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Snapping scapula syndrome is a condition in which the shoulder blade, or scapula, grinds against the chest wall and produces an audible popping or snapping sound. The condition may or may not cause pain, depending on the underlying cause. In most cases, a snapping scapula is caused by inflammation and swelling of soft tissue, ligaments, bone, or cushioning sacs called bursae. When the scapula cannot easily slide along the chest wall, bones rub together and produce the characteristic noise and sensation. The condition can usually be treated with rest, ice, and pain relievers, but a badly injured shoulder may need surgery.
The scapula is attached to the chest wall and ribs at the scapulothoracic joint in the upper-middle back. The joint can become inflamed due to repetitive overuse of the shoulder or direct trauma to the ribs, scapula, or muscle tissue. People who repeatedly raise or swing their arms, such as baseball players, can experience gradually worsening bursa inflammation that leaves joints tight and causes bones to rub against each other. A healing rib or shoulder blade can also produce a snapping sound if it does not grow back into proper alignment.
A snapping scapula caused by bursitis may be very painful. It can cause soreness after physical activity that becomes more painful and more persistent over time. The shoulder may also start to swell, causing limited range of motion, tenderness to the touch, and weakness in the arm. A person with a milder injury might not notice any symptoms besides the popping noise and grinding sensation when moving his or her shoulder.
An individual who experiences a snapping scapula should visit a doctor, even if it does not cause serious pain. A physician can conduct a thorough physical examination, ask about past shoulder injuries and take diagnostic imaging scans. X-rays and magnetic resonance imaging screens may reveal bone abnormalities or bursa inflammation.
Mild snapping scapula syndrome related to overuse typically gets better in one to two months with rest. A person may be fitted with a sling to help immobilize the shoulder while it heals. Ice and anti-inflammatory drugs can help with pain and swelling. If pain is severe, the doctor may inject a corticosteroid solution directly into the scapulothoracic joint. When the patient starts feeling better, he or she can perform light stretching exercises to regain flexibility and full use of the shoulder.
Arthroscopic surgery is only necessary if nonsurgical treatments fail to relieve symptoms. An orthopedic surgeon can cut away damaged bursa and cartilage tissue, repair muscles and tendons, and shave rib bones if necessary. Following surgery, a patient usually needs to wear a sling and engage in physical therapy for several months to fully recover.