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Conservative measures are often the first forms of treatment offered to patients with slipping rib syndrome, especially those in which symptoms are minor. [16] Often the patients will be reassured and recommended to limit activity, use ice, and take pain medication such as nonsteroidal anti-inflammatory drugs (NSAIDs). [ 4 ]
Costochondritis, also known as chest wall pain syndrome or costosternal syndrome, is a benign inflammation of the upper costochondral (rib to cartilage) and sternocostal (cartilage to sternum) joints. 90% of patients are affected in multiple ribs on a single side, typically at the 2nd to 5th ribs. [1]
Costochondritis is most commonly confused with Tietze syndrome, as they have similar symptoms and can both affect the costochondral and sternocostal joints. Costochondritis is considered a more common condition and is not associated with any swelling to the affected joints, which is the defining distinction between the two.
The McKenzie method is a technique primarily used in physical therapy.It was developed in the late 1950s by New Zealand physiotherapist Robin McKenzie. [1] [2] [3] In 1981 he launched the concept which he called "Mechanical Diagnosis and Therapy (MDT)" – a system encompassing assessment, diagnosis and treatment for the spine and extremities.
The costochondral joints are the joints between the ribs and costal cartilage in the front of the rib cage. They are hyaline cartilaginous joints (i.e. synchondrosis or primary cartilagenous joint). Each rib has a depression shaped like a cup that the costal cartilage articulates with. There is normally no movement at these joints.
The malpositioning seen on radiography may not cause any symptoms at all. If there are related symptoms, however, therapeutic options include chiropractic care, physical therapy and nerve block injections. As a last resort, decompressive laminectomy may be attempted to relieve pain symptoms and remove the abnormally enlarged portions of bone. [6]
Weight loss, to relieve symptoms and slow the progression of the stenosis; Physical therapy to support self-care. [37] Also may give instructions on stretching and strength exercises that may lead to a decrease in pain and other symptoms. Lumbar epidural steroid or anesthetic injections have low quality evidence to support their use. [36] [38]
The cast is usually worn for 6 to 8 weeks. After the cast is taken off, some patients are prescribed arch support for about 6 months. Also, moderate exercise is often beneficial, and physical therapy may help as well. [citation needed] Prognosis for children with this disease is very good.