Ask the Docs
Why Does My Back Hurt When I Breathe? What is it and how to fix it?
By Dr. Jonathon Chung of Keystone Chiropractic
“It hurts right here (points to middle of back), especially when I take a deep breath in.”
“It’s like someone is poking a knife in the middle of my back.”
“Every time I try to stand up all the way, my back spasms.”
“I just want to crack this pinch in my back.”
There are times when pain can literally take your breath away. I know this feeling well because it’s one of the main things that brought me to the chiropractor’s office for the first time. That sharp, stabbing pain coming from a very pinpoint spot in the middle of your back. Sometimes it’s just a really annoying feeling that won’t go away, but other times it can make you feel crippled by back spasms.
In many cases, this pain comes from the joint where your ribs connect to your spine. Sometimes people will say that you have a rib head that’s “out of place”, misaligned, or sprained. For the sake of today’s article, we’ll just call it rib pain.
It’s a frustrating problem because it can happen out of no where. Sometimes you just wake up with the pain, other times it’s from twisting or turning too quickly, and in my case, it was from lifting too much weight overhead. Fortunately, even though we don’t know much about the pain, we do have effective strategies to help manage it when you feel it.
Why Does It Hurt So Bad?
The interesting thing about pain from a rib head is that the intensity and level of annoyance is really high for a problem that is pretty harmless. It’s not like a herniated disc where you may have other serious complications that arise, but the pain can sometimes be as debilitating.
Although this joint won’t result in pinched nerves that can cause muscle weakness or loss of feeling, it is extremely dense in pain generating tissue.
The ligaments shown on the image above, as well as the direct connection of the rib to the vertebra can be full of pain fibers called nociceptors. This joint is not supposed to have very much movement. If the joint gets overloaded and sprains the ligament, or if there is too much friction between the joint surfaces, then it stimulates an aggressive pain response in the brain.
When the pain response is initiated, the nervous system often looks to brace an area of injury, this typically comes in the form of muscle tightness and spasticity. As the muscles tighten around your ribs, it limits your ability to breathe in deeply. The muscle spasticity may also compress the nerves, arteries, and veins passing around the curvature of the ribs causing additional sources of pain and discomfort.
Unlike other parts of the body like the hand, shoulder, and low back, you don’t have a choice in moving your ribs. Your ribs move whenever you take a breath, and breathing is a little bit important to the maintenance of life. The more it moves, the more it can agitate the painful joint even if there’s minimal tissue damage.
How to fix it?
For most people, this pain will go away within a week without any treatment. However, if you have the pain for longer, you may need a little bit of outside help to correct the problem.
Most chiropractors can address the pain with a spinal adjustment to the thoracic spine or rib head. Typically patients will feel a substantial amount of relief within a few visits. When combined with some corrective exercise, you probably won’t have any further issues unless you reinjure the joint.
After my weightlifting injury I found myself having rib pain repeatedly even though I was getting regular adjustments to my back. You can say that I had chronic rib problems because I struggled to get long term relief.
I didn’t get long term relief until I got my upper neck corrected which finally seemed to make my spine maintain itself for months instead of a few days at a time. The way the neck influences the structure of the spine led to persistent muscle imbalance in my thoracic spine. Just like the image below, when the hips and shoulders rotate inappropriately, the rib cage can become a problem area.
Whether your problem is brand new or chronic, a Structural Corrective approach to the spine can lead to substantial relief.