Overview of Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction
Rib issues can happen in many ways. This article talks about how to spot, diagnose, and treat rib problems that are caused by inhaling. These problems with the ribs can cause pain in the chest wall and muscles, thoracic outlet syndrome (a condition that causes pain in the neck and shoulder, numbness and tingling of the fingers), and intercostal neuralgia (a condition that leads to intense, sporadic, and recurring pain in certain areas of the chest).
If the ribs don’t move as they should, it can lead to a build-up of surplus fluids in the tissues below the skin, as well as a worse respiratory issue.
Inhaling rib issues happen when two or more ribs move towards the patient’s head and don’t move as they normally should. This occurs when the ribs lift while breathing in and don’t move freely back to their regular spot when breathing out.
To treat inhaling rib issues, the doctor needs to identify the main rib causing the problem. This is done so they can allow the ribs to move as they normally should. The treatments usually are done by an osteopath and include moving the ribs directly and indirectly. Treatments that are direct move the ribs to their normal stopping point, whereas treatments that are indirect move the ribs to their comfy spot. The end goal of treating this issue is to make the patient more comfortable, improve the flow of fluids in the body, and return the movement of the chest wall back to normal.
Anatomy and Physiology of Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction
The thoracic cavity is the part of the body that houses important organs like the heart and lungs. It is protected by twelve pairs of ribs. These ribs connect to the sternum (breastbone) at the front of the body, while the back of the ribs connect to the spine. Ribs 1 to 7 are known as ‘true ribs’ as they connect directly to the sternum. The next three ribs, known as ‘false ribs’, connect to the cartilage of the rib above them, not directly to the sternum itself.
Ribs 11 and 12 are called ‘floating ribs’. Unlike the other ribs, they are not connected at their front ends to the sternum or to the cartilage. This is why they are known as ‘floating’.
Your ribs have a particular design for connecting to your sternum and to your spine. There are areas for these connections – the ‘head’, ‘neck’, and ‘tubercle’. The head of the rib is flat so it can connect to the sternum or to the cartilage.
There are certain muscles attached to the ribs that help with breathing. When you breathe in and out, these muscles move your ribs up and down, which increases and decreases the space in your thoracic cavity. The ribs moving like this helps air flow into and out of your lungs. Ribs 1 to 4 move up and down more prominently, whereas ribs 5 to 10 move more sideways, a bit like a bucket handle moves.
The muscles for breathing include the scalenes, intercostals, and the diaphragm. The first rib, for example, is lifted up when you breathe in by the scalene muscles. The diaphragm also plays a crucial role in breathing. When you breathe in, your diaphragm muscle flattens out, making more space in your thoracic cavity so air fills your lungs. When you breathe out, your diaphragm relaxes and returns to its dome shape. This process also helps move lymph, a fluid in the body, and returns it back into the blood system.
Why do People Need Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction
Myofascial Release is a type of physical therapy often used to treat various conditions. This technique is particularly useful in various situations such as, for the elderly, people who are severely ill, those with diseases causing degeneration, individuals with Down Syndrome, or pregnant women. It can also be helpful if for some reason you can’t tolerate a more direct therapy approach, if you have bleeding disorders, if you’re dealing with swelling due to poor lymphatic flow, or if you don’t have any symptoms but want to maintain your health.
High-Velocity Low Amplitude is another physical therapy technique. It might be a suitable option if you have no known medical issues, if other indirect manipulation techniques haven’t worked for you or if you have stubborn health issues that resist treatment.
Muscle Energy is a therapy technique that lets patients use their own muscle energy in a very specific way to help improve their range of motion and alignment. This technique can be useful for patients who had undergone surgery, patients who are confined to an intensive care unit, or people who can’t participate in active muscle contraction for some reason. This technique is also beneficial for people without any symptoms who would like to maintain or improve their flexibility.
When a Person Should Avoid Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction
There are certain medical conditions that can stop or limit treatments like Myofascial Release, which is a technique to release tension in the muscles and surrounding tissue. For instance, this treatment may not be recommended if you have:
- Broken ribs
- New surgical cuts in the treatment area
- Advanced cancer that might spread if lymph flow – which is the body’s way of removing waste – is increased.
High-Velocity Low Amplitude techniques, a type of therapy mostly using quick and gentle moves, may also not be recommended if you have conditions such as:
- Degenerative bone disease which is a condition where the bones lose their normal density or strength.
- Broken ribs
- Acute muscle sprains – a sudden injury to a muscle.
- Vertebrobasilar disease – a group of diseases that occur when there is poor blood flow to the back of the brain.
- Loose ligaments, as seen in Down Syndrome – a genetic disorder characterized by a range of physical and cognitive issues.
- Pregnancy
- Bleeding disorders – conditions that can affect the way your blood normally clots.
- Cases where the doctor finds any reason for concern while checking your medical history.
- A situation where you shouldn’t have any pressure on the joints between rib and spine due to new fractures or cancer spread.
Raising the rib, a treatment that involves lifting the rib cage to improve your breathing, may not be suggested if you have:
- Recently broken ribs
- A recent spinal surgery
- A skin infection in the treatment area
- Red, swollen skin on the treatment area.
Equipment used for Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction
Manual manipulative techniques are procedures where you, as a patient, are either sitting straight up or lying flat on your back. During these methods, the doctor gently moves your body or guides you to move in certain ways. These techniques work best if you, your doctor, and ideally a padded manipulation table are present. These treatments are part of what is known as osteopathic manipulative treatments, which are used to improve health and resolve symptoms in various parts of the body.
If a special treatment table isn’t available, do not worry. The doctor can still carry out the osteopathic techniques. They would simply have you lie down on the floor or sit down to do so.[11]
Who is needed to perform Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction?
The patient, that is you, and your doctor, who is responsible for your medical care. Both you and your doctor work together in your healthcare journey.
Preparing for Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction
Before starting any hands-on treatment, like osteopathic manipulative treatment, it’s important that the doctor gets either verbal or written agreement from the patient. The doctor will fully explain what they will do during the procedure and where they will put their hands during the treatment. They’ll also talk about the potential benefits and risks of different treatment options and how these relate to the patient’s unique health situation.
For new patients, the doctor will first do a thorough check-up that includes a full medical history and physical exam. They may also do some imaging tests, similar to X-rays, before starting high-velocity low amplitude treatments, which are techniques used in osteopathy to help treat certain health issues. This helps the doctor to understand the patient’s body better so they can provide the most effective treatment.
How is Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction performed
If you are experiencing rib problems due to inhaling, the doctor can identify these issues by examining the movement of your chest wall. This check is done with you lying down or sitting up. The doctor puts their hands on your chest, and asks you to breathe in and out, watching for any uneven movements. The doctor might repeat this lower down on your rib cage too. When your rib is not working properly, there will be more space below that rib and less space above it. Once the doctor finds the problem area, they can then proceed to treat it. Multiple techniques could be used to fix the dysfunctional rib.
Rib raising is a method that applies pressure to the rib against the spine. This gentle technique is used without any surgical tools and it is mostly used for patients in the hospital. Using this method, the doctor puts their fingers under the problem area of the rib, pushes upwards, and holds it in place until there is relief. This can help ease any restrictions in motion, increase your chest wall movement, and help to normalize the part of your nervous system that connects to the ribs.
Performing a myofascial release is another technique which can help to increase the flow of lymph, release muscle tension, and can be done on patients who are seriously ill. This technique is based on treating the tissues over the muscles and the bones by applying force to them. As a result, the rib cage is able to move freely without restriction. When conducting a myofascial release, the doctor puts their fingers on the lower edges of your rib cage and senses the side which has less softness and mobility as the restricted side. Next, the doctor puts pressure on that side until the tissues begin to soften, this is known as release.
The High-Velocity Low Amplitude (HVLA) technique is another method that is commonly used. In this method, the doctors use a short and quick movement that is applied in the direction in which the dysfunctional rib cannot move. This technique can be done on patients in different positions such as lying face down, sitting, and lying in a supine position.
Muscle Energy is another technique that is used in which the patient is actively involved. In this technique, the doctor moves the patient into the position of restriction and the patient attempts to move back into a neutral position while the doctor applies resistance. This can help make your rib that was previously not moving properly, move freely again.
What Else Should I Know About Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction?
Chest pain can be a common symptom that makes people seek medical help. Being able to pinpoint the cause of the pain – whether it’s heart-related, related to the lungs, or due to issues with the muscles and skeleton – is crucial. This prevents serious conditions from being overlooked. Dealing with problems related to the muscles and skeleton can make a huge difference. It can reduce the number of people needing to be admitted to hospitals, save money on diagnostic tests, and reduce the amount of time patients need to stay in hospital.
To shorten the time spent in hospital, doctors may try to decrease the use of certain medications including inhaled steroids, statins, and antibiotics delivered directly into the veins (IV antibiotics). These medicines are commonly used in treating inflammatory lung diseases like pneumonia and asthma, as well as non-inflammatory diseases like chronic obstructive pulmonary disease (COPD) and emphysema.
A type of therapy known as lymphatic pump techniques has been shown to reduce time spent in hospital, decrease the use of antibiotics for pneumonia, and improve immunity. Treatments that improve rib function can be very beneficial for patients dealing with a range of conditions such as intercostal neuralgia (pain caused by damaged nerves between the ribs), cystic fibrosis (an inherited disorder that damages the lungs), and lymphatic congestion (a build-up of excess fluid). Techniques that move the ribs can improve chest flexibility, and have been found to be helpful for patients with pneumonia caused by viral infections.
One condition often seen by doctors is the thoracic outlet syndrome. This condition causes numbness or tingling and a loss of movement or feeling in an upper limb. It can result from a number of causes such as abnormal cervical ribs (extra ribs above the first rib), neck or shoulder injury, or issues related to the muscles and skeleton, or due to healing bone fractures. When thoracic outlet syndrome is due to issues with the muscles and skeleton, treatments to relieve cervical rib issues can be beneficial.
The brachial plexus is a network of nerves that control movement and sensation in the upper limbs. A branch of this network spans across an area made between the cervical rib and certain muscle attachments. It can be the source of loss of sensation in the upper limbs due to pressure on the brachial plexus.
A recent study found out that the most common reasons for osteopathic manipulative treatment (a comprehensive manual therapy used to correct problems with the spine and musculoskeletal system) in patients admitted to the hospital were chest pain, rib pain, spinal pain and as an additional treatment for lower respiratory infections. Despite this, the study noted that whether the patient was treated with myofascial release (a type of therapy used to treat skeletal muscle immobility and pain), rib movement, or a lymphatic pump (used to stimulate the lymphatic system and improve immunity) there was no change in lung function tests after treatment. However, most patients reported benefits from the osteopathic manipulative treatments and said that they have improved respiratory symptoms.
