Is It Ok to “Crack” My Back?
by onsite, September 7, 2016
The idea of a person getting their “back cracked,” or going to a chiropractor to get their neck and back “adjusted,” seems to be a subject that most of us have pondered but don’t quite understand. We’ve all had a friend pick us up at times or push on our back to attempt at making it “crack” or “release.” I’ve had hundreds of patients over the years with neck and back pain tell me that their back “cracks” throughout the day, wondering if this is something they should be worried about. Most of us have had a parent or grandparent at some point tell us not to “crack or pop” our joints because it will cause arthritis. The goal of this article is to give people a better understanding of what is happening within the body when we get that “crack” or “pop” feeling. We will also discuss the situations in which “self-manipulating” or cracking one’s neck or back on your own can be unsafe.
For the rest of the article I am going to refer to “cracking the back” as a “manipulation”, although many people also refer to this as an “adjustment.” When a joint is manipulated, and we feel that pressure release and hear a cracking noise, what is actually happening within our joints to make that sound? It’s a pretty complex phenomenon but I’ll try to keep it simple.
The joints in our body contain oxygen, nitrogen, and carbon dioxide gases as well as fluid that lubricates the cartilage or protective surfaces between joints (where two bones come together). We want the joints in our body to be wet, lubricated, and slippery so that bony prominences move seamlessly on one another without excessive friction. We know that when you put liquid under pressure gas bubbles or air pockets are created. This creates increased pressure, and when these bubbles or pockets are released then an audible “cavitation” or popping sound can be heard. So when pressure builds up within a joint from being in a non-optimal or slightly abnormal posture for a period of time, we can release that by quickly moving the joints in a specific direction.
It’s similar to opening a can of soda. The pressure in the can is released when you open it, and the gas bubbles forcefully rise to the top with a pop. In the same sense, popping a bottle of wine elicits a similar phenomenon. Pressure builds up within the bottle, when it releases there is a large pop. Within our body when these gas bubbles are released during a self-manipulation or when we see a professional, the fluid in the joints is able to lubricate the joint surfaces and cartilage restoring frictionless movement. Typically, this makes us feel much better, less stiff, and like we can move more easily—but the results are temporary.
Am I Causing Potential Problems By Cracking My Own Back or Neck?
Most chiropractors take a strong stance against a patient self-manipulation, arguing that manipulations always need to be done by a professional. I believe this to be a gray area, because I don’t believe that self-manipulating is always a bad thing. The problem is that many people continually self-manipulate with their joints in poor positions, with increased force. The cumulative effect of self-manipulating over time in this manner can definitely contribute too various arthritic and disc related problems. If these self-manipulations are not controlled or done in a specific fashion, we can overstress a lot of the supporting structures around our joints including nerves, ligaments, discs, and others. Although we may feel some relief initially, we are not accounting for the increased laxity we are building into our joints with these excessive movements. If we are self-manipulating numerous times a day, which if done incorrectly will stretch out structures that support our joints, then over time we will lose stability in our joints. What causes a huge majority of spinal injuries (whether in the low back or neck) is INSTABILITY. The integrity or position of the joints in the spine becomes compromised resulting in disc bulging, the development of bone spurs, or spinal narrowing resulting in pinched nerves.
On the other hand, self-manipulating in a controlled manner with specific exercises or stretches that have been taught by a physical therapist or chiropractor is safe, and can be a very beneficial part of a daily maintenance program. The middle back or thoracic spine is a region that gets stiff and “tight” in many individuals. Maintaining good joint mobility and optimal alignment in this region of the back is crucial for maintaining low back and neck health. Often times joints in the low back or neck are forced to move excessively because of stiffness within this region. There are many safe and great techniques to stretch and self-mobilize or manipulate these joints and surrounding tissues. However, these techniques need to be taught specifically from a skilled professional to be done safely and effectively.
ARE YOU A SELF MANIPULATOR?
Self-manipulators are a large group of patients that have a similar presentation. This is what their patient profile usually looks like:
These patients crack or pop their neck, back, hips, and other joints frequently throughout the day to stay comfortable. They typically have very flexible or hypermobile joints, meaning they can hyperextend their knees and elbows. They usually stand with their pelvis tilted forward resulting in an increased curve in their low back/lumbar spine. People in this group often have a history of gymnastics, cheerleading, swimming, yoga, or some type of activity that causes them to be in positions of extreme flexibility. The most common age/sex category I see self-manipulators is females 15-45 years old (this is anecdotal). These patients usually demonstrate deficiencies in deep core or hip strength. Because there joints a hyper-flexible and they don’t have high level stabilization from their muscles, these patients feel pressure in their joints as they get slightly out of alignment or position. To keep discomfort under control, these people self-manipulate regularly throughout the day. However, over time these patients tend to get less relief from self-manipulating, and will eventually begin to have degenerative arthritic changes in their spine much at a much earlier age.
If you fall into this category of what I described above, it’s important to see a physical therapist or chiropractor. They will help get you on a program to stabilize your joints and develop strength in specific areas. This will help your joints stay in a better position, so you don’t have to self-manipulate all day to minimize pain! We perform safe and effective adjustments, and also provide targeted exercise prescription so patients can truly fix their problem. As a result, they don’t have to see a chiropractor for maintenance for the rest of your life. To get long lasting relief and begin fixing the cause of your back pain CLICK HERE for a FREE PAIN EVALUATION & MOVEMENT ASSESSMENT.
Lastly, we should never be allowing someone else that is not trained to “crack” our back or neck. I’ve had patients tell me their personal trainer or strength coach attempted “adjusting” them, and have seen several instances where this has caused injury. Allowing someone to pick you up or give you a bear hug to elicit a pop in your back probably isn’t going to do any significant long term damage. But this definitely isn’t something that we want to get in the habit of doing on a regular basis!
Photo Credit: http://drdepanfilis.com/chiropractic-care/the-chiropractic-adjustment/