Log In

Contact Us

Monday to Friday: 8am-8pm
Saturday: 9am-1pm
020 7937 8978


Read our latest Patient Testimonials or view our video testimonials.

Read testimonials from our coccyx pain patients on www.coccyx.org

what clinic 2013

Top Wellness Clinic in London
Sayer Clinics London W8, W1 & EC2 is ranked as a top Wellness Clinic in London UK
Verified by Yocale.com

Call us on 020 7937 8978 to book an appointment

Mid Back, Rib & Chest Pain

Sayer Clinics London Costochondritis specialist treatment Clinics for Rib pain, Chest pain and Intercostal pain.

West London W8, West End W1 and Moorgate City EC2.

Are you suffering severe chronic or acute pain in your ribs? Was it brought on by an impact, coughing, weight-training or years of slouched posture at a computer. Does the pain spread from your breastbone throughout your chest, between your ribs and under your breast?

Is there pain on touching or pressure on your ribs as well as with breathing, twisting movements or turning over in bed?

Have you been told that "it's muscular or stress" and been prescribed drugs like pregabalin, gabapentin, amitryptalline or other addictive codeine, morphine-based drugs which minimally reduce pain but make you feel miserable, tired and low? Drugs do not cure costochondritis.

 If you can travel to London, contact us without delay for effective Costochondritis, Tietze, Intercostal Neuralgia, Rib pain treatment that works.

Computer and laptop work with poor posture is by far the commonest cause of chronic costochondritis, intercostal neuralgia, rib pain and chest pain.



Call Alexandra or Lucie on 020 7937 8978 or Book online 24/7 here

Severe referred rib pain to the side and front of your chest can be caused by nerve and muscle inflammation at the facet joints of your middle-back, rhomboid muscles or ligaments between your shoulder blades or from nerves in your lower neck or mid-back. It can be aggravated by breathing in, forced inspiration, coughing, lifting, twisting or side-bending of the neck or mid-back spine and ribcage.


Signs & Symptoms of Intercostal Neuralgia:

● Intense, sharp, stabbing upper chest pain

● Deep aching upper chest pain

● Pain worsens with coughing or laughing

● Pain that spreads around the chest wall

● Skin in the area has reduced sensitivity

Causes of Intercostal Neuralgia: 

● Poor posture  
● Prolonged coughing 
● Chest or rib impact or injury 
●  Pregnancy


Signs & Symptoms of Costochondritis: 

● Pain to the side of your sternum - breastbone

● Pain feels sharp and inflamed

● Pain increases with coughing or taking a deep breath in.

Causes of Costochondritis Include:

● Overdoing weights, gym exercises and intense coughing

● Injury or impact to the chest

● Osteoarthritis, Rheumatoid Arthritis, Ankylosing Spondylitis

● Joint infections or shingles

● Poor posture with stiff rounded middle back from slumped computer posture.


Chronic chest pain is often found to be referred from the lower neck or upper mid-back pinched nerves causing local pain as well as a deep ”hot knife or deep, sick ache” of referred intercostal nerve pain into the ribs at the back and to the breastbone and costal rib cartilages at the front of the chest. This referred rib pain may also be felt in the arm and hand.



***Patients with fever, severe cough or breathing difficulties plus frontal chest pain should first consult their medical practitioner***

Consulting us for your costochondritis at Sayer Back and Neck pain Clinics in London includes a full case history and examination of your heart and lungs to rule out a lung or heart condition.

We examine and detect mechanical sources of pain, if indicated take digital computed x-rays or an ultrasonic examination of the chest and ribs. Our aim is to successfully treat musculoskeletal rib or referred nerve or muscle pain condition physically.


Our costochondritis treatment succeeds using expert specialist Manipulation, Physiotherapy, Medical Acupuncture and Therapeutic Massage:

  • Chiropractic or Osteopathy manipulation treatment – specific, gentle spinal manipulation to mobilise and normalise spinal or rib joint and muscle function.
  • Physiotherapy and Physical Therapy – laser, ultrasound, electrotherapy, massage, exercise and rehabilitation
  • Japanese Acupuncture, dry needling or Medical Acupuncture and Therapeutic Massage helps relieve chronic and acute neck, rib and shoulder pain
  • Postural training and advice on correct ergonomic seating and computer screen height and position is essential. We train you how to stand and sit properly and how to adjust your workstation in our uniquely effective way to avoid repeated future damage to your neck and spinal joints.
  • Medical treatment of mild muscle pain includes non-steroidal anti-inflammatory drugs (NSAIDs). These  should only be used in the short term.


 Effective treatment for Costochondritis 

Rib and chest pain is often a deep ache or sharp, stabbing pain between the ribs which may spread as a sick-ache around or through to the front of the chest under the breast. It is usually very tender to touch the tender spots between the ribs.

Many worried sufferers spend a lot of anxious time in hospital having extensive heart, lung and breast examinations and tests while an expert in costochondritis can quickly diagnose the source of the pain when it is a simple but excruciating intercostal neuritis or referred dorsal rib pain which radiates into the chest and ribs as well as  potentially into the side of the neck and arm as an ill-defined sickening ache. 


Costochondritis is an acute inflammation of the cartilage that connects ribs to breastbone or sternum at the costosternal joints.   

‪Pain caused by traumas, falls and fracture are obvious causes of chest and rib pain whilst costo-sternal pain (Tietze’s syndrome) or intercostal neuralgia feels more like a heart attack or a very tender 'bruise' pain where your ribs attach toyour breastbone or sternum - but usually follow hours of inertia on a laptop rather than over-exertion.

Rib pain may be called costochondritis, intercostal neuralgia, intercostal neuritis or costo-transverse sprain and can be caused by heavy lifting, sustained awkward posture, sleeping on your front or the ‘wrong’ pillow. Our manual treatment to cure costochondritis in pregnancy is also very effective and it is felt as deep chest pain as if from the heart, lungs, breast or oseophagus or can cause pain on deep inspiration - breathing in.


Sayer Chiropractic and Physiotherapy experts in London for successful specialist treatment and costochondritis cure for rib pain.

Rib pain most often follows years of poor, rounded posture where the middle thoracic spine becomes rounded (kyphotic) with the chest dropping vertically from slouching at desks, laptops and sofas. This kyphotic, rounded posture has become "normal" in the last 10 years due to laptops, iPads and nearly everybody sitting badly all day working at computers.


People typically try to ”stand up straight” by pushing their shoulder blades up and back and poking or jutting their chins up and forward. This not only looks completely ridiculous but loads huge strain into the supporting muscles and ligaments which hold up your head and worsens muscle and joint pain in the middle-back, chest and neck. Scoliosis or sideways spinal curvature further aggravates these stresses and pain.

When rib pain becomes chronic, recurring and longterm, treatment with painkillers, anti-inflammatory drugs (NSAIDs) or steroid injections into spinal joints is short-term, of very limited help and with potential side-effects.

At Sayer Clinics we can, where indicated, take diagnostic low-dose digital x-rays of the spine and ribs and ultrasound scans of soft tissue lumps or cysts as needed and treat spinal, rib and chest pain with spinal manipulation, long-term postural rehabilitation, deep muscle massage and specific muscle exercises.

Our rib and chest pain painless treatment helps you to long-lasting postural improvement, better spinal function, better breathing and fitness.

Mr Michael Durtnall and his brilliant team are in constant demand and renowned as leading costochondritischest, rib pain and intercostal neuralgia specialist therapists here in London to efficiently diagnose, effectively and successfully treat and intelligently advise on the cause and resolution of your pain and to rehabilitate your health, posture, ergonomics and exercises for your best future health.

 Sayer Clinics: London - Best Costochondritis Treatment

  • Specialist manipulation costochondritis treatment – specific, gentle spinal manipulation to mobilise and normalise spinal joint function
  • Physiotherapy and Physical Therapy – laser, ultrasound, electrotherapy, deep tissue trigger point massage, exercise and rehabilitation
  • Medical Acupuncture or Therapeutic Massage helps relieve chronic neck and middle back pain
  • Advanced and unique postural training, treatment and advice on correct ergonomic seating and computer screen height and position is key.

Sayer Clinics Chiropractors and Osteopaths in Central London are highly trained in medical diagnosis and will check for and rule out more serious medical conditions before starting physical treatment. If we suspect a heart or lung problem, fracture, osteoporosis, rib infection or cancer we will refer you to your medical practitioner or hospital without delay.

The upper ribs form attachments for neck muscles and pectoral muscles where tightness or acute spasm can constrict nerves and blood flow causing numbness in the arm and hand. The shoulder blade (scapula) should glide smoothly over the ribs but rib dysfunction causes restricted scapular movement with pain on shoulder and arm movement and can cause the ”hot knife” agony pain of rhomboid muscle spasm as well as longer-term levator scapulae shortening, rotator cuff injury and ‘stiff chest’ syndrome.

Sayer Clinic Chiropractic and osteopathic treatment of chronic and acute rib pain involves a detailed examination of the joints and muscles and assessing movement of individual ribs. Treatment restores movement and reduces pain and muscle spasm for chest, shoulder or arm pain.

Rib Pain, Intercostal Neuralgia, Chest Wall Syndrome and Posture 

Most musculoskeletal chest pain seen each day at Sayer Back and Neck Pain Clinics across central London involve costochondritis or intercostal muscle strain. The diagnosis is clinical and after other causes of chest pain such as Rib Fracture, shingles, Myositis and Thoracic Outlet Syndrome have been excluded.

Slipping / Clicking Rib Syndrome

Dull chest joint and rib pain lasting hours or days with occasional stabbing pains brought on by particular postures or movements. 

Usually 8th-10th 'false' ribs, attached by fibrous tissue can let the rib tips slip up and back, pinching the intercostal nerve. Tenderness of the lower costal cartilages may be felt as upper abdominal pain when pulling the ribs forwards.

Successful treatment involves skilled manual therapy treatment, spinal mobilisation and postural rehabilitation of kyphotic - rounded middle back - the usual suspect in very many rib problems.

Exercise Trauma

Stress fractures of the first rib and sternum are a form of indirect trauma from extreme muscular forces seen with competitive athletes. Excessive muscular contraction with heavy lifting or excessive plank exercises can injure the intercostal muscles and rib joints with pain between the ribs aggravated by movement, coughing or breathing.



Costochondritis -  Xiphodynia - Tietze’s Syndrome

Costochondritis is chronic tenderness over the costo-chondral or chondro-sternal front rib joints. It is treated with skilled manual therapy and laser or ultrasound therapy at Sayer Clinics where we importantly manually treat and rehabilitate the poor posture, contracted chest, rounded and stiffening middle back and poking-forward-chin associated with sitting at sedentary jobs with screens too low.  

RTA motor vehicle accidents and whiplash injuries can also cause seatbelt-chest pressure injuries at the chest wall between the ribs and intercostal muscles which is extremely painful and requires early physiotherapy and chiropractic assessment and treatment.


Screens should be at eye-level whilst sitting with our novel, painfree and sustainable posture which we teach to our patients.

Xiphodynia is pain at the lowest pole of the sternum or breastbone and is a variant of costochondritis. Nerve supply from 4-8th thoracic intercostal nerves can mimic cardiac, gastric, or gall-bladder/biliary pain. Tenderness at the xiphoid process with moderate pressure is indicative.

Tietze’s Syndrome is not to be confused with costochondritis, Tietze's is an inflammatory condition of the costochondral (rib-cartilage) junction of the chest wall in teenagers and the early twenties. There is a red, hot, firm, tender, swelling, commonly at the 2nd costo-sternal joint. Our patients also present with painful tenderness at many other rib joints for which we have an unrivalled record of successful costochondritis cure. Pain and inflammation resolves over several sessions of manual physical therapy treatment, including laser or ultrasonic therapy with our excellent London physiotherapists and chiropractors.

Precordial Catch Syndrome. Intense pain over the heart on inspiration which resolves in less than a minute, is extremely localised, with sudden onset and resolution. The cause is not known and is not of serious concern.


Breast Pain. Breast pain is common and is often cyclical with sensitivity of breast tissue to oestrogen and progesterone. Fibrocystic lumps or Fibroadenomas are discrete, rubbery lesions which slowly enlarge and are usually not painful. If lesions persist longer than three months or enlarge the patient should see their GP or breast specialist.



Breast pain is often associated with intercostal muscle spasm and inflammation due to poor slumped posture, twisted rib cage or subluxated or stiff mid-dorsal rib-vertebral joints in the upper middle back. Wearing over-tight, underwired bras for long hours every day and over several years, typically causes breast tissue fibrocystic thickening and fibrosis.


Book first at Sayer Clinic: Kensington W8 to consult rib pain expert Mr Michael Durtnall, Costochondritis manipulation specialist in London for your initial consultation, and if indicated, x-rays or a diagnostic ultrasound scan and before starting effective treatment. Michael combines specific drug-free rehabilitation with our highly skilled costochondritis specialist Physical Therapists, Sofia Ornellas Pinto, Katy Goncalves, Karolina Krzaczek and Marta Dias de Oliveira at Sayer Clinics EC2, W1 or W8.

If you suffer mid-back or rib pain our London costochondritis specialist clinics will help you. We successfully treat Costochondritis patients every day who come to us from all over the world.

One thing we are very sure about is that the sooner you start treatment with us to improve your joint and muscle function,  flexibility, posture, exercise and fitness the sooner you will achieve and maintain excellent, pain-free future health.

Call Alexandra or Lucie on 020 7937 8978 – or Book online 24/7 here 


🌞 We are always here to help you