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I have seen a chiropractor for the last three years on quite a regular basis. I am seen once a month for maintenance but sometimes have to be seen more often (up to 2 to 3 times per week). Besides herniated and bulging discs in my neck & back, my most common issue is that I have rib heads that come out of place (rib sublaxation). This tends to cause me a great deal of pain. I am continually having these adjusted with no permanent results. I have even changed my chiropractor to see if I could get better results (with no luck). Is there something else I can try? I am very active with tennis, exercise, etc. and do not want to give up my lifestyle but would like more permanent results.

Optional Information:
Female

Already Tried:
Chiropractic Care (Adjustments)

Customer (name blocked for privacy)

Status: Closed Value: $8

Have you every seen a medical doctor (M.D.) or an osteopathic physician (D.O.)?

Reply to Family Physician's Post: My family physician is a D.O. but I usually see him for everything except for GYN visits and my chiropractic issues.

Osteopathic physicians are trained in OMT (Osteopathic manipulative therapy) - in addition the full range of diagnostic/therapeutic skill of allopathic (M.D.) physicians.

Personally, I have had some training in OMT (in continuing education seminar) - and have found many of those skill very useful in treating patient with musculoskelatal problems. There are very significant differences in approach between osteopathy and chiropractic physicians. Most important is the fact that chiropractors are limited to maniupulation.

A complete physical examination, and possibly some screening lab work or X-rays would be a start. If your D.O. does not actively do much OMT - he could probably refer you to a D.O. who does or as an alternative - a Physical Therapist who has received training in the techniques.

Having manipulations so frequently for an extended period can cause joint structures to become overly lax - which allow things to keep slipping "in" and "out" all the time.

For information on Osteopathy - here is the website for the American Osteopathic Association
http://www.osteopathic.org/index.cfm?PageID=ost_main

I found you a good article on slipping rib syndrome - this is a case report of a swimmer with slipping rib syndrome: http://www.pubmedcentral.gov/articlerender.fcgi?tool=pubmed&pubmedid=15970959

Another option is prolotherapy - an injection of a concentrated dextrose solution designed to decrease laxity of connective tissues. It is considered an "alternative medicine approach" which has limited evidence to support it's use
Here is the abstract of a review of this procedure:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16162983&query_hl=6&itool=pubmed_docsum
and one related to its use for spinal pain
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15863087&query_hl=6&itool=pubmed_docsum

Edited by FamilyPhysician on May 21 2006 at 2:54 PM

Reply to Family Physician's Post: As a D.O., what would you do for a patient with my complaint? Have you treated rib sublaxation in patients and if so, how have you addressed the complaint(s) and how have the patients responded?

I'm sorry - I hope you didn't get the idea that I was a D.O. I am a M.D. who has had LIMITED number of courses in OMT.

I would not be able to specifically diagnose a condition by distance - But I'm sure that a D.O. who does OMT on a regular basis could at least provide a more complete evaluation that the chiropractors.

I also usually have patients with symptoms such as your see a physical therapist with the goal to reviewing their body mechanics/posture to see if there is something they are doing which is causing the problem to recur.

Frequently they are able to teach the patient stretching techniques to reduce the recurrence. One stretch I find often helps - running your hand down the outside of your thigh as far as possible - holding it for a few seconds and then repeating on the other side (Several reps each side - alternating) The other involves sitting with your arms crossed in front of you chest (your hand holding the opposite elbow region) and then gently twisting your upper trunk to either side - holding it for 5 seconds - again alternating sides.

Edited by FamilyPhysician on May 21 2006 at 3:50 PM

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