Rib pain when sitting/laying down

Within the past few months or so, I've been having pain in my ribs if I sit leaning forward even slightly. It's worse at nights when I try and sleep and it keeps me tossing and turning all night trying to find a position to relieve the pain and it's really taking a toll on my sleep hours. The pain is on both sides of my rib cage a few inches in front of where my arms would rest if they were relaxed at my sides.

On my right side, I do have a rib that's twisted and made a indention about the size of a fist in my side. I'm not sure if it's just curved or gone completely under another, I haven't had it x-rayed because I have no medical insurance and my doctor's trying to keep things affordable. This rib I do have issues with rubbing and grinding ect. But there's no deformities on the other side. The pain is usually even if I'm sitting and if I'm on my side, it hurts on both sides as well, seemingly more pain on the side that curves rather than the one laying against the bed. The only way I can describe it is like there are ribs pushing against other ribs and putting pressure on them. That's what it feels like.

I haven't been able to talk to my doctor about the pain yet, since my next appointment isn't until early Feb. In the meantime, does anyone else have this problem? Is there any relief I can find other than pain meds? I can't sit straight up straight to relieve it because of my spine and it about puts me in tears when I do so that's out of the question.

In both sitting and laying down, my spine also hurts horribly and I do have mild scoliosis. I'm sure that's most likely the problem, but have any of you had similar issues you were able to find solutions to? I would really appreciate any kind of tips I can try. The pain is really starting to get to me and getting so frustrating at night. Any kind of pressure seems to hurt my poor little ribcage.

Thank you so much,

H

Edited January 4, 2013 at 10:59 pm

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Hello Hannah and welcome!

I am sorry for your pain. So, it sounds like you have at least one...and probably more...subluxated ribs. (A subluxation is a partial dislocation) It is also possible from the spine pain you are describing that at least one or more vertebrae are also subluxed.

When my ribs and vertebrae sublux, I have to take a muscle relaxant because my muscles go into spasm and actually lock the rib and/or vertebra out of place...so the muscle relaxant allows the bones to go back where they belong. The longer they have been out of place, the more challenging it can be to get them back in place.

On Christmas day, SandyL, a member on this forum, gave another EDSer very good tips on some ways to get a subluxed rib back in place. Here is what he wrote:

"On subluxed rib heads

Subluxed rib heads are one of the more common problems of people with Ehlers-Danlos syndrom or hypermobility syndrome. The ribs join the lateral processes of the spine in a joint where the rib end overlaps the front surface of the lateral process. Subluxation of this joint leads to pain at the site, most often between the shoulder blades. The subluxation often stretches the nerve for that level, which runs along the bottom of the rib. That may result in pain that seems to go through to the front or around to the side. The whole business is quite painful. I am aware of six procedures which, at least sometimes, correct the subluxation.

1. Fold your arms across your chest and twist your shoulders sharply to the opposite side.
2. Hang by your arms from the edge of a door or other overhead support. If your shoulders sublux easily, this may not be a good idea.
3. Tie a tennis ball into the middle of a nylon stocking, lay the stocking on the floor, lay down on the tennis ball (using the ends of the stocking to position the ball) so that the ball is a little to the side of the sore spot, then put enough weight on the ball to spring the rib a little away from the lateral process.
4. Have someone stand in front of, reach around and lay the base of a thumb along the rib to the side of the sore spot, then give you a firm hug. How firm will require practice. Start easy and work up to the right pressure.
5. Bend your elbows and hold them at your sides. Have someone stand behind you and lift sharply on your elbows.
6. See a chiropractor or osteopathic physician who does manipulation.
The subluxation my be brought on by coughing or by lifting/carrying heavy loads."

As far as pain in EDS, there are actually many ways to bring the levels down...though it often requires an entire toolbox. Pain in EDS is unique in the medical world because it is one of the few conditions causing both chronic and acute pain. To address this pain, we often have to use a variety of medicinal and non-medicinal strategies. This requires becoming a collector of methods of pain relief; a toolbox to battle pain. In addition to medicinal options you can work out with your doctor, some non-medicinal options include TENS unit, heating pad, ice, Topical products like Biofreeze or Tiger Balm, Warm soaks with Epsom salts, braces, canes, walkers, scooters, wheelchairs, Meditation, Biofeedback, Deep Breathing, Physical Therapy, Exercises, Massages, Acupuncture, Dry Needling, and Distraction. There are more options, but the more you can access when needed, the better your pain control will be.

Dr. Francomono describes her 5% Plan for Pain Relief. Take, for instance that your medications take care of 20% of your pain relief. Then you use your TENS unit for another 10% reduction. Some Tiger Balm on your painful joints brings another 5% of pain relief. Maybe you could pull out your heating pad too for another 5% of pain relief. Then you decide upon a warm soak with Epsom Salts for another 10% pain relief. Deep breathing and some PT exercises combine for another 10% of relief. And then you watch a great movie for another 15% of pain relief. So now you have 75% of your pain managed effectively. How would your days be different if 75% of your pain was gone? Dr. Francomono’s plan demonstrates the importance of using multiple strategies…even if each one only makes a tiny difference, the difference made when they all are added together is significant.

Mark’s 16 Page article about EDS Pain and what to do about it: http://www.ednf.org/documents/Pain_and_Managing_Pain_2012S.pdf

Dr. Levy’s 2011 Conference presentation on Pain Medications for EDSers: http://www.ednf.org/index.php?option=com_content&task=view&id=2052&Itemid=8 8889219

Dr. Tennant’s Intractable Pain Patient’s Handbook for Survival:http://pain-topics.org/pdf/IntractablePainSurvival.pdf

Anne Lynch-Jordan, PhD 2012 Conference presentation including Cognitive Behavioral Therapy, Biofeedback, Meditation, etc., “Pain Management: More than Just a Pill” http://www.ednf.org/images/2012Conference/Handouts/Lynch-Jordan_Pain_Manage ment_More_than_a_Pill_3notesS.pdf

Michelle O'Sullivan & Michele Pavlis, 2012 Conference, “Occupational Therapy Management of Hypermobility in EDS”, http://www.ednf.org/images/2012Conference/Handouts/OSullivan_Occupational_T herapy_Management_of_Hypermobility_in_EDS_notes.pdf

I hope you are able to get some relief soon. If not, you may want to ask about moving your appointment up if possible.

Gentle hugs...

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Thank you so much for the suggestions. I'll most definitely give these a try and see if it helps. I do have deformed vertebra which is a huge factor in problems like this, but I'll keep testing things to see what works. Thank you!

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I also have a lot of pain at the bottom of my ribcage in the areas you are referring to. The pain is usually worse on my right side, but it's definitely an issue on both sides. The pain sort of wraps around from my side to the front of my chest, in a few inches, and around and a little behind or under the bottom of my rib cage. For me, I think it has to do a lot with my posture in that I slouch (like many EDSers - due to the weakness/laxity in our "core" muscles. In order for me to sit (or even stand) up straight, I need to consciously "hold" myself up, which isn't possible for me to do all day/every day given my very limited energy supply. I've also noticed that sometimes if I sleep on my side and my body is not properly aligned, the tilt of my hips can also result in my ribcage digging into the soft tissue. My "theory" is that because my rib cage is so long (and the bottom of my rib cage is very close to the top of my hip bone), when I slouch, I suspect my ribs are digging into the soft tissue underneath. The tissues are quite tender and painful to touch. My physician (who knows EDS very well) confirmed that the pain I was experiencing around the bottom of my rib cage was, in fact, muscular. I haven't had as much pain in that area over the past few weeks, but it has returned within the past week or so and at the moment is hurting fairly consistently.

I often use a heating pad in an attempt to at least help with the tissue soreness. Perhaps a warm bath would help. I also found my symptoms improved when I began taking an NSAID regularly. It may be helping to keep the inflammation down. I hope you find something that helps. I actually posted about this issue earlier this year, and I have included the link to this discussion below. Maybe this discussion will give you some ideas as well.

On a very random note, during my childhood (and even now once in awhile) my mom very critically told me to "stand up straight" and all I could say is "I am trying". I can think of several instances in which I was criticized (whether it be by my mom, sister, friends, whomever) for something that I could not control or change. It wasn't until my mid-late 20s that I started to realize that the content of the criticisms I received was mostly related in some way to EDS, whether it be not standing up straight, hyper-extending my knees, frequent falls/ankle sprains, etc. Eventually, after many years of enduring hundreds of agonizing medical appointments (and useless medical professionals), the pieces of the puzzle (i.e., my many health issues, pain, fatigue, etc.) started falling (and continue to fall) into place and finally resulted in my diagnosis.

http://www.inspire.com/groups/ehlers-danlos-national-foundation/discussion/ pain-bottom-of-rib-cage/

Best wishes to you!

Erin

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