Dr. Hanif warmly welcomes you! Thanks for consulting at my virtual clinic HCM. I have carefully worked through your case, and can well realize your health worries. Being your physician, I want to assure, I will take care all of your medical concerns. Heimlich s maneuver or the abdominal thrusts is a life saving procedure in patients who chokes. Sometimes due to the rapid and string thrusts there may be a muscular spasm, tissue injury to the digestive system that is all naturally related to the procedure. There may also be a strong push on the rib cage and that may cause pain due to spasm or physical injury to the intercostal muscles or the Costochondral joints may hurt due to the over flexion and over extension at those functionally immobile joints. The torque produced due to the thrushes may lead to pain in those joints. You need not worry as there are very less chances of rib fracture or some serious injury (although it may happen in inexperienced hands). Apply Bengay ultrastretch ointment over the painful areas and massage gently. Take a heating blanket (or heat pad) and wrap around her rib cage. It will give soothing effects to her. Give her Tylenol too for pain relief and to reduce inflammation. The burping issues can be handled with diet rich in vegetables, fruits, salads, salmon and eggs; and, by adding Citrucel dietary fiber in her diet with a plenty of water. If she gets no benefits, go for a digital X Ray of the chest to see any fracture or joint issues. Hope I answered all of your questions. Please click on I Find This Answer Helpful and don t forget to add your precious positive feedback to help me able to assist you better in future too. Have a wonderful time ahead. Keep in touch for a follow-up too to let me know if you have any doubts & need further assistance. I am available 24/7 for providing you my expert medical opinion on any issue. Have a blessed time ahead. Regards! DR. MUHAMMAD HANIF USA