Adam Rufa - 5/22/2006

Question
Hi,

For the past few years I've had bad back pain, but could never figure it out. I have a very painful crepitus (bumping, grinding, thumping sensation) in my scapulothoracic joint. It feels as if my Scapulae (both right and left) are bumping against the backs of my ribs. One can see this "thumping" when I move my shoulders and it's clearly audible, even from a few feet away. It's very painful and has thickened my trapezius to the point where I can barely feel deep tissue massage. I have a feeling of tightness and am uncomfortable 100% of the time. What is beginning to worry me, however, is how this condition is affecting the rest of my body. Last week, it felt like I had an impinged nerve - I couldn't raise my right arm above my head and my right deltoid was tingling with bad pain. I took some anti-inflammatory medicine and it seemed to help - but two days ago I woke up with the same pain, but in my left deltoid and MUCH, MUCH worse. It's inflammed, warm to the touch and extremely sensitive. I'm beginning to fear that whatever is happening in my scapulothoracic joint is pinching the nerves that feed into my arms. I'm training to become a massage therapist and am afraid of not being able to work because of this pain. Some helpful background: I used to be a Varsity Rower (repetitve motion that could have affected my scapula, since that is the area affected by the motion involved in rowing) - and during my time as a rower, I was sick with Anorexia and Bulimia, which I fear might have affected my joints. I have a snapping hip and have had tendonitis in both feet. Any insight you can give would help a lot. Thanks You!

Answer
Anne

Sorry to hear about your symptoms. These types of problems can be difficult to treat and diagnosis however, I often have good luck with them.

If you look up snapping scapula syndrome you may find some information about it. The difficulty is determining what is causing the symptoms. Some of musculoskeletal possibilities are:

     Rib dysfunction
     Thoracic outlet syndrome
     Cervical dysfunction (disk, DDD, spurring ect.)
     Trigger points
     Thoracic spine dysfunction

These problems can be addressed with manual therapy (mobilization / manipulation), correction of muscle imbalances, neurogenic exercises and several other treatments.

I would advise that you see an MD to rule out any non-musculoskeletal problems and then if appropriate get in to see a manual therapist.


Good luck

Adam