Exploring a Potential Link Between Slipping Rib Syndrome, Sexual Activity, and Sexual Pain Disorders: A Cross-Sectional Study

Background Slipping Rib Syndrome (SRS) is an underrecognized condition involving hypermobility of the false ribs (ribs 8–10), leading to pain across the entire abdominal and pelvic region. This study explored a potential link between SRS, sexual activity, and sexual and pelvic pain disorders. Methods A cross-sectional survey was distributed through convenience sampling (July 2024-November 2024). Sociodemographic questions, diagnostic timelines, and Patient Global Impression of Change (PGIC) were used to assess the self-reported efficacy of pelvic floor physical therapy (PFPT) for sexual and pelvic pain among those with SRS. Results Seventy-nine SRS patients participated, primarily female (91.2%), white (96.9%), with an average age of 33.4 years. Delay in SRS diagnosis averaged 5.4 years, with common misdiagnoses of costochondritis, anxiety, or gastrointestinal issues. Over half (54.4%) had EDS, mainly the hypermobile subtype (81.1%). More than 50% reported having a moderate to severe impact on sexual activity because of their SRS symptoms, and 26.9% attributed their pain to SRS. Common comorbidities included hypertonic pelvic floor (45.2%), endometriosis (21.6%), vaginismus (19.4%), interstitial cystitis (16.1%), and pudendal neuralgia (12.9%). Only 50% with both endometriosis and SRS could consistently differentiate between symptoms. For those participating in PFPT for treating sexual/pelvic pain symptoms, the average PGIC score was 4.5, indicating no change to minimal improvement, and 18.2% experienced worsening symptoms. Similarly, when attempting diaphragmatic breathing, 31.3% reported worsened symptoms and 41.7% reported no change in sexual/pelvic pain symptoms. Conclusion This is the first study to show that SRS impacts sexual activity and may even contribute to sexual and pelvic pain disorders. SRS symptoms overlap with conditions like endometriosis, which may complicate diagnosis. More research is needed to contribute to underscoring the link between the rib cage, pelvic floor, and nerve issues to improve quality of life, diagnostic strategies, and management among patients with SRS.