Cervical Rib: The Extra Neck Bone Some People Are Born With — What You Need to Know
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 17, 2026
Quick Answer
A cervical rib is an extra bone in the neck present at birth, starting at the lowest neck bone and sometimes reaching the first rib. It has no function and is rare. It usually causes no symptoms, but some people have arm and hand pain, tingling, numbness or weakness. Treatment, if needed, includes physical therapy, medicines or surgery.
What the research says
A cervical rib is far more common in people with thoracic outlet syndrome. In a meta-analysis of 141 studies (77,924 participants), the pooled prevalence of cervical rib was 29.5% in people with thoracic outlet syndrome versus 1.1% in healthy individuals; among symptomatic people with a cervical rib, 51.3% had vascular and 48.7% had neurogenic thoracic outlet syndrome (Henry et al., World Neurosurgery, 2018 [1]).
Surgery can restore arm function. In a small case series of five female patients (mean age 20.6 years) who had the cervical rib removed through a supraclavicular approach, symptoms improved and limb function was restored, with a mean recovery time of 9 weeks (Yadav et al., Annals of Medicine and Surgery, 2021 [2]).
Rare variants can still be treated successfully. In a report of three patients with arterial thoracic outlet syndrome and a cervical rib fused to the second rib, all had the ribs removed through the armpit (transaxillary approach) with removal of the anterior scalene muscle (scalenectomy) and completed physical therapy, with complete resolution of symptoms (Hines et al., Annals of Vascular Surgery, 2014 [3]). Case reports and small series like these are limited evidence.
What Is a Cervical Rib?
A cervical rib is an extra bone you may have in your neck at birth. This rare bone does not look like a typical rib in your chest. It can be more vertical or diagonal instead of horizontal like the ribs in your chest. A cervical rib starts from the lowest bone in your neck and can extend to the first (top) rib in your chest.
Here is the key fact: a cervical rib does not do anything — it does not have a function.
In most people, a cervical rib does not cause issues. In others, it causes pain in the arm or makes it difficult to use the hand — for example, trouble gripping a pen.
What Are the Types of Cervical Ribs?
There are four cervical rib types:
Type | What it looks like |
|---|---|
Type 1 | A complete rib that reaches your first rib |
Type 2 | An incomplete rib with one end that does not attach to anything |
Type 3 | An incomplete rib that attaches to a fibrous band |
Type 4 | A short bone that sticks out from the lowest vertebra in your cervical spine (in your neck) |
How Common Is a Cervical Rib?
A cervical rib is rare. Up to 1% of people have one (and sometimes two) cervical ribs at birth. Cervical ribs happen more in females.
Nearly 30% of people who have thoracic outlet syndrome — a condition where blood vessels or nerves in the space between your collarbone and first rib are squeezed — have cervical ribs.
What Are the Symptoms of a Cervical Rib?
Cervical rib symptoms can include:
Symptom | What it means |
|---|---|
Neck or arm pain | Aching in the neck or arm on the affected side |
A lump in your neck | A visible or palpable extra bone |
Tingling or numbness in your hand or arm | A pins-and-needles feeling or loss of sensation |
Weakness in hand and forearm muscles | Reduced strength when gripping or lifting |
Clawing (bending) of your fingers | Fingers bend into a claw shape, except the thumb and index finger |
Most people do not have symptoms of a cervical rib. You are more likely to have symptoms if you have bad posture or have experienced trauma to your upper body.
What Causes a Cervical Rib?
Researchers think a mutation (change) in HOX genes — genes involved in skeletal development — may cause cervical ribs. Cells in a developing fetus may form a bone in the wrong place, and it becomes a cervical rib.
What Are the Complications of a Cervical Rib?
Cervical ribs can compress a nerve or your subclavian artery — the large artery that carries blood from your heart to your arm. A cervical rib can cause thoracic outlet syndrome, which can be dangerous without treatment.
If you have symptoms, they can get worse without treatment. You can also get blood clots in your subclavian artery or brain.
How Is a Cervical Rib Diagnosed?
A healthcare provider can do a physical exam that includes an Adson test. If your cervical rib is compressing your subclavian artery, a provider can feel your extended arm’s pulse get weaker when you turn your head.
Most of the time, providers find cervical ribs when they are looking for something else. Cervical ribs can show up on a chest X-ray or a cervical (neck) X-ray.
Providers may use other tests to make a diagnosis, like:
Test | What it checks |
|---|---|
MRI (magnetic resonance imaging) | Detailed pictures of soft tissues, nerves, and blood vessels |
CT (computed tomography) scan | Detailed cross-sectional pictures of the bone and surrounding structures |
Nerve conduction studies | How well your nerves are working |
Electromyography (EMG) | How well your skeletal muscles and nerves are working |
Evoked potential tests | How well nerve signals are getting to your brain |
How Is a Cervical Rib Treated?
A cervical rib does not need treatment if you have no symptoms. If you have symptoms, treatments may include:
Treatment | What it does |
|---|---|
Physical therapy | Can treat a cervical rib’s compression of a nerve |
Medicines | Muscle relaxers or pain relievers can help with discomfort |
Cervical rib removal (surgery) | A provider can perform surgery if the rib is causing thoracic outlet syndrome. For better symptom prevention, a surgeon may also remove your first rib along with the cervical rib. Any surgery carries a risk of bleeding or infection. |
The average recovery time after surgery is about nine weeks.
What Can I Expect if I Have a Cervical Rib?
The outlook is good for people who have surgery to remove a cervical rib. Their affected arm works normally again, and symptoms rarely return after surgery.
Without treatment, if you have symptoms, they can get worse — and blood clots in the subclavian artery or brain are possible.
Can a Cervical Rib Be Prevented?
No. You cannot prevent cervical ribs because they develop before birth.
When Should I See My Healthcare Provider?
If your cervical rib starts causing symptoms, contact your provider. If you have surgery, you will need follow-up appointments so your provider can see how well your body is healing and make sure you are not having any issues. You may also need to do physical therapy for a number of weeks after your operation.
Good questions to ask include:
What type of cervical rib do I have?
Do I need treatment?
What is the best treatment for me?
Are my future children at risk of inheriting a cervical rib?
Conclusion
A cervical rib is an extra, purposeless bone in the neck that some people are born with — and most never know they have it. It is rare, shows up more often in women, and usually causes no symptoms at all. When it does cause problems, they appear in the arm and hand: pain, tingling, numbness, weakness, or claw-shaped fingers.
Treatment ranges from watchful waiting to physical therapy, pain medicine, or surgery to remove the rib — and for people who have surgery, the outlook is excellent, with the arm returning to normal function in most cases.
A note of reassurance: Maybe you had no idea there was an extra bone in your neck, but you cannot ignore the pain in your arm. That pain is not normal, and you do not have to suffer with it. Talk to your healthcare provider about the best treatment for you. Be sure to ask questions if there is anything you do not understand about your condition or treatment.
Frequently Asked Questions
What is a cervical rib?
A cervical rib is an extra bone you may have in your neck at birth. It starts from the lowest bone in your neck and can extend to the first (top) rib in your chest.
Does a cervical rib have a function?
No. A cervical rib does not do anything — it has no purpose.
How common is a cervical rib?
A cervical rib is rare. Up to 1% of people have one (and sometimes two) cervical ribs at birth. It happens more in females.
What do the four types of cervical ribs mean?
Type 1 is a complete rib that reaches the first rib. Type 2 is an incomplete rib with one end that does not attach to anything. Type 3 is an incomplete rib that attaches to a fibrous band. Type 4 is a short bone that sticks out from the lowest vertebra in your cervical spine.
What does a cervical rib look like?
A cervical rib does not look like a typical rib in your chest. It can be more vertical or diagonal instead of horizontal.
What are the symptoms of a cervical rib?
Symptoms can include neck or arm pain, a lump in your neck, tingling or numbness in your hand or arm, weakness in hand and forearm muscles, and clawing (bending) of your fingers except your thumb and index finger.
Do most people with a cervical rib have symptoms?
No. Most people do not have symptoms. You are more likely to have them if you have bad posture or have experienced trauma to your upper body.
What is claw hand?
Clawing (bending) of your fingers except your thumb and index finger — a sign that nerves are being affected.
What causes a cervical rib?
Researchers think a mutation in HOX genes involved in skeletal development may cause it. Cells in a developing fetus may form a bone in the wrong place.
Is a cervical rib inherited?
A cervical rib develops before birth, linked to gene changes in the developing fetus. Whether your future children are at risk of inheriting one is a good question to ask your healthcare provider.
Can a cervical rib be prevented?
No. You cannot prevent cervical ribs because they develop before birth.
What complications can a cervical rib cause?
Cervical ribs can compress a nerve or your subclavian artery. They can cause thoracic outlet syndrome, which can be dangerous without treatment. Symptoms can worsen over time, and blood clots in the subclavian artery or brain are possible.
What is thoracic outlet syndrome?
A condition that can be caused by a cervical rib compressing nerves or blood vessels in the space between your collarbone and first rib. It can be dangerous without treatment.
How is a cervical rib diagnosed?
Usually by accident — when a provider is looking for something else. It can show up on a chest X-ray or cervical (neck) X-ray. A physical exam may include an Adson test, where your arm pulse weakens when you turn your head if the rib is compressing the subclavian artery.
What is the Adson test?
A physical exam maneuver. If your cervical rib is compressing your subclavian artery, a provider can feel your extended arm’s pulse get weaker when you turn your head.
What other tests might be used?
MRI, CT scan, nerve conduction studies, electromyography (EMG), and evoked potential tests.
Does a cervical rib need treatment?
If you do not have symptoms, no. If you do have symptoms, treatments may include physical therapy, medicines (muscle relaxers or pain relievers), or surgery to remove the rib.
What is physical therapy used for with a cervical rib?
Physical therapy can treat a cervical rib’s compression of a nerve.
When is surgery needed?
If the rib is causing thoracic outlet syndrome. A surgeon may also remove your first rib along with the cervical rib for better symptom prevention.
What are the risks of surgery?
Any surgery carries a risk of bleeding or infection. The average recovery time after surgery is about nine weeks.
What is the outlook after surgery?
Good. The affected arm works normally again, and symptoms rarely return after surgery.
When should I see my healthcare provider?
If your cervical rib starts causing symptoms, contact your provider. If you have had surgery, keep your follow-up appointments and do the recommended physical therapy.
Related Reading
What Is Arterial Thoracic Outlet Syndrome? A Plain-Language Guide to the Arm Blood Flow Problem That Rarely Gets Spotted Early explains how a compressed artery near the collarbone causes arm symptoms.
Venous Thoracic Outlet Syndrome: Understanding Subclavian Vein Compression covers vein compression under the collarbone and how it is treated.
Brachial Plexus Injury: Symptoms, Causes, and Treatment describes damage to the nerves that run from the neck to the arm.
Neck Pain: Symptoms, Causes, Diagnosis, and Treatment reviews common causes of neck pain and when to seek care.
References
Henry BM, Vikse J, Sanna B, et al. Cervical rib prevalence and its association with thoracic outlet syndrome: a meta-analysis of 141 studies with surgical considerations. World Neurosurgery. 2018;110:e965-e978. PMID 29203316. https://doi.org/10.1016/j.wneu.2017.11.148
Yadav AK, Shrestha S, Shrestha SR, et al. Cervical rib, case series from a university hospital of Nepal. Annals of Medicine and Surgery. 2021;72:103061. PMID 34888041. https://doi.org/10.1016/j.amsu.2021.103061
Hines K, Graf E, Liu D, Freischlag JA. The rare case of cervical rib fusion to the second rib. Annals of Vascular Surgery. 2014;28(3):742.e5-742.e8. PMID 24485068. https://doi.org/10.1016/j.avsg.2013.05.016
Cleveland Clinic. Cervical Rib. Cleveland Clinic. Medically reviewed; last updated August 8, 2024. https://my.clevelandclinic.org/health/diseases/cervical-rib
Fliegel BE, Menezes RG. Anatomy, Thorax, Cervical Rib. Updated July 17, 2023. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. PMID 31082045. https://www.ncbi.nlm.nih.gov/books/NBK541001/
Feldman AM. Thoracic Outlet Compression Syndromes (TOS). Merck Manual Professional Version. Last updated May 2026. https://www.merckmanuals.com/professional/neurologic-disorders/peripheral-nervous-system-and-motor-unit-disorders/thoracic-outlet-compression-syndromes-tos
Medical disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you experience arm pain, numbness, tingling, weakness, or claw-shaped fingers, see your healthcare provider for a proper evaluation. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on Rinnit.
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