Posted by our chiropractor Dr. Beau Billett.
One of the most common statements I hear when someone comes to see me is – “my back has gone out, can you pop/crack it back in?” This statement leads to my usual response- “if your back has gone out, then where did it go?” It is a common misnomer that people have that their backs can “go out”. Unless you have a significant injury with a traumatic joint separation and dislocation, it is unlikely that you back is “out”. What actually occurs is that a joint complex has lost its normal motion and is fixed or stuck, which can then cause pain, irritation to nerves etc. Chiropractors, call this joint dysfunction a Subluxation. Rather than popping or cracking it back we chiropractors perform an adjustment, with the intention of restoring normal motion back to the joint. Various techniques that chiropractors use do create a popping or cracking sound. So what is this popping sound that you hear during a chiropractic adjustment? One thing I can say is that is not “bones cracking”.
Some chiropractic techniques cause a popping sound whereas others do not.
When an adjustment is given, the joints that are stuck or fixed, open up briefly (we call it gapping the joint). It is the process of this joint gapping that creates the sound you hear. The actual pop is called a cavitation, and it is the release of gas that makes the popping sound. The joints of the spine are called synovial joints. The key thing with synovial joints is that joint itself is covered by a joint capsule which is filled with a fluid, called synovial fluid, that acts to lubricate and nourish the joint. Dissolved into this synovial fluid are a few gasses, Oxygen, Nitrogen and CO2. When a joint is gapped, or opened up, the gas is rapidly released from the fluid and you hear the distinctive popping sound. It is similar to the release of gas bubbles when you cork a champagne bottle. Once the joint is opened up, the synovial fluid re-lubricates the surface and hopefully normal motion has been returned to the joint.
It is important to realize that not every adjustment results in a popping sound, in fact, some chiropractic adjusting techniques never cavitate the joint. I personally use a mixture of techniques in which some create the sound and some don’t. The point is, while a ‘pop’ is sometimes felt when giving and adjustment (which by the way does feel great), it is not an indicator of whether or not the correct motion has been restored. This is why we always recheck that area again after the adjustment to determine if proper motion has been restored. For those of you who are not keen on having their joints “cracked” then these techniques, that don’t create the popping sound, may be for you. Please discuss with your chiropractor if you are not comfortable with the sound and we can discuss the options with you.
Still on the “cracking” topic, the other question I get asked a lot is, does cracking my knuckles lead to arthritis? The simple answer is no. There have been a few studies that investigated whether or not cracking knuckles caused arthritis. They did conclude that cracking knuckles will not increase the risk of arthritis, but (and there is always a but) knuckle cracking was related to hand swelling and lower grip strength and there may be a connection to soft tissue injuries. So, even though it will not give you arthritis, it may not be a good habit to get into.
What do you think? Do you like or dislike the cracking noises during an adjustment?