Slipping rib syndrome: Causes, treatment, and diagnosis Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What is slipping rib syndrome Medically reviewed by Angela M. Bell, MD, FACP — By Bethany Cadman — Updated on April 27, 2022Slipping rib syndrome is a condition where the lower ribs slip away from their usual position. It occurs because of a defect or hypermobility in the cartilage that connects the ribs to the rib cage. Slipping rib syndrome can cause a person to feel pain in their abdomen, lower chest, and lower back. The condition is rare, and it can often be difficult to diagnose. This article looks at the causes and symptoms of slipping rib syndrome and when to contact a doctor. What is slipping rib syndrome Share on PinterestFriso Gentsch/picture alliance via Getty ImagesSlipping rib syndrome occurs when the ligaments around the ribs move, causing the ribs to shift or “slip.” It usually affects the eighth, ninth, or tenth ribs, also known as false ribs. These ribs do not join the sternum directly. However, they connect to the seventh rib via fibrous tissue or ligaments. This connection allows for greater movement and flexibility of the lower chest region. If this cartilage sustains damage or becomes weak, the ribs may slip. Symptoms of slipping rib syndrome When slipping rib syndrome occurs, the movement can irritate the nerves and strain muscles in the affected area. The result is inflammation and pain. The most common symptoms of slipping rib syndrome are:back painabdominal painpain in the middle of the chestpain in a person’s sidepain in the back of the ribs“popping” or “clicking” feelings, or the sensation that the rib is slippingdifficulty breathing due to pain during rib cage expansion and contraction In most instances, a rib only slips on one side, though it is possible for slipping rib syndrome to occur simultaneously on both sides of the ribcage. Complications Slipping rib syndrome can cause chronic, recurring pain. This may affect a person’s ability to sleep properly and impair their daily lives. Additionally, if the condition affects a person’s breathing, they may not be able to engage in exercise or may find day-to-day activity difficult. Causes of slipping rib syndrome Slipping rib syndrome occurs when intercostal cartilage between the ribs weakens and allows movement. This movement is often known as hypermobility. Movement of the cartilage may occur due to physical damage, congenital anomaly, or be of unknown origin. Congenital anomalies are conditions that a person has from birth. Conditions that may cause ribs to slip include:direct traumaindirect trauma from twisting, or jerking movementsmuscle tissue attached to the ligaments degeneratinga severe and continuous cough Diagnosing slipping rib syndrome Many of the symptoms of slipping rib syndrome are similar to those of other conditions. This means that a doctor may order several tests before confirming the diagnosis. A doctor will ask about a person’s symptoms and medical history and may perform a hooking maneuver test. The test involves the doctor hooking their fingers under the person’s rib margins and moving them upward and back. If manipulating the ribs in this way reproduces the patient’s pain, the doctor may diagnose slipping rib syndrome. A 2019 study found that dynamic ultrasounds can diagnose slipping rib syndrome in most cases. This form of assessment can also give medical professionals information on other ribs and risks in the surrounding areas. As slipping rib syndrome causes general pain and discomfort, people may mistake it for other conditions with similar symptoms. These may include:cholecystitis or inflammation of the gallbladderhepatosplenic abnormalitiesesophagitis, inflammation or irritation of the esophagusgastric ulcersstress fracturesmuscle tearspleuritic chest paininflammation of chondral cartilage in costochondritis or Tietze syndromeappendicitisvarious heart conditions Treatment for slipping rib syndrome Slipping rib symptoms may disappear on their own. However, if the condition impacts a person’s daily life, they may require additional treatment. Treatment will depend on the severity of someone’s pain and discomfort. Oral medications Doctors will often initially recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to treat pain from slipped ribs. In some cases, a person may also be able to reduce mild pain from a slipped rib with over-the-counter medications. Medical treatments Other treatments for slipping rib syndrome include:corticosteroid injectionslocal anesthetic injectionsnerve blocksmanipulation of the ribs into place Surgery If the condition causes continuous or severe pain, and if other treatments are ineffective, a person will require surgery. This is the only option to definitively cure slipping ribs. The surgical procedure is known as costal cartilage excision or resection. This procedure involves removing cartilage that is causing pain and discomfort in the chest. A 2020 analysis found that costal cartilage excision and resection resolved symptoms in most cases. Alternative treatments Some people may be able to manage their symptoms with noninvasive treatments and management techniques. These can include:physical therapyheat therapytopical NSAIDs creams and gelschiropractic treatmentelectronic stimulation When to contact a doctor It is essential to seek immediate medical attention if a person experiences intense chest pain or difficulty breathing. These could be signs of a serious or life threatening medical emergency, such as a heart attack. If pain is ongoing, causing discomfort, and affecting daily activities, a person should visit their doctor as soon as possible. As the symptoms of slipping rib syndrome are similar to other, more severe conditions, it is vital to get a proper diagnosis and start treatment quickly. Frequently asked questions What is the outlook for people with slipping rib syndrome The outlook for most people with slipping rib syndrome is positive. Many cases will resolve with rest and physical management. Surgical interventions are minimally invasive and typically produce positive results. What activities should people with slipping rib syndrome avoid A person will also usually experience pain when undertaking particular activities involving the rib cage movement. Examples include bending, heavy lifting, pulling, and pushing. Avoiding these activities and other strenuous forms of exercise may help reduce pain. What are the other names for slipping rib syndrome Other names for slipping rib syndrome include:twelfth ribrib-tip syndromenerve nippingclicking ribinterchondral subluxationcostal margin syndrome Summary Slipping rib syndrome occurs when one, or some, of a person’s lower ribs move out of place. This displacement can affect nerve endings and soft tissue in the surrounding areas. This can cause pain, discomfort, and difficulty breathing. Symptoms may resolve independently. However, several treatment options are available should slipping rib syndrome cause significant pain. Treatment options involve physical therapy, oral medications, painkilling injections, and surgical intervention. The outlook for people with slipping rib syndrome is typically good, and long-term management is possible. Last medically reviewed on April 27, 2022RespiratoryBones / OrthopedicsSports Medicine / Fitness 6 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Gress, K., et al. (2020). A comprehensive review of slipping rib syndrome: Diagnosis and management.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7901126/Khan, N. A. J., et al. (2018). Slipping rib syndrome in a female adult with longstanding intractable upper abdominal pain.https://www.hindawi.com/journals/crim/2018/7484560/Mazzella, A., et al. (2020). Costal cartilage resection for the treatment of slipping rib syndrome (Cyriax syndrome) in adults.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995823/Romano, R., et al. (2021). A new sign of the slipping rib syndrome?https://academic.oup.com/icvts/article/34/2/331/6374795Van Delft, E. A. K., et al. (2016). The slipping rib syndrome: A case report.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855817/Van Tassel, D., et al. (2019). Dynamic ultrasound in the evaluation of patients with suspected slipping rib syndrome [abstract].https://link.springer.com/article/10.1007/s00256-018-3133-zFEEDBACK:Medically reviewed by Angela M. Bell, MD, FACP — By Bethany Cadman — Updated on April 27, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageRib cage pain: Six possible causesMedically reviewed by Graham Rogers, M.D. The rib cage protects vital organs, such as the heart and lungs. Pain coming from a person’s rib cage may be nothing serious, or it may be a medical…READ MOREBack rib pain: What is causing it?Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT Many people have back rib pain at some point. 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