Rib dysfunction in pregnancy

By Dr. Alison Gault

Rib pain is quite a common musculoskeletal complaint in pregnancy. One of the possible causes for pain in the rib cage  in pregnancy is dysfunction of the rib.  This is when one of the joints that attach the ribs to the thoracic spine gets ‘stuck’ and is no longer able to move as it should.  This results in inflammation within the joint and also aggravation of the surrounding muscles such as the erector spinae that travel up either side of the spine and the intercostal muscles that pass between the ribs.  Even though one joint is generally the worst, often a group of ribs can be effected.

The symptoms of a rib dysfunction generally include:

• A sharper grabbing pain to the side of the spinal column where the costovertebral joint lies
• Muscle tightness and pain surrounding the joint
• Muscle tightness and pain in the intercostal muscles often experienced around the side of the rib cage

You may also experience symptoms further afar due to compensation patterns of the spine and also the far reaching effects of muscle tightness.  These can be symptoms such as headaches, neck pain and arm discomfort.

What is the cause of rib dysfunction in pregnancy

I believe that it is due to one of two things.  The first cause is an acute event such as bending over to pick something up and the joint gets strained.  This would most commonly be felt quite suddenly and you would defiantly know that something had happened.

The other cause could be a preexisting issue in the area that is aggrevated by the natural widening of the rib cage making room for the growing baby and uterus.  If a particular area of the spine or rib cage is lacking movement and malliability due to such conditions as scoliosis or a long term postural strain, the rib cage is not able to widen easily and gets aggravated.  In this instance, the onset of the pain would likely be more gradual and be associated with a growth spurt of pregnancy when the rib cage is being forced to widen.  You might also be familiar with this kind of pain having experienced it in the past.

In the first instance of acute onset, the pain generally settles down quickly within a few days and can be aided by using some ice, natural anti-inflammatory cream approved for pregnancy, treatment from a musculoskeletal practitioner as well as rest and avoiding aggravating activities.

If the problem is due to a lack of ability to compensate, this will more likely be a longer term issue. It may ease on its own over time as the hormone relaxin takes more of an effect.  Other things to help would be some hands on treatment to reduce muscle tension and improve motion of the spine, pelvis and ribs.  Stretches and improving posture with core strengthening exercises such as an exercise DVD addressing the core, a pregnancy pillow and lumbar chair cushion to improve spinal alignment.

In you have experienced problems in the thoracic spine or rib cage prior to getting pregnant, it would be a good idea to try and prevent issues developing by staying as flexible as possible with stretching and hands on treatment.  Exercise such as swimming, yoga or pilates would be great to keep you rib cage mobile and your muscles loose.

What products would help rib pain in pregnancy?

An adjustable total body support pillow will support your belly, back and pelvis to support some of the weight and enable better alignment of the spine when lying on your side.  This will reduce some of the muscular drag from the weight of the belly and lessen strain on the joints, ligaments and muscles of the rib cage. This is a great product for prevention as well as improving comfort if you are symptomatic.

The Great Expectations – Post natal workout is a program specifically designed using classic physiotherapy, Pilates and other techniques to strengthen the core muscles. Having good core strength improves alignment of the spine and pelvis so that there is not too much strain in any one area of the body.  We also sell a pack including the DVD and all the exercise equipment you need to get started.

A belly brace gently lifts the belly to reduce strain and improve alignment.   The weight of your belly is more evenly distributed rather than such a forward pull.

The Belly Bra has a wide supportive band help in place by a maternity singlet that gently lifts and supports the belly.  This can aid in taking some of the strain off the abdominal muscles and rib cage.