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Costo-vertebral joint strain commonly occurs with excessive coughing, sneezing or lifting or suddenly with a twisting motion of the spine.

The costo-vertebral (CV) joint is the connection between the ribs and the spine. More exactly it is the connection of the ribs to the thoracic spine (part of spine between the neck and lower back). The CV joint is held together by strong ligaments that provide support to the joint. When the joint becomes strained the ligaments are damaged or torn resulting in pain and inflammation.

There are 24 CV joints in the spine i.e. one on each side for each of the 12 ribs.

Symptoms of Costo-vertebral joint strain

•    Pain on the side, front, or back of the ribs
•    Pain is relieved by lying on one side and increases when lying on the other side
•    Pain increases with coughing and sneezing
•    The pain often mimics angina or indigestion
•    There is often an associated muscle spasm that limits motion of the thoracic spine and ribs, and sometimes even the neck and lower back

Diagnosis and treatment

Your physiotherapist will be able to diagnose and treat this condition. Treatment initially will aim to reduce pain and inflammation. This may include the use of electrotherapy, ice or heat. Treatment would also focus on restoring normal pain free movement. Your physiotherapist may use such techniques as massage, stretches, breathing exercises mobilizations and manipulation to achieve this. Your therapist would also give you a home exercise program and advise you on any return to sport.