Snapping scapula syndrome, also known as scapulothoracic crepitus, is a condition that affects the shoulder and causes a snapping or popping sound when the arm is moved. The sound is caused by the movement of the scapula (shoulder blade) against the ribcage. Despite being a common condition, the exact cause of snapping scapula syndrome is not well understood, and can often be misdiagnosed. In this article, we will take a closer look at the causes, symptoms, and treatment options for this condition.
ICD-9-CM CODE- 726.10 Disorders of bursae and tendons in the shoulder region unspecified
ICD-10-CM CODE- Bursitis of unspecified shoulder
Causes of Snapping Scapula Syndrome:
The exact cause of snapping scapula syndrome is not clear, but it is related to a combination of factors. Some of the most common causes include:
- Bony Abnormalities: Bony abnormalities, such as an uneven scapula shape, can cause the scapula to rub against the ribcage and causes a snapping sound.
- Muscle Imbalances: Muscle imbalances around the shoulder can cause the scapula to move abnormally, leading to a snapping sound.
- Joint Degeneration: As we age, our joints can become degenerated, leading to a reduction in mobility and stability. This can cause the scapula to move abnormally, leading to a snapping sound.
- Repetitive Movement: Repetitive movements, such as throwing a ball or lifting weights, can cause the scapula to move abnormally, leading to a snapping sound.
- Non-traumatic injury to the long thoracic nerve:
- Influenza
- Drug overdose
- Traumatic injury to the long thoracic nerve:
- Impact injury
- Stretch to the cervical spine
- Electrical shock
- Mastectomy with axillary node dissection
Symptoms of Snapping Scapula Syndrome:
The main symptom of snapping scapula syndrome is a snapping or popping sound with the moving arm. This sound is usually accompanied by pain or discomfort in the shoulder area. Other symptoms of snapping scapula syndrome include:
- Pain or Discomfort: Pain or discomfort in the shoulder area, which can range from mild to severe.
- Stiffness: Stiffness in the shoulder area, makes it difficult to move the arm.
- Weakness: Weakness in the arm, making it difficult to lift heavy objects.
- Decreased Range of Motion: Decreased range of motion in the shoulder, making it difficult to reach overhead.
- Crepitus
- Muscle spasms along the rib cage
- Scapular instability
Differential Diagnosis:
- Scapular dyskinesis: A condition where the scapula does not move smoothly and efficiently during arm movements.
- Bursitis: Inflammation of the bursae (small fluid-filled sacs) that cushion the joints and muscles, leading to pain and discomfort.
- Tendinitis: Inflammation of a tendon, often caused by overuse or repetitive movements.
- Fracture: A break in one of the bones in the shoulder, causing pain and discomfort.
- Arthritis: Inflammation of a joint, causing pain and discomfort.
- Pinched nerves: Compression of a nerve, causing pain and discomfort.
- Referred pain: Pain that originates from another area of the body and is felt in the shoulder or arm.
Diagnosis:
Diagnosing snapping scapula syndrome can be difficult, as the symptoms are often similar to those of other conditions, such as rotator cuff injuries or shoulder impingement syndrome. A doctor will typically perform a physical examination and ask the patient to move their arm in different ways to determine if there is any pain or discomfort. In some cases, imaging tests, such as X-rays or MRI, may be helpful to get a better look at the scapula and surrounding structures.
Treatment of Snapping Scapula Syndrome:
Treatment for snapping scapula syndrome typically involves physical therapy and exercises to strengthen the muscles around the shoulder, improve joint mobility, and correct any muscle imbalances. Some common physical therapy exercises include:
- Scapular Stabilization Exercises: These exercises focuses on strengthening the muscles around the scapula to improve stability.
- Range of Motion Exercises: These exercises help to improve the range of motion in the shoulder, making it easier to move the arm.
- Strengthening Exercises: These exercises help to strengthen the muscles in the shoulder and arm, improving overall strength and reducing pain.
- If there is pain and inflammation, then
- Ice
- Rest
- Activity modification
- Ultrasound
- Electric stimulation
In severe cases of snapping scapula syndrome, surgery may be necessary to correct any underlying bony abnormalities or to repair any damaged tissues. The type of surgery performed will depend on the specific cause of the condition and the extent of the damage. Some common surgical procedures for snapping scapula syndrome include:
- Scapuloplasty: This procedure involves surgically altering the shape of the scapula to reduce friction and improve mobility.
- Bursal Resection: This procedure involves removing any bursae (small fluid-filled sacs) that are causing friction and contributing to the snapping sound.
- Tendon Repair: In some cases, the tendons around the shoulder may be damaged, causing the snapping sound. Tendon repair surgery involves repairing any damaged tendons to reduce friction and improve mobility.
After surgery, physical therapy and rehabilitation will be necessary to help the shoulder recover and regain strength. This may involve exercises to improve range of motion, strength, and stability, and may take several months to complete.
Exercises for Snapping Scapula Syndrome:
There are several exercises that can help alleviate symptoms of snapping scapula syndrome and improve shoulder mobility and strength. Here are a few commonly recommended exercises:
Sit or stand with your back straight and your arms at your sides. Squeeze your scapula together and hold for 5 seconds. Repeat 10 times.
Stand with your good arm supported on a table or chair and let your affected arm hang down. Move your affected arm in small circles, first in one direction and then the other. Gradually increase the size of the circles as your shoulder improves.
Stand with your feet hip-width apart and hold a resistance band with your arms extended in front of you. Pull the band towards your chest, keeping your arms close to your sides. Repeat 10-15 times.
Stand with your face towards the wall and place your hands on the wall at shoulder height. Slowly bend your elbows to lower your body towards the wall, then push back to the starting position. Repeat 10-15 times.
Stand with your back against a wall and your arms raised above your head. Keeping your arms straight, slide your arms down the wall as far as you can, then bring them back up to the starting position. Repeat 10-15 times.
Stand with your feet hip wide apart and hold a pair of dumbbells at your sides. Shrug your shoulders up towards your ears and then lower them back down. Repeat 10-15 times.
Stand with your feet hip-width apart and hold a pair of light dumbbells in front of your thighs. Keep your arms straight as you raise the dumbbells out to the sides until they are level with your shoulders. Lower them down to the starting position. Repeat 10-15 times.
Conclusion:
In conclusion, snapping scapula syndrome is a common condition that can cause a snapping or popping sound in the shoulder when the arm is moved. While the exact cause of this condition is not well understood, it is believed to be related to a combination of factors, including bony abnormalities, muscle imbalances, and joint degeneration. Treatment for snapping scapula syndrome typically involves physical therapy and exercises to strengthen the muscles around the shoulder, improve joint mobility, and correct any muscle imbalances. In severe cases, surgery may be necessary to correct any underlying bony abnormalities or to repair any damaged tissues. With proper diagnosis and treatment, most people with snapping scapula syndrome are able to recover and regain full use of their shoulder.