the noises made by chronically painful ribs

THE LIKELY REASON YOUR CHRONICALLY PAINFUL RIBS ARE MAKING NOISE

Rib Tissue Pain

Good morning everyone. I got this via someone posting on my RIB PAIN / RIB TISSUE PAIN page and thought I would answer it via a post instead of via a comment (only a few comments can be answered due to restraints on my time). 

Dr. Schierling,

I’ve been battling back right rib pain for over three years. At rest I’ll lean to the left, and when I do I feel multiple popping along the right side along with some of the sharpest pain I’ve felt next to dislocating my knee. I’ve done NSAIDS, local steroids, facet joint injections, epidurals, RFA’s, and local nerve blocks. Nothing works including muscle relaxers. The snapping is constant and repetitive nothing like popping knuckles, like dislocating snap in the back that can snap when leaning to the left or reaching out for something.I haven’t slept well in that three years usually about three hours a night. I’ve done the X-rays and MRIs.  The latest MRI shown thoracic herniation.  Waiting on a sonogram on the gallbladder to rule that one out.

Bobby T

Hello Bobby,  Every once and a while, I will take an email or blog comment from someone, and if I think lots of people could benefit, turn it into a post, which is exactly what I did today.  HERE is a previous example of this.

First, it’s important to realize that MRI does not provide a fraction of the diagnostic power we have been told it has (HERE, HERE, and HERE).  This is because many — probably most — of these sorts of problems are “FUNCTIONAL” as opposed to pathological.  Unfortunately, “THE BIG FIVE,” while sometimes able to bring about some temporary relief, is never a solution.  As for Radio Frequency Ablations (burning nerves via heat created from radio waves run through long needles that have been run into nerves), I often see them work for months at a time.  However, once they wear off, they never seem to work well again, and actually end up creating more pain because I believe they “scar” the nerve (SCAR TISSUE, you must remember, is as much as 1,000 times more pain-sensitive than normal tissue). 

Your problem does not act like Gallbladder.  Nor does it sound like one of the many problems associated with DISC HERNIATION (thoracic herniations are rare anyway).  There is a chance that you have damaged the cartilage.  However, MOST DOCTORS are competent enough to diagnose this problem rather easily.  What they are not good at diagnosing, however, are problems based on FASCIAL ADHESIONS and Connective Tissue restriction. 

Because Scar Tissue is so radically different than normal, healthy tissue (HERE), it is capable of causing lots of problems.  Due to the restricted range of motion and “tethering” that is almost universally associated with Scar Tissue (sometimes QUITE SUBTLY), the adhesed tissue will be pulled or stretched in ways it was not intended to.  This can create a variety of “NOISES” and is part of what is known medically as “creep” or “crepitus”.   Best guess is that this problem could be solved or at least helped very quickly with TISSUE REMODELING

However, without more information (and probably an exam to see exactly where the pain is), this post is just that — a guess. Sincerely, Dr. Russell S. Schierling

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