How Chiros Treat Heart Attacks (Spoiler: We Don’t)
Watch the YouTube video HERE!
A 40-year old man wakes up in the morning. Drowsy, he heads to his bathroom and turns his shower up to steamy. As he reaches up to grab shampoo, his chest suddenly tightness, his breath gets caught in his lungs, and he can’t move without pain all throughout his left side. What does he do?
The immediate urge here is to call 911 for a suspected #heartattack or cardiac event. There is merit to this – our protagonist is over the age of 35, male, has chest pain, and discomforts on his left side. These are all symptoms of a suspected #heartattack.
So what does he do? He gets to the ER as fast as possible, and after a short examination, was dismissed. What happened to him?
Well, he came to my clinic and after one treatment session left feeling 95% better. This is a REAL patient of mine, and a true story. As a quick disclaimer: #chiropractors do NOT treat #heartattacks.
This patient was presenting with:
- Unilateral (one-sided) pain that reached from around his back into his left sternal area
- The pain originally onset from a very common movement – reaching & twisting over head to grab a shampoo bottle
- There was no trauma involved
- He is a very active individual & meticulous in his diet plan
- He has pain on inhalation & all thoracic movements
- No neurological signs were present (like numbness down his arms)
- Feeling down the sides of his spine, he had some very tight paraspinal (muscle) knots
What’s the diagnosis?
This patient was presenting with something we refer to as a “#ribdysfunction”. Anecdotally referred to as a “rib-out-of-place”, #ribdysfunctions are issues with the costovertebral joints, or rib-spine joints, secondary to intercostal muscle spasm (which are the small muscles that exist between your ribs). When these little guys spasm they apply tension to the costovertebral joint capsule, which we perceive as pain.
One myth to put to rest is that #ribdysfunctions are not actually ribs “moving out of place” – although to the patient, they sure as hell may feel that way. The rib head remains in the proper location, however inflammation is abound. Due to the proximity of the intercostal nerves – right by the costovertebral joints – the resultant inflammation from a #ribdysfunction may affect the nerve itself. This is why we may pain radiating into the front of a chest area with a #ribdysfunction. For a rib to be truly partially dislocated or medically subluxated out of spot would require some pretty severe trauma. Think motor vehicle accident, or getting hit in the back with a baseball bat.
The bad news with #ribdysfunctions it that they can hurt like hell, and usually come on for seemingly innocuous reasons. Individuals who have never had a #ribdysfunction before (or who don’t know any better) may honestly believe they are having a #heartattack. That’s how bad the pain can be. I myself am no stranger to #ribdysfunctions – I’ve been getting them since I was 15. Infact, I was the person who also thought he was having a #heartattack, however I was able to think my way out of that, given that 15 year olds don’t get #heartattacks very often.
The good news is that #ribdysfunctions are NOT DANGEROUS, usually resolve pretty quickly, and respond very well to chiropractic adjustments. Perhaps I shouldn’t say this, but this condition is actually comically nicknamed “the moneymaker” in a lot of chiropractic clinics, given that the before-and-after comparison of a patient having a #ribdysfunction and then getting adjusted is quite frankly night & day. The patient could be crawling into your clinic room, and skipping out of it. For this particular patient, we took a pain that was rated an 8/10 on a visual analogue scale and dropped is all the way down to a 2 in one visit.
Why do #ribdysfunctions happen? For the same reason that we would strain our neck or our low back; through improper movement patterns that our soft tissues are either not braced, or mobile enough to accommodate. So the question then is, how do we prevent them?
Whenever I have a patient presenting with a #ribdysfunction, a key component of their treatment plan is various thoracic #mobility ##exercises. My three most commonly prescribed are the cat-camel #exercise, the thread-the-needle #exercise, and a seated thoracic twist. If you would like to see these in action, watch the video above! Knocking these guys out twice a day decreases the likelihood of #ribdysfunction occurring, as well as decreases the severity of them should they occur.
The question for the average individual to be able to answer then is how to distinguish between a #ribdysfunction, and a genuine #heartattack. One is an annoyance for the next week, the other is possible death.
Two things to look out for in a #heartattack are numbness down EITHER arm, or potential jaw pain. There is a belief that numbness presents down your left arm with a #heartattack, but don’t let numbness down your right arm and not your left be the reason you don’t call 911. As well, there is no reason that I can anatomically think of that a #ribdysfunction would present with numbness in the upper limbs, or jaw pain.
#ribdysfunction pain will be provoked by certain thoracic (trunk) movements. You will also likely be able to find a position that , when remained in, reduces the your perceived pain. As well, they are commonly caused by small seemingly innocent movements (most commonly being rotational). #heartattacks are movement independent.
Finally, a #ribdysfunction will have a very obvious, focal point of pain beside the spine. If you were to feel down the sides of the spine along the paraspinal musculature, there will be a very obvious spot which, when pressed on, will greatly provoke the pain. A #heartattack will have no such focal spot – referral will probably be everywhere.
The last thing to note for this post is that a healthcare practitioner will probably very easily be able to distinguish between a #ribdysfunction and a #heartattack. However, to everyone that is NOT a healthcare practitioner, it is way way better to call 911 if you think you are having a #heartattack. It is better to make an unnecessary call and everything to be okay, then to not make a necessary call and… yeah.
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