The 5 Do’s and Don’t of Mid back, rib or chest pain
If you have pain in your mid back or chest and you aren’t sure what your next steps should be, then read on.
If you have been following this blog recently you will know that previously I have written about what causes rib pain as well as some ways to know if your mid back or rib pain might be something more worrisome that you shouldn’t miss. If you have missed it, read that post here.
However, during the last week I had a client who hadn’t been able to get into the practice for an extended period after their mid back pain had started and to make matters worse, not only did they not know what to do to try manage their issue, they had spent the best part of a week getting anxious about what was causing their issues.
This situation got me thinking;
“How do people what sort of chest/mid back pain they have and how do they know what to do for it?”
This thought inspired me to write these blog posts, the top 5 ‘Do’s’ and ‘Don’ts’ of how to manage chest/mid back pain.
The top 5 Do’s of mid back pain:
Get informed!
It is important to know your enemy. By far the most likely cause of your mid back/chest pain is something mundane and mechanical, but it is important to be aware of problems not to be missed that can cause your chest pain.
To read about some of the ways to screen to know if your mid back or chest pain is of more…immediate concern, read the “So how do I know if I need…to go the emergency room?” section of my previous post about rib pain.
Use ice and/or heat to calm down your inflammation and pain.
Yes, you CAN take an immediate active role in helping to calm down the discomfort you feel, even if you don’t wish to take pain killers or anti-inflammatories.
The correct use of heat or ice on your area of injury can help to decrease the level of pain you feel while still allowing you to take it easy while you have the injury.
There is a lot more to this topic but to make it as simple as possible; the general consensus is to try ice (frozen water…not the other type…that has too many side effects) if the injury is “acute”, that is, under 48 hours old.
Put the ice/icepack/peas on the effected area wrapped in a damp tea towel, 20 minutes on, then taking the cold off the area for 20 minutes. Repeat this for 1 hour and 40 minutes.
Beyond the first 48 hours the research suggests trying heat and Ice alternatively, or just heat.
To be completely honest with you, in my opinion, the research is not as conclusive as it was once thought to have been. As a result, although I recommend you try the guidelines, your only goal is to help ease inflammation and make the area feel better, if you find that one works better than the other, the goal is to make you feel better so that you can heal, so I would recommend that you use the modality that works best for you.
For a full run down of when you use, check out my previous post “Ice Ice Maybe”.
Keep moving.
If you have mechanical mid back or chest pain you’re likely to find that sitting is your worst enemy. Keep moving but don’t over do it.
When I say move I do NOT mean “take up squash”, “weed your garden” or “help your friend move house”, rather I mean that movement within your pain tolerance, at a relaxed and easy pace like walking, will help your body dissipate inflammation as well as start injured soft tissues to heal.
Listen to your body however, do not over do it! If you have decided not to take pain killers your body will be able to tell you if you’re doing too much. If you have taken pain killers, the absence of pain is NOT a signal that you have had the opportunity to heal and fix the underlying issue, the last thing that you want is for the pain killers to wear off only for you to discover that you are now in worse shape than you were before you took them.
Frequently in practice I will tell my clients to avoid sitting but don’t over do it, and if you ARE settling down to watch TV or a movie later in the day, commandeer the couch to lie down, preferably with ice or heat on the area, lying down doesn’t place as much strain on the affected tissues and so should give your body a chance to heal.
Watch your posture.
Specifically for mid back and chest pain, I am referring to Forward Head Posture (FHP). This one goes hand in hand with number 3, if your head is sitting forward compared to your shoulders it places an immense amount of extra pressure on your neck, upper and mid back, as well as promoting closing in and seizing up of your anterior chest structures.
In fact, I believe that FHP is a major contributor to mid back and rib pain, especially when its the “this came out of no where” type.
For discussion on posture, click here.
Get Help!
There is not prize for having the most pain in your mid back and chest. No one is helped by you waiting to see if it calms down only to arise again out of the blue down the track.
The faster you deal with issues like this the easier it generally is to get positive change. Not to mention, given how important it is to make sure you aren’t missing any of the more pressing reasons you might have mid back and chest pain, it is important that a health professional check you over and make sure you’re OK.
For more info about what you can do for your mid back, rib pain or chest pain, do not hesitate to get in contact with us.
The top 5 Don’ts of mid back pain.
DON’T have your partner or friend “crack” your back or stand on your back for you.
I know this might sound like I am being funny but it’s real. Believe me, I understand the temptation, especially when you feel like “getting it to crack” is all you need for it to feel like it will let go, but trust me when I say, that sort of thing is best left to the experts.
Chiropractors go to university for 5 years to learn how to adjust people be as specific as possible and minimise risk as well. Most importantly, we know when NOT to manually adjust someones mid back pain.
Your partner or friend might have good intentions but it is not worth putting that responsibility on them.
At the very least, you wouldn’t want someone to accidentally re-enforce the negative behaviour your mid back, rib or chest is exhibiting.
DON’T Panic!
Even if you are concerned that your chest pain IS something you will need to visit an emergency room for, panicking about a possible diagnosis will make things worse.
As I said before, the most likely cause of your mid back, rob or chest pain is mechanical and non life threatening, so be alert but not alarmed.
If you feel OK but are in pain and you want to do something about it, get in contact with us quickly so we can help you get on track ASAP.
However, if you are genuinely concerned about your chest pain, rib pain or mid back pain, and think it might possibly be a heart attack or stroke, DO NOT HESITATE to call 000.
There is no point worrying about what would happen if it turns out you didn’t need to go to hospital. I have spoken to several medical doctors and ambulance officers about this and all of them say the same thing, they would much prefer to see someone who didn’t have a heart attack than not at all when they did.
Again, if you think you’re having a stroke or a heart attack, do not wait for confirmation, call an ambulance immediately.
DON’T put off managing the problem or hope it will go away.
This sort of magical thinking does NOT lead to good health outcomes.
Imagine applying this type of approach to a car, if it’s not running properly and you haven’t gotten it serviced, you probably shouldn’t drive it to Queensland (assuming one day we can again).
Waiting to see if an issue like this calms down and “fixes itself” is in my opinion one of the best ways to create a chronic recurrent injury.
Commonly in practice we will see client’s who are on their 4th or 5th relapse of the same problem “only this time it’s just not calming down like it normally would.”
Typically injuries, even ones that come out of no where and can come and go will get worse over time. They get more frequent, take longer to calm down, get more painful and eventually, they become all 3.
The sooner you get onto your injury is generally the fastest way to recover and in my experience involves the least risk of recurrence.
DON’T work through it.
This one obviously goes with our last point as well as the “keep moving” point from before. Do not overdo it.
Your body is in pain for a reason, even if that reason isn’t always immediately evident.
If you have chest pain, rib pain or mid back pain, there is an underlying cause to it, and if that cause is mechanical, pushing through the pain and acting as you would normally runs the risk of injuring you further or exacerbating your pain.
DON’T go it alone.
This is potentially the most important point and yes, I am aware that this is literally the same as the “Get Help” section above.
Again, there is not prize for having the most pain in your mid back, ribs or chest.
Health care professionals are here for you to use when you need us. Living your life at half speed because you are in pain isn’t noble, it just limits your quality of life and no matter how good your intentions of not looking after yourself first and focusing on those around you, none of them want to see you suffer and all of them appreciate you the most when you are at full strength and not in pain.
For more info about what you can do for your mid back, rib pain or chest pain, do not hesitate to get in contact with us.
RIB PAIN AND CHIROPRACTIC PART 2: WHAT TO EXPECT WHEN YOU VISIT US WITH RIB PAIN
If you have rib pain, pain in the rib area or you have pain in your mid back region and don’t know why, this post is about what you can expect if you came to see us as a chiropractor in South Melbourne.
This is the second part of a 2 part post about rib pain, for the first post click here so that there aren’t any spoilers.
Ok, so you’re up to date on part one? Excellent.
Let’s face it...as chiropractors, back pain really is our thing. You might have already guessed but along with neck pain and headaches, back pain including the mid back and rib regions makes up a large number of the people who come to visit us initially.
Unsurprisingly therefore, it is important for us to be able to efficiently find out what is happening in these cases and be able to determine their best course of action to move forward.
Ordinarily we would make a video of our assessment procedures of a specific region, however as Martin and Kieran are remaining separate from each other due to social distancing measures within the practice to combat the coronavirus, we haven’t been able to film one like we have for back pain and neck pain.
Instead I am afraid you’ll have to come on this journey ‘old school’ and use your imagination while I explain our process.
Please be aware, this description is for general purposes only and is not an exhaustive description of what you may personally experience.
Each person is different and so are their injuries, so we treat every client individually depending on their presentation.
For example, rib pain sufferers might require a neurological examination, for others we might require X-rays and for some, we may not be the ideal first place for their care at all!
We take pride in our initial examination's ability to individually assess rib pain sufferers quickly and effectively to determine their needs and best course of action.
Please see this explanation of a potential first visit with us as a guide to understand our thinking.
STEP ONE: HISTORY
To be begin, we need to make sure that you get to tell us all that you need to tell me about your rib pain, things like;
When did it start?
How did it start?
What makes it better?
When did it start?
What makes it worse?
What does it feel like?
Does it change when you move/sit/stand/lie down?
However mostly we want to understand is; what does the pain mean to you?
For a lot of people, the pain is only a part of the problem.
A big part of it is the impact that it's having on your life.
What are the things that the pain is stopping you from doing that you love to do or need to do in your life?
It’s really important that you get to tell us all about your rib pain so that we know what's going on.
STEP TWO: PALPATION
Next when you come to see us complaining of rib pain, is a palpatory assessment.
What we’re looking for with that assessment are areas where the joints are restricted in the motion.
When they are out of balance, they are not able to move the same left and right.
We also want to see if there are areas where there's increased muscle tension and/or the presence of tenderness.
We are looking for the areas where things are just not working how they should.
Once we've done that palpatory assessment of the area that is giving you problems, we will often also extend the examination beyond that area of pain because your spine is linked with the way the whole body works and so we will often then extend up into assessing how your neck is working or in other related areas.
STEP THREE: SHOW US YOUR MOVES
When we are assessing somebody who's come to see us with rib pain is to assess how they bend, move and twist.
Often when you have rib issues that will affect how far you can go one way compared to the other. The way we measure that is we use inclinometry, which is where we use an accurate measuring tool to see how far you can bend to the left comfortably and then compare the left side to how far you can move to the right. Simple as that.
STEP FOUR: ASSESS ALIGNMENT
The next step when we are assessing somebody who has come to see us with rib pain is we assess the alignment of their spine.
Posture is the window for us to be able to assess alignment.
To do this, we use specialised software where we can take a photo from the side and from the front.
We then digitise those photos and then analyse them to see if there are indications of misalignment in the spine.
The way the software works is that we first take a photo and it uses the iPad to make sure that we have a photo that is absolutely vertical.
The software then places a grid around exactly where straight up and down is and then we can compare landmarks on you that should also be aligned to see exactly how straight up and down or symmetrical your posture is.
So, you have looked at all that, what now?
After going through the above and/or any other investigations that your issue demands, and determining that we ARE the right people to help you with your rib pain, we would get you underway as soon as possible.
If you have any further questions or concerns about rib pain, please do not hesitate to get in contact with us.