Cyriax syndrome: what to do to cure? (Symptoms and Treatment)

cyriax syndrome

Article reviewed and approved by Dr. Ibtissama Boukas, physician specializing in family medicine 

You feel a chest pain when you make a special effort like coughing, sneezing or lifting an object? It is perhaps the Cyriax syndrome. It is a condition that affects ribs and which leads to intercostal nerve compression.

Although there is no treatment to permanently get rid of this rib pain, there are various solutions to learn to live better with it. Discover them in this article.

Definition of Cyriax syndrome

Le Cyriax syndrome is a condition of low ribs. It is also referred to as the syndrome of slippery coast,  snapping coast or, costal end syndrome.

It mainly affects the 8eThe 9e and 10e ribs, most often on the right. The latter will undergo a subluxation at the level of their anterior cartilage.

As a reminder, these ribs are called "false ribs". because their point of attachment to the sternum is indirect. In fact, they are attached by the costal cartilage common to the last three ribs.

The cartilage that composes them has the particularity of being fragile, just like the interchondral ligaments. This makes the area more susceptible to malformation.

Thus, the Cyriax syndrome consists of a tilting of the cartilage that has become more mobile than normal (hypermobile). Indeed, this subluxation comes from a costal cartilage that is too flexible. Two cases are possible: either the cartilage tilts below, or it tilts above. This can lead to compression of a nearby nerve.

Specifically, the intercostal nerve located between two ribs is compressed or irritated, hence the appearance of strong and spontaneous pains, as well as other characteristic symptoms of Cyriax syndrome.

What are the causes of this syndrome?

Research shows that men are the most affected by Cyriax syndrome, regardless of their age. In the majority of cases, this syndrome is the result of physical trauma.

There can be different types of trauma that can cause this disorder. First, it can be direct trauma. In this case, the shock is made directly on the ribs. For example, we can cite:

  • certain sports such as boxing or rugby where there is always contact;
  • sports requiring sudden movements (golf, shot put, etc.);
  • falls (for example, while skiing);
  • work using force: pushing a vehicle by leaning on its ribs;
  • road accidents (often a collision with the steering wheel of the car);
  • traffic accidents.

Trauma can also be indirect. This is often the case of an unsuitable muscular effort such as:

  • particularly intense pushing efforts (such as childbirth);
  • tensile forces;
  • lifting heavy loads;
  • a sneeze louder than usual;
  • a bad posture habit.

What about the symptoms of Cyriax syndrome?

Most patients who suffer from this syndrome complain of localized pain, particularly in the chest. It can radiate to other areas of the body such as the back and abdomen. This pain can also be accompanied by snapping or jumping sensation in the ribs.

The characteristics of abdominal pain during the syndrome

In addition to rib pain which is the main complaint of the patient, the latter may also experience abdominal pain. These are explained by a intercostal nerve irritation. This nerve is compressed during subluxation. Sometimes the pain can be felt in the upper part of the stomach.

The painful sensation is not permanent. It is generally triggered by particular efforts or movements of the trunk (especially extreme and sudden movements), a cough, a laugh or even a deep inspiration. It is most often relieved by rest.

Digestive disorders

Le Cyriax syndrome can also be responsible for poor digestion when pain occurs in the back.

How is this disorder diagnosed?

Le diagnosis of Cyriax syndrome is performed following a physical examination. The latter is based on the palpation of the ribs. This is the "picking manoeuvre". The examiner's finger will be placed under the costal margin. He will gently pull his finger up. This movement pinches the overlying intercostal nerve, and will then cause a pain characteristic of Cyriax syndrome.

In some cases imaging is required to confirm the diagnosis.

Imaging examination in case of Cyriax syndrome

In principle, we often ask for x-rays if lesions of the ribs. Imaging tests will detect the presence of fracture or tumor on the ribs or cartilage. In fact, this kind of balance sheet is above all necessary to find the origin of the rib pain. It eliminates serious causes.

Note that it is important to consult a health professional as soon as you feel a chest pain or abdominal. Indeed, a clinical examination will make it possible to clarify the diagnosis, and to exclude an alternative attack (sometimes more serious) which can come from:

Differential diagnosis of Cyriax syndrome 

Treatment: Can Cyriax syndrome be cured?

There are various treatments to relieve Cyriax syndrome. They are all symptomatic, that is, they are aimed at relieving the syndrome. In fact, there is still no curative treatment for Cyriax syndrome. However, it should be noted that one can very well live with this condition.

There are drugs that relieve the pain felt by the patient. These include muscle relaxants and analgesics. The goal is to allow the intercostal muscles to not further sensitize the compressed nerve.

Un elastic bandage can also be used to support the trunk area and stabilize the ribs. This will provide an optimal environment for healing, and the avoidance of sudden or extreme trunk movements.

You can also make a botulinum toxin infiltration to calm the symptoms of a Cyriax syndrome. This technique is indicated if the pain becomes unbearable for the patient and interferes with the exercise of daily tasks. This is not a trivial intervention. The toxin will paralyze the intercostal muscle for some time. This relieves the compression of the nerve during this time. The effects of botulinum toxin can last for a few weeks or a few months.

La physiotherapy also has a place in the treatment of Cyriax syndrome. It is based in particular on the stimulation of the abdominal, dorsal and intercostal muscles.

You can also consult an osteopath to help you manage this painful rib syndrome. Osteopathy will work on your costal cartilage through various osteopathic manipulations. One of the objectives will also be to work on the posture if it influences the symptoms. At the same time, osteopathy will reduce inflammation in the ribs. The recommended exercises will also reduce tension and pressure on your rib cage.

Among the natural methods, yoga is often used. The goal is always to relieve compression in the nerve. We recommend two postures in particular to improve the opening of the rib cage:

  • sheathing;
  • and chest extensions.

When the usual drug treatments and natural medicine have not shown efficacy, it is possible to resort to surgery. Although rarely used to treat Cyriax syndrome, it is sometimes indicated when the pain felt becomes unbearable or debilitating.

The principle of surgical treatment of Cyriax syndrome is simple: it consists of removing the ribs in question (costectomy). The goal is to lift the compression on the nerve in order to relieve the pain. It should only be noted that the risk of compression at the level of the lower ribs is not ruled out.

To live with Cyriax syndrome, you can adopt certain habits. First, think about working on your posture. You have to learn to stand up straight, but surtout Vary your position regularly so as not to cause more pressure on your chest.

To know 6 tips from the physio to straighten your back (including exercises), see the following article.

La rib pain or abdominal related to a Cyriax syndrome is triggered by the efforts. Stop torturing your mind that this is a incurable syndrome at the risk of worrying you all the time. This will only accentuate the painful sensation. Think about managing your stress. You have many breathing exercises to help you.

What about natural remedies?

Although they are not supported by solid scientific evidence, several natural products and home remedies are used to treat rib pain, in particular for their anti-inflammatory properties. It is essential to consult a doctor beforehand, mainly to avoid drug interactions and side effects.

Here is a non-exhaustive list of plants and essential oils that are effective in controlling pain and inflammation. The products are available on the site Country. Use promo code LOMBAFIT15 if you wish to obtain one of the following products, or any remedy aimed at relieving your symptoms and improving your quality of life:

  • Turmeric. Thanks to its antioxidant and anti-inflammatory powers very powerful, turmeric is one of the most used plants in a culinary and therapeutic context. The composition of turmeric is essentially made of essential oils, vitamins (B1, B2, B6, C, E, K) and trace elements. But it is to its composition rich in curcumin and curcuminoids that we owe them and calm skin of this spice.
  • Ginger. In addition to the special flavor it brings to the kitchen and its aphrodisiac properties, ginger is a root well known for its anti-inflammatory powers. the gingerol gives it its anti-inflammatory action. It is an active component acting on the inflammatory pain related to chronic joint inflammatory diseases, including rheumatoid arthritis, lupus, rheumatic diseases, etc. It has been proven that this active element is also effective in acting on the inflammation linked to arthritis and sciatica. Ginger also has other benefits thanks to its high potassium content and its richness in trace elements (calcium, magnesium, phosphorus, sodium) and vitamins (provitamin and vitamin B9).
  • Omega-3s. Omega-3s are polyunsaturated fatty acids that play a very important role in the functioning of our body. They are provided by food in three natural forms: docosahexaenoic acid (DHA), alpha linolenic acid (ALA) and eicosapentaenoic acid (EPA). Beyond their action on the brain and the cardiovascular system, omega-3s prove very effective against inflammation. Indeed, they have the ability to act on the inflammatory mechanisms in osteoarthritis by slowing down cartilage destruction, thus they reduce the intensity of osteoarthritis pain. Sciatica, being most often linked to an inflammation secondary to a herniated disc, it can also respond to omega-3 provided it is consumed regularly. 
  • Lemon eucalyptusEucalyptus is a plant most often used in the form of herbal tea or essential oil. She would have anti-inflammatory effects which give it the ability to act on the bone and joint pain in general and the pain of sciatica in particular.
  • wintergreen. Wintergreen is a shrub from which a very interesting essential oil is extracted. It is one of the most used essential oils in aromatherapy. This oil extracted from the shrub bearing the same name, is used in massage to relieve sciatica and act like a analgesic. Indeed, it provides a heating effect thanks to its ability toactivate blood circulation locally.

Remember that these products do not replace medical treatment. Do not hesitate to consult for support adapted to your condition.

Are you looking for solutions to relieve your pain?

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