Snapping Scaputa Syndrome

Snapping scapula syndrome, also known as scapulocostal syndrome or scapulothoracic syndrome, is characterized by a grating, grinding, popping or snapping sensation of the scapula onto the back side of the ribs or thoracic area of the spine. The condition can be quite painful and is extremely irritating. The normal treatments of NSAIDS, cortisone, trigger point injections, physiotherapy, chiropractic care, and surgery often lead to suboptimal results. In my experience, Prolotherapy is the best chance a person has for a cure of this condition.

So what causes the scapula to snap?
The most common condition a traditional medical doctor thinks of is weakness of the serratus anterior muscle. This can cause a winging of the scapula, which then can snap. Typically this is from a long thoracic nerve injury which typically improves over time. If a person holds out their hands in front of them with the elbow extended and does not notice a winging of their scapula (or someone behind them doesn’t notice it), then this is not the problem.

The typical physical therapy approach to snapping scapula syndrome, scapulocostal syndrome, or scapulothoracic syndrome is to strengthen the serratus anterior muscle and/or put the person through a scapular stabilization exercise program. While this is helpful (even when someone undergoes Prolotherapy) it is rarely curative. For the person to be cured of this condition, they will often require Prolotherapy.

Again the question: So what causes the scapula to snap? What, realistically, could cause the scapula to start rubbing against a rib? It is likely going to come from some injury to the scapula. This is quite doubtful, yet, almost 100% of the traditional treatments are given to the scapula or the muscles that attach to the scapula. Doctors inject cortisone into and around the scapula. People get trigger point injections or massage therapy to break up “scar tissue.” While this approach gives some temporary relief, it is rarely curative. Remember I said that this condition can be quite painful and is extremely irritating. Trust me, when people spend a lot of money on therapies that are helpful, but not curative, when they believe they are going to get cured, this is also quite irritating. For the person with snapping scapula syndrome, the best alternative treatment, in my opinion, is Prolotherapy.

In my opinion, the most likely cause of the majority of snapping scapula syndrome, scapulocostal syndrome, and scapulothoracic syndrome is slipping rib. A rib that is too mobile will surely rub on the underneath side of the scapula. When the person gets chiropractic or osteopathic manipulation, it feels better for awhile, but, again, the snapping returns. The snapping comes back because the ligaments that attach the ribs to the vertebrae (costovertebral ligaments) remain injured. Prolotherapy treatments to these ligaments that are causing the snapping scapula syndrome can cure the condition.

So how do rib-vertebrae ligaments get injured?
1. Coughing: Have you ever coughed hard? Especially when you are sick? Anything that increases intrathoracic pressure like a cough or valsava maneuver (yes, like during a bowel movement) can cause those ligaments to stretch or be torn.

2. Trauma: Obviously any trauma to the side or onto a rib could injure it. Anyone who has had a hockey stick or elbow to the side or the ribs can end up with snapping scapula syndrome. Sometimes it caused by open heart surgery or lung surgeries. Any surgery that involves cracking open a rib or the chest can stretch those ligaments.

3. What about pregnancy? If this condition (snapping scapula syndrome) occurred after pregnancy, then most likely it started as a rib that is too mobile and is rubbing beneath the scapula. During pregnancy the body produces a lot of relaxin, which is the hormone that causes ligaments to get lax or stretch so the baby can come out the vagina. During the last part of the labor there is a lot of pushing by the mother to get the baby out, and this can cause injury to the rib-vertebrae junction. Such a person needs Prolotherapy to correct it.

If you or someone you love has been diagnosed with snapping scapula syndrome, scapulocostal syndrome, or scapulothoracic syndrome, consider telling them about Prolotherapy. Prolotherapy is a technique that stimulates the body to repair painful areas. Specifically, it involves injections into ligament/bone interfaces to stimulate ligaments to repair. Ligaments are bands of collagen that provide stability to joints like the rib-vertebrae junction. Prolotherapy to the costovertebral junctions can cure snapping scapula syndrome. Typically, a person is seen every four weeks for four to six visits to achieve a complete cure. If you are interested in making an appointment, feel free to give our office a call at 708-848-7789.