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Michael Durtnall : Postural Computer Neck with Rib pain, chest pain, intercostal and arm pain

Sayer Clinics Chiropractor, Michael Durtnall of our Kensington practice,  discusses.

Imagine the misery of months of constant computer-related daily neck pain, middle-back, intercostal and chest pain. Increasingly many of us don't need to imagine it because we suffer this agony every day - if you repeatedly self-click your neck and grind your shoulder blade against your ribs it does not help - it perpetuates the pain.

Sayer Back and neck pain clinics in the City of London, West End and Kensington seem uniquely able to fully treat and cure this ubiquitous, yet marginally-recognised and poorly treated problem efficiently and pretty-much guaranteed every time.

Middle back pain with referred chest pain and arm pain has become a universal problem because almost everyone is sitting at computers in stylish and expensive but still appallingly bad ergonomic chairs. Everywhere, absolutely the wrong advice is given by so-called ergonomics experts - who tell you to place your feet in front, to lean-back in the chair and to work with your screen just below eye-level - this is guaranteed to create a hideous posture where your upper-back is rounded, chest is dropped down, shoulders are jammed backwards and up and your chin is poking forwards and upwards at a ridiculous angle. If your screen is also further away than your visual focal-distance it will create a forward shearing of the lower neck joints which cause compression and pinching of the nerves of the lower neck with chronic pain and spasm. Your neck becomes increasingly arthritic in just a few years.

Typically taller, stretchier young people from teenagers to late-thirties with looser ligaments most frequently suffer chronic neck pain, initially referring into the rhomboid muscles between the shoulder blades which then refers pain deep through to the front of the chest between the ribs and around the chest wall with a sickening, gnawing ache and muscular spasms. This chest-wall muscle, tendon and ligament pain and inflammation of the intercostal muscles and joints where the ribs attach to the sternum then refers more pain usually down the left arm with deep, depressing, heavy pain into the shoulder, elbow, hand and wrist. You can't sleep on your front without exacerbating the problem and you can't turn your neck to reverse cars or carry more than a little shopping a short distance without getting severe spasms and burning pain into the neck and shoulder.

These relatively looser-ligamented people then find themselves clicking and overstretching their necks and grinding their shoulder blades against their rib cage in a perpetually repetitive cycle of misery. Their friends comment on these repeated self-stretching tics but they are not even aware that they are doing it.

The sickening pain just continues DAY AFTER DAY, chronically for months until the chest pain is so unbearable that they think they are having a HEART-ATTACK.

So they end up in HOSPITAL for days of expensive medical scans and tests for cardiac conditions!!! - but which are all NEGATIVE!!!

Sufferers eventually and anxiously arrive at Sayer Clinics in miserable pain.

We digitally visualise the neck and thoracic spinal areas with incredibly detailed "three-dimensional" x-rays. We are able to show you the multiple depths and layers of your anatomy from spinal curvatures and early arthritic changes to signs of old injuries often from decades before. We can even show you the digital computed x-ray signs of the earliest beginnings of osteoarthritic joints in your neck or back.

At Sayer Clinics we address the difficult but necessary postural changes alongside incredibly measured and skilled chiropractic and osteopathic manipulation and specific ultrasound or laser 'inflammation calming treatment' to regain the normal movement of previously locked and torsioned neck, thoracic spine, chest and intercostals.

We give UNIQUELY knowledgeable advice and exercises and we work very hard to reduce the strain and tension in the inflamed lower cervical spine muscles: Trapezius, Levator scapulae, Rhomboids and the countless deeper, postural muscles of the neck and upper thoracic spine. This condition needs extremely focussed massage and very deep muscular manipulation by our splendid physical therapists.

For total rehabilitation the computer screen must be incrementally raised higher to eye-level and we recommend the correct forward tilting chair with neck-rest, but crucially show you how to sit to prevent recurrence of neck pain.

Once successfully treated, our patients stand and sit taller, with beautiful, vibrant posture and are soon fitter, more positive, happier and energised. They absolutely love their new pain-free posture and mobility. They refer us all their colleagues and friends who have suffered similar musculoskeletal problems who then all come in to see us for their course of 'posture makeover treatment'!

So, if you suffer pain in your chest? Does it spread from your neck and upper dorsal spine into the front of your chest or around your ribs and down your arm? Computer and laptop work for long hours with poor posture is the major cause of neck, shoulder, rib and chest pain. It can also be the result of whiplash and traumatic sports injuries.

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 spine and ribcage.

Chest pain referred from the lower neck or upper mid-back causes local pain as well as a deep ”hot knife or deep burning ache” and referred intercostal nerve pain into the ribs at the back and to the breastbone and costal rib cartilage at the front of the chest. This referred rib pain is usually also felt in the arm and hand.

ALERT: Patients with FEVER, severe COUGH or breathing difficulties with frontal chest pain should consult their medical practitioner.

Consulting us at Sayer Back and Neck pain Clinics in London includes a full case history and an examination of your heart and lungs to rule out a lung or heart condition. We examine and detect mechanical sources of pain, take digital computed x-rays, if indicated, and aim to successfully treat the musculoskeletal rib or referred nerve or muscle pain condition physically.

Treatment with Chiropractic, Osteopathy, Physiotherapy, Japanese or Medical Acupuncture , Physical Therapy, Shiatsu and Deep Therapeutic Massage:

Chiropractic or Osteopathy treatment, Physiotherapy and Physical Therapy laser, ultrasound, electrotherapy, massage, exercise and rehabilitation

Japanese or Chinese acupuncture or Medical Acupuncture and Therapeutic Massage help relieve chronic neck rib and shoulder pain

Receive postural retraining and advice on correct ergonomic seating and computer screen height and position.

Medical treatment of muscle pain includes non-steroidal anti-inflammatory drugs (NSAIDs). These only help in the short term but risk gastric acid reflux symptoms.

Rib and chest pain with deep ache or sharp, stabbing pain between the ribs spreads as a sick-ache through to the front of the chest under the breast where it is painful to touch the tender spots between the ribs.

Many middle aged men spend a lot of anxious time in hospital having extensive heart tests when they actually have a simple but excruciating intercostal neuritis, costochondritis or referred dorsal rib pain radiating into the chest and ribs as well as into the side of the neck as an ill-defined sickening ache down the arm.

Trauma, 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 to your breastbone or sternum.

This usually follow hours of inertia on a laptop or iPad rather than over-exertion. It can also be caused by seat-belt trauma as you are restrained during a car accident.

Rib pain - costochondritis, intercostal neuralgia, intercostal neuritis or costo-transverse sprain can be caused by heavy lifting, sustained awkward posture - falling asleep with your head lolling on a long car journey or flight, sleeping on your front or the ‘wrong’ pillow and is felt as deep chest pain as heart-pain, breast-pain or from lungs, stomach or oseophagus or as pain on deep inspiration.

Rib pain is often due to years of poor rounded posture where the middle thoracic spine becomes rounded (kyphotic) with the chest dropping vertically while 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 and working at computers and slouching on sofas.

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 utterly ridiculous but loads huge strain into the supporting muscles and ligaments which hold up your head and over time damages the muscles, which become fibrotic and the joints, which become arthritic, in the middle-back, chest and neck. Any scoliosis or sideways spinal curvature aggravates these stresses and pain enormously.

When rib pain becomes chronic, recurring and long term, medical treatment with painkillers, anti-inflammatory drugs (NSAIDs) or steroid injections into spinal joints is short-sighted, short-term, of limited help but with side-effects!

At Sayer Clinics we take diagnostic low-dose digital x-rays of the spine and ribs and treat spinal, rib and chest pain with spinal manipulation, long-term postural rehabilitation, deep muscle massage and core muscle exercises.

SAYER BACK PAIN CLINICS IN LONDON are the WORLD COSTOCHONDRITIS AND RIB PAIN EXPERTS to effectively treat the cause of your pain and rehabilitate your function and posture for good. Chiropractic postural training, treatment and advice on correct ergonomic seating and computer screen height and position is the key.

Sayer Clinics Chiropractors and Osteopaths in London are highly trained in medical diagnosis and will check for and rule out more serious medical conditions before starting any physical treatment. If we suspect a heart or lung problem, fracture, osteoporosis, rib infection, cancer or metastasis 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 subscapularis or rhomboid muscle spasm as well as longer-term levator scapulae shortening, rotator cuff injury.

'Stiff chest’ and 'musculoskeletal chest pain' syndromes result from years of contracted chest posture with super-tight pectoral muscles, intercostals, diaphragm muscles and fascia. Deep muscle-stretch massage with our incredible physiotherapists, shiatsu and acupuncturists gradually rehab the chest to become posturally-corrected, flexible and pain-free.

Chiropractic and osteopathic treatment of rib pain and chest pain involves detailed examination of the joints and muscles and assessing the mobility of individual ribs and joints. The recipe of therapy modalities changes for each individual patient at each treatment visit to enhance your improvement as your needs change.

Treatment restores wonderful pain-free movement and banishes chest, shoulder and arm pain.

The SOONER you address your posture, ergonomics at work, individual exercises and Pilates-based core fitness the better you will become for your future health.

Sayer Chiropractic, Osteopathy, Physiotherapy, Acupuncture, Shiatsu, Massage and Digital X-rays in London expertly and successfully treat your musculoskeletal neck shoulder, chest and arm pain.


Michael Durtnall DC MSc FRCC
Fellow Royal Society of Medicine
Chairman: Sayer Back and Neck Pain Clinics London