An uneven rib cage means the two sides of the rib cage are not symmetrical. A person with an uneven rib cage may have issues with their breathing, posture, or body confidence.

Alternatively, a person born with an uneven rib cage may find they do not have any associated pain or issues.

An uneven rib cage can occur for a variety of reasons. This article will go through the causes of, and treatments for an uneven rib cage.

Poland syndrome is a disorder that causes a person to be born with missing, or underdeveloped, muscles on one side of the body. According to the Genetic and Rare Diseases Center, it typically occurs on the right side of the body and is more common in males than in females.

An infant born with Poland syndrome may have an underdeveloped or missing upper rib cage, causing the rib cage to be asymmetrical.

A person with Poland syndrome may also have the following symptoms:

  • missing chest muscles
  • unusually short or webbed fingers
  • no armpit hair
  • underdeveloped skin and fat tissue on the affected side
  • underdeveloped nipple or breast tissue
  • underdeveloped shoulder or arm bones

The severity of Poland syndrome can vary. An adolescent going through puberty may notice lopsided growth as the first sign of Poland syndrome.

Learn more about Poland syndrome here.

Treatment

People with mild Poland syndrome may not need any treatment. However, more severe Poland syndrome may require reconstructive surgery.

Surgery to correct Poland syndrome involves reconstructing the missing chest muscles using existing muscle. The surgeon can use a rib graft to replace any missing ribs.

A person who requires surgery for Poland syndrome should wait until they have gone through puberty, if possible. Surgery, before a person is fully developed, can lead to the asymmetry of the chest becoming worse.

Females with Poland syndrome should wait until the breasts are fully developed before having reconstructive surgery. This will ensure the reconstructed breast will be symmetrical to the other one.

Scoliosis is a condition that causes a person to have a curved spine. Scoliosis can affect either side of the body and give the appearance of an uneven rib cage.

Although a person of any age can get scoliosis, it is most common in females and in children of 11 years of age and older.

Someone born with scoliosis may only notice the condition as they grow and go through puberty.

Symptoms of scoliosis can include:

  • tilted shoulders, with one more pronounced shoulder blade
  • uneven waist
  • ribs more prominent on one side than the other
  • one hip higher than the other
  • the appearance of leaning to one side
  • spinal cord issues, causing numbness, weakness, and loss of coordination

Learn more about scoliosis here.

Treatment

The treatments for scoliosis can depend on:

  • a person’s age
  • stage of development
  • the severity of the spinal curve

An infant with scoliosis will typically need to see their doctor every 4–6 months for X-rays. The doctor will observe the progress of scoliosis. Occasionally, a child’s scoliosis will improve or resolve by itself.

Other types of treatment include:

Bracing

If a young person’s scoliosis becomes worse, the doctor may recommend that they wear a corrective brace to prevent it from deteriorating more. When worn for 16 hours per day, a young person’s need for surgery can decrease.

A corrective brace is worn underneath clothes and a person can remove it when showering.

Casting

Casting involves covering the individual’s chest in a plaster cast. Every 6 months, a healthcare professional will replace the cast.

Although casts can provide better curve management than braces, they can be uncomfortable and inconvenient.

Surgery

If a person’s spinal curve progresses, surgery can sometimes be necessary.

There are various surgeries available for the treatment of scoliosis, including:

  • spinal fusion
  • hemi-epiphysiodesis, or spinal fusion on the curve to allow the other side to grow normally
  • hemivertebra resection, where a surgeon removes malformed vertebra to allow the spine to straighten
  • growing rods, involving attachment of metal rods to the spine to help it grow straight

Exercise and massage

Massage, pilates, and yoga may help with pain in a person with scoliosis.

However, these methods cannot reverse symptoms or prevent scoliosis from worsening.

Learn more about exercises to help with scoliosis here.

Cervical ribs are nonfunctioning ribs that grow near the neck.

Most cervical ribs go unnoticed through a person’s lifetime. However, they can appear as a hard lump near the collar bone.

Cervical ribs can occur on either side of the body but are more common on the left side.

On rare occasions, cervical ribs can compress surrounding blood vessels, causing numbness and tingling in the arm. Compression by the cervical rib can also cause the arm to become blue and swollen.

Treatment

Although a person with a cervical rib or ribs will typically experience no symptoms, surgery is available to remove the rib should complications occur.

Pectus excavatum, also known as funnel chest, is a condition that causes a person’s breastbone to sink into their chest, leaving a large dent.

Doctors can find it difficult to diagnose pectus excavatum in infants as symptoms typically present in early childhood or adolescence.

People with pectus excavatum may experience the following symptoms:

  • shortness of breath when exercising
  • chest pain
  • fatigue
  • palpations
  • tachycardia, where the heart beats more than 100 times a minute
  • wheezing when exercising
  • asthma, or upper respiratory tract infections
  • fainting or dizziness
  • feeling unable to exercise
  • unpleasant sensation of fullness in the stomach
  • anxiety and low body image

Pectus excavatum more commonly occurs in males than females.

It can occur on both or either sides of the chest.

Treatment

Anti-inflammatory medication, physical therapy, and acupuncture can help with pain management for a person with pectus excavatum.

Younger people can use vacuum bells to correct the dip in the chest. The device involves a person applying a suction cup to their chest for 1 hour per day.

A person with pectus excavatum should preferably have corrective surgery during adolescence if required. However, the surgery is also available for adults and older adults.

According to a 2017 review, surgery for a person with pectus excavatum can improve cardiopulmonary function, increase self-esteem, and decrease associated symptoms.

Pectus carinatum, or keel chest, occurs when the rib cage pushes outwards. This condition can give the rib cage an uneven appearance.

Males are four times more likely to have pectus carinatum than females.

Pectus carinatum can occur on both sides, or either side, of the chest, but is more likely to appear on the right side.

People with pectus carinatum are unlikely to have other symptoms, although they can occasionally experience:

  • tenderness of the chest
  • shortness of breath
  • abnormally fast breathing when exercising
  • reduced endurance
  • low body image

Learn more about pectus carinatum here.

Treatment

Corrective braces are a treatment option for pectus carinatum. However, a person will need to wear the braces for 14–24 hours a day. Also, they become less effective after a person turns 19 years old due to changes in the flexibility of the chest wall.

Given that pectus carinatum often produces no adverse symptoms, surgery is usually cosmetic. Some people with pectus carinatum take up bodybuilding to minimize the protrusion of the breastbone.

A person with uneven ribs should visit a doctor if they are experiencing any pain or distress.

A number of different conditions can cause uneven ribs. However, these conditions are usually manageable, with treatments and pain relief available.

Typically, a person with uneven ribs will experience few, or no, adverse side effects.

Should a person find that they are experiencing pain or distress, they should visit a doctor.