Treatment of Iliac-Costal Syndrome with Rib Removal

Q: Dr. Eppley, I am very interested and serious about the procedure.  Although I am not seeking rib modification for cosmetic reasons only. I am an avid walker and cycler. During exercising and movement, my lower ribs touch my hip bones (or something in there!)   It is extremely bothersome and impedes my workout significantly. I realize there can be some risk and residual rib pain. Staying fit and working out is critical to my health. I realize you may not resolve the issue completely, but any relief would be acceptable. I am financially prepared for this and interested in pursuing rib modification.  Thank you Dr Eppley, I know you are highly experienced in this procedure and I greatly appreciate your assistance.

A: What you are describing technically is known as iliac-costal syndrome. Getting rid of the outer half of ribs #s 11 and 12 on the affected side has proven to be vey helpful in symptom relief in this rib-associated syndrome. I have had some patients who have requested removal of rib #10 also but that rib should have no contribution to impingement on the iliac crest given its more horizontal orientation.

Dr. Barry Eppley

Indianapolis, Indiana