Q: I was in a car accident over 18 months ago and my ribs still hurt especially when I lift or even rub against anything. Is it normal for this to happen for so long?

A: Rib pain is considered the most intense and irritating pain a person can experience secondary only to fascial pain.

The ribs form a protective shield for your internal organs including your heart, lungs, liver, pancreas and spleen. The ribs are attached by extremely strong criss-crossing fibers called intercostal muscles. Any insult (trauma) provoking these muscles cause an innate response for them to contract. Once contracted, the muscles pull together or approximate each rib so they create a solid bone mass as to protect the vital organs underneath them. The pain occurs because also lining each rib and running its entire length from anterior to posterior is the intercostal nerve.

The nerves, running bilaterally between every rib, are very sensitive to light touch and pressure. In the event of irritation they immediately send signals to the intercostal muscles to contract and elicit an excruciating pain response. This reaction is a means of telling you and your brain to stop what is creating a potential damage to your vital organs.

The reason the pain maintains a chronic nature is to continue the protective mechanism of preventing further injury.

Acute rib injuries require ice, rest and compression. X-rays are very important in severe injuries to differentially diagnose fractures. MRI’s or CT’s (Cat Scans) can help determine if there is internal organ damage.

Chronic problems such as yours can heal with appropriate nutritional supplementation, moist heat treatments and stretching. You may also require wearing a rib belt when doing aggressive activities to avoid re-exaccerbation

Quote of the week: " The greatest thing in this world is not so much where we are,

but in what direction we are moving." O.W. Holmes