Though its various names appear to have nothing to do with the spine, slipping rib syndrome can cause severe back pain in your thoracic spine-or your middle back when one of your ribs shifts out of normal position. Costal chondritis, costochondritis and Tietze syndrome are sometimes used interchangeably and characterized by inflammation of the part of the rib that is cartilage. Most often the pain subsides after a few weeks or months but swelling may remain for a longer period of time.Slipping rib syndrome is a rare disorder that is known by many other names, including floating rib syndrome, lost rib syndrome, costal chondritis or costochondritis, and Tietze syndrome (for the German surgeon who discovered it).

Treatment consists of local heat, analgesics, anti-inflammatory drugs, or local steroid injections.

The medical history and physical examination are usually sufficient for diagnosis. It may be useful to use local heat as much as possible providing this does not aggravate the condition. It is important to find a suitable lying position in order to reduce the degree of discomfort. The pain from costochondritis may be most noticeable when an individual is lying in bed at night. The pain typically diminishes after a few weeks or months, but the swelling may persist. Sudden coughing or deep breathing accentuates the pain. The pain may have a sudden or gradual onset, and may be mild or severe, dull or sharp in nature. The tenderness and swelling are localized. Most patients have only one joint involved, usually the second or third costochondral joint. Pain, tenderness, and spindle-shaped swelling occur in one or more of the 4 upper ribs. The syndrome usually affects older children and young adults. Rheumatoid arthritis, ankylosing spondylitis, or Reiter's syndrome may involve costochondral joints but are distinguished easily by their other clinical features. The term costochondritis is often used interchangeably with Tietze's syndrome, but some restrict the former term to pain of the costochondral articulations without swelling. It is characterized by swelling of one or more costal cartilages causing pain that may radiate to the neck, shoulder, or arm and mimic the pain of coronary artery disease. Named after Alexander Tietze, a German surgeon (1864-1927), Tietze's syndrome is an inflammation of the costochondral (pertaining to the ribs) cartilages.

Slipping rib syndrome test