Self-reported genitopelvic pain disorders and symptoms among individuals with confirmed or suspected slipping rib syndrome: An exploratory cross-sectional survey
Jenny Niedenfuehr, David StevensObjective
Slipping rib syndrome is an underrecognized condition characterized by hypermobility of the false ribs (ribs 8–10), resulting in pain throughout the abdominal and pelvic regions. This study aimed to describe genitopelvic pain disorders and related experiences among individuals with slipping rib syndrome.
Methods
An exploratory, descriptive, cross-sectional survey was distributed using convenience sampling from July 2024 to November 2024. Sociodemographic characteristics, diagnostic timelines, and the Patient Global Impression of Change were used to assess the self-reported efficacy of pelvic floor physical therapy for genitopelvic pain disorders among individuals with slipping rib syndrome.
Results
Seventy-nine individuals with slipping rib syndrome participated; most were women (92.2%) and White (96.9%), and the mean age was 33.4 years. The average diagnostic delay was 5.4 years, and frequent misdiagnoses included costochondritis, anxiety, and gastrointestinal conditions. More than half (54.4%) had Ehlers–Danlos syndrome, predominantly the hypermobile subtype (81.1%). More than 50% reported moderate to severe impacts of slipping rib syndrome on sexual activity, and 26.9% attributed their vulvar or pelvic pain directly to the condition. Common comorbidities included hypertonic pelvic floor, chronic pelvic pain syndrome, endometriosis, vaginismus, interstitial cystitis, and pudendal neuralgia. Among participants who received pelvic floor physical therapy for genitopelvic pain disorders and symptoms, the mean Patient Global Impression of Change score was 4.5, indicating no change to minimal improvement, and 18.2% reported worsening symptoms. Diaphragmatic breathing similarly resulted in no improvement or worsening of symptoms in many participants.
Conclusions
This study is the first to explore the potential impact of slipping rib syndrome on sexual activity and its possible contribution to genitopelvic pain disorders. Symptom overlap with gynecologic conditions complicates diagnosis and management. These findings underscore the importance of evaluating for slipping rib syndrome during pelvic health assessments, particularly in patients with persistent or unexplained pelvic and abdominal pain. Further research is needed to clarify the musculoskeletal mechanisms underlying pelvic pain and to guide interdisciplinary care for individuals with slipping rib syndrome.