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Causes of Slipping Rib Syndrome

Slipping Rib Syndrome refers to a condition in which your lower ribs’ cartilaginous tips become loose and cause pain in the chest and upper abdomen. In a healthy individual, ribs 8, 9, and 10 – which are also called floating or false ribs – are not directly connected to the sternum, but they are kept in place by loose fibrous tissue known as cartilage. 

When this cartilaginous connection becomes misaligned, dislocated, or loose, one or more of the lower ribs may become detached from the ribs above. The loose rib’s tip may also begin to curl inwards, thus pinching or compressing the nerves located between the ribs (intercostal nerves). This phenomenon is known as interchondral subluxation, and its causes are not fully understood.

thoracic spine depiction to show slipping rib syndrome

Nonetheless, we know that some key risk factors can cause further development of this syndrome. Let’s look at these below. 

Direct Trauma

The lower ribs of the rib cage are known as “floating ribs”, and are not anchored directly to the sternum. This makes them more susceptible to injury and trauma, which may move them out of alignment.

Traumatic causes of SRS include blows to the rib cage, falls, or injuries to the chest caused by playing contact sports such as football, rugby, or wrestling.


SRS might also stem from the micro-damage caused by carrying heavy weights or suffering from a continuous severe cough.

Hypermobility of The Rib Cage

Rib hypermobility is a condition that might arise from defects at birth, genetic malformations, or injury. If you have rib hypermobility, the ligaments that connect each rib to the sternum, to the spine, or to its own costal cartilage are weak or loose. This increases the risk of ribs moving out of alignment and becoming detached from the fibrous tissue that connects them to the ribs above.

Sudden Extension or Flexion

Sudden and forceful movements involving your upper abdomen or chest may lead to the dislocation of the costal cartilage connecting the lower ribs to the rib cage. These movements include rapid twisting, lifting motions, throwing, or pushing.

Congenital Anomalies

Anomalies in the chest wall present at birth, such as sunken chest or pigeon chest, as well as defects of the ribs or sternum, can alter the structure of the rib cage and make SRS more likely.

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Symptoms of Slipping Rib Syndrome

Slipping Rib Syndrome is often unrecognized or misdiagnosed because the symptoms it causes overlap with those of other conditions. For example, having trouble breathing and experiencing severe chest pain may be the symptoms of a heart attack. 

What’s more, every person might experience symptoms that vary in nature and intensity. Below, we’ll look at the most common telltale signs that you may be suffering from SRS. 

Chest Pain

Intermittent sharp pain followed by dull or aching discomfort in the lower chest and upper abdomen is the most common symptom of SRS. Painful sensations may extend to your flank, affect one or both sides of the rib cage, or intensify when bending, twisting, sneezing, coughing, or stretching. 

Popping and Clicking Sensations

Because of misalignments in the rib cage, you might begin to experience popping and clicking noises when performing movements, such as bending forward. These sounds are due to the ribs’ cartilage moving in and out of place, or the ligaments slapping from one bony surface to another during movement. 

Difficulty Breathing

When the lower ribs become dislocated, they may compress nearby structures, including the muscles and nerves around vital organs. This can translate into difficulty breathing or inhaling fully.

Regenerative Treatment Options for Slipping Rib Syndrome

Slipping Rib Syndrome might not be a life-threatening condition, but it can certainly cause debilitating, long-lasting pain. That’s why looking beyond pain relievers, corticosteroid injections, and non-steroidal anti-inflammatory drugs is crucial to finding a treatment plan that is sustainable in the long term. 

Orthagenex combines two of the most advanced regenerative orthopedic treatment options to provide each patient with a custom-designed therapy that does not involve medications or surgery. Let’s look at how these orthopedic regenerative treatments work.

Super-Concentrated PRP for Slipping Rib Syndrome

Platelet-rich plasma (PRP) refers to autologous blood samples that have been processed to have platelet concentrations that are 10-40 times higher than baseline levels using a laboratory setting. The use of PRP in regenerative medicine has received significant interest, due to its ability to deliver high concentrations of growth factors precisely and non-invasively to an area in need.

PRP procedures involve injecting the body’s own healing factors (platelets) into the injured tissue using image guidance with fluoroscopy and MSK ultrasound. This procedure can be used to treat a variety of orthopedic conditions, including joint instability, minor arthritis, ligament, and tendon injuries, and strains.

More than 30 randomized controlled trials have been carried out on the effectiveness of PRP to support the body’s ability to heal naturally by stimulating the stem cells within the targeted area.

Bone Marrow Concentrate Injections for Slipping Rib Syndrome 

Stem cells are an essential component of the human body and play an important role in the repair of injured bones, ligaments, tendons, and other tissues. However, when we age or suffer an injury, the body may become unable to deliver enough stem cells to the area in need.

To help with this, bone marrow concentrate procedures at Orthagenex use imaging guidance to deliver concentrated bone marrow containing stem cells to the area in need. This encourages the body’s inherent ability to heal itself by replenishing cell population in the injured area.

In practice, bone marrow concentrate procedures are carried out by cannulating the bone near the pelvis with a trocar, a sharp-tipped device. This provides a narrow tunnel that can be used to collect samples of the bone marrow’s liquid component, which is rich in stem cells.

BMC procedures can assist patients in improving their spinal health and mobility without the lengthy and painful rehabilitation periods associated with surgery.


If you suffer from Slipping Rib Syndrome, the chances are that your chest pain is overpowering every aspect of your life, from simple activities such as tying your shoes to performing well at work. 

However, taking medications every day or living in fear of having to undergo surgery are no longer the only two treatment options for SRS. At Orthagenex, we can help you discover a regenerative treatment program based on your unique needs and goals.

Now Available In:

Powder Springs, GA | New Lenox, IL

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