Snapping scapula syndrome

Back to Patient education: shoulder

What is snapping scapula syndrome?

Snapping scapula syndrome is a popping, clicking, grinding or snapping of the bones and tissues in the shoulder blade when lifting or moving the arm. The disorder ranges from a mild inconvenience for some to a truly disabling condition for others. Symptoms may be painful and are often audible. The condition is most commonly diagnosed in young, active people who perform repetitive overhead movements in sports such as swimming, weight lifting or baseball, or at work.

What causes snapping scapula syndrome?

Most cases of snapping scapula syndrome result from overuse of the arm, overtraining, poor posture, shoulder weakness, neck conditions, tumors or shoulder joint problems. Other causes include trauma, congenital bone or soft tissue problems, or inflamed bursae – the fluid-filled sacs that cushion the bones and muscles of the shoulder blade.

What are the symptoms?

Grating, grinding or snapping may be heard or felt along the edge of the shoulder blade as it moves along the chest wall. Sometimes the joint pops or thumps during movement. Additional symptoms include pain in the back or top of the shoulder when lifting the arm or shrugging the shoulders, and weakness or inability to lift the arm overhead.

How is snapping scapula diagnosed?

In addition to a complete physical exam and patient history, your doctor may order an X-ray, MRI, and/or CT scan to confirm the diagnosis and rule out other damage to the spine, ribs and shoulder blade.

What is the treatment?

Snapping scapula syndrome often responds to non-operative treatment, including rest, activity modification, physical therapy, anti-inflammatory pain medications and steroid injections. If these measures fail to bring relief, or if symptoms worsen, surgery may be recommended. Surgery is also the preferred treatment in the case of a bone abnormality.

The procedure is called a scapulothoracic bursectomy/partial scapulectomy. The surgeon makes several small incisions and inserts a tiny camera (called an arthroscope) into the scapulothoracic joint. Small instruments are used to remove the inflamed bursa, as well as the upper corner of the scapula closest to the rib cage. Arthroscopic surgery has many benefits to patients, including smaller incisions, less muscle and tissue trauma, less post-operative pain and a faster recovery.

Following surgery, patients usually spend several weeks in a sling to allow the soft tissues to recover. Rehabilitation follows to restore range of motion, strength and flexibility.