscle relaxation, and help to realign abnormal collagen fibers and scar tissue.
- Tecar therapy may help to reduce inflammation and promote lymphatic drainage
To look more of the science involved in WinBack Tecar therapy check out the link here.
Seek Help
First rib syndrome can be frustrating to live with, but you can do something about this and resolve your problems. Symptoms often improve immediately after seeing a physical therapist. To prevent surgery, conservative management with skilled physical therapists is, and should always be, the first line of defense against recurring symptoms. Here at Symmetry Physical Therapy, our physical therapists work one-on-one with each patient during every hour. This approach allows us to develop a fully unique, personalized program aimed at preventing recurrence and helping the patient return to normal. If you or a family member is suffering from first rib syndrome, please contact us to get back to your normal life as quickly as possible.
Feel free to give us a call at (305) 331 2277 to schedule an appointment.