Popping, cracking, clicking. The extra satisfying, crunchy cracking sound.
That’s what jumps to mind when we think about chiropractic care. With so many of us suffering from stiff necks and backs from working gruelling long hours at the desk, it’s no surprise we’re lapping up ASMR videos featuring intense cracking sounds.
In a study by Singapore General Hospital, 73% of office workers surveyed experience pain in one or more of their body parts, notedly the neck, shoulder and back.
But the question is, what are chiropractors doing when they crack our necks and spine? Is popping our necks ourselves safe?
What’s that loud cracking sound?
Let’s start by breaking down the mystery of the cracking sound.
It isn’t your bones cracking, mind you, as that will be extremely painful and far from satisfying. The cracking sound comes from gas being released from the joints, known as a cavitation.
Cavitation is a situation where rapid changes of pressure in a liquid, results in the formation of small vapour-filled cavities in places where the pressure is relatively low. It’s essentially a bubble of gas popping in the joint. A study by Kawchuk et al theorises that the cracking sounds is due to cavity formation, rather than bubble collapse.
In essence, these studies explain that the cracking sound is produced by either a gas changing to a liquid or a liquid changing to a gas, at a high speed. Think of it like opening a bottle of champagne, or a can of coke — a loud hissing sound is produced due to the gas bubbles escaping.
Your neck houses vital “wirings” needed for your body to function.
The neck is such a vital and sensitive area due to the importance of the nerve system.
Think of the nerve system like the wiring system in your house. Just like your brain, you have a main electrical power source powering and controlling everything — and all your toasters, TV and appliances are able to work because its wires are connected to the main power. Similarly, your muscles, joints, skin, organs etc are connected to your brain via nerves.
At the top of your neck, there is the brain stem. Think of the brain stem like the fuse box in your house. If a single wire is damaged, it would turn off that one appliance. But if the fuse box is damaged, every appliance is affected.
This is the same for the body. The brain stem, located in the neck, has the highest concentration of nerves and is a control centre for the nerve system. It houses the most important nerves in the body, apart from the brain.
With all these important nerve “wirings” in your neck, you can see how cracking your neck haphazardly just for shiok is actually a terrible idea.
Why does my neck feel stuck and uncomfortable?
As mentioned, the brain stem in our necks controls our nerves and even our digestion, heart rate and respiration. In fact, our cranial and cervical nerves supply all information and feeling to the head, neck, shoulders, arms and hands!
If your neck is feeling uncomfortable, it could be due to misaligned joints in the neck caused by poor posture, stress, muscle tension and/or injuries. When this happens, pressure builds up in the nerves in your neck, causing discomfort and make you want to crack your neck to release this build-up of tension.
Is it safe to crack your neck?
Many people have worries about the complications of neck adjustments, often citing stroke as a potential outcome. When you delve deeper into studies of patient cases who experienced stroke, you will find that a majority of these cases occurred in non-chiropractor clinics, while some patients have already showed signs of stroke before they saw a chiropractor.
In general, statistically, the risk of something going wrong from spinal adjustments when performed by a certified chiropractor are about 1 in 4 million.
As a comparison, ibuprofen has a 1 in 50,000 risk of death and liver biopsy has a 1 in 500 risk of death. As a result, a liver biopsy is 10,000 times more dangerous than a spinal manipulation — and this is only to test the liver, not treat it!
It’s paramount to be careful and visit a legitimate chiropractor, as chiropractic care is still considered a form of complementary treatment and is currently not regulated by MOH.
Should I be cracking my own neck? It feels so good.
The short answer is no. I will absolutely not recommend yourself — or your masseuse, friend or anybody else — try and adjust or crack your neck.
While it may feel good to crack your own neck, this can actually be dangerous. When performed by a professional, it is specific and precise. However, nobody is able to accurately adjust their own neck. Even as a practising chiropractor myself, I wouldn’t be able to adjust my own neck precisely!
You could end up moving the joints above or below the specific stuck joint that needs to be moved and aligned properly. This can result in joint hypermobility syndrome (JHS), which is characterised by joint instability, fatigue and chronic pain. In fact, studies show that about 3% of the population have joint hypermobility (joints that are prone to move too much). Physiotherapy would be the preferred treatment for this condition.
As for the stuck joint, it will become more hypomobile (joints prone to move too little). Over time, this will result in changes to the shapes of these bones. The body, seeing them to be unstable, will lay down more bone in an attempt to stabilise the area, forming osteophytes.
Why does it feel so good to hear these pops in the neck?
When you crack your neck or back, there may be a release of endorphins in the body. The endorphins act as a pain reliever, similar to Panadol. But this does not fix the problem.
As you begin to like that hit of endorphins when you crack your neck, you may find that you need to do this more and more often. Like a pain killer, the cracking hides the problem momentarily. Too much cracking can lead to the damage of cervical and vertebral arteries, and is especially dangerous for a person with cardiovascular disease.
Why do you have to see a chiropractor for neck and spinal alignments?
Chiropractors have had years of training in analysing the techniques of cervical adjustments and are equipped with the knowledge to diagnose if the bones are really misaligned. They will be able to adjust accordingly and precisely.
Again, the goal of cervical and spinal manipulation is not to produce a sound, but to release the pressure on the nerves so the body can heal properly.
Neck alignments are also not for everyone, especially those with existing medical conditions. For instance, patients with scoliosis should see an orthopaedic surgeon instead for diagnosis and treatment.
So, as gratifying as it may be, resist the temptation to intensely crack your neck on your own! The cracking sound you enjoy for a split second is not worth your body’s long-term well-being.
Dr Shaan Rai is a chiropractor focused on upper cervical care of the spine and specializes in treating migraines and vertigo. He completed 5 years of Chiropractic Masters at AECC, UK and has practised in London and Singapore. He is also an active member of the General Chiropractic Council U.K. and the Alliance of Chiropractic (Singapore).