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patients with noncardiac chest wall pain may have symptoms that become chronic or recurrent yet often lack adequate diagnosis and treatment plans leading to further disability decreased physical activity anxiety and depression abnormal rib biomechanics may be a cause of chest wall or upper abdominal pain and should be considered after visceral pathology has been ruled out osteopathic diagnosis of the ribs may help differentiate rib somatic dysfunction from referred pain originating from thoracic viscera and provide diagnosis and treatment options previous studies have demonstrated that osteopathic manipulative treatment has proven beneficial in providing pain relief and improved thoracic motion in patients with costochondritis cost a vertebral joint dysfunction and post Renate mihrab dysfunction ribs 1 through 5 move in a pump handle motion ribs six through 10 move in a bucket handle motion and ribs 11 and 12 move in a caliper like motion to alter the dimensions of the thorax during re
