General Question

auhsojsa's avatar

During a neck adjustment or rotation what makes the popping sounds?

Asked by auhsojsa (2511 points ) February 18th, 2012

You can hear the sound more consistent with the neck rotation. Is that the same as what pops during a neck adjustment?

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33 Answers

gasman's avatar

I think it works the same as cracking your knuckles. The joint space, sealed by the synovial membrane, is suddenly subjected to negative pressure from mechanical tension, like pulling on a suction cup. This leads to cavitation: bubbles of gas suddenly form within the joint, causing a click or pop. The joint won’t usually crack again until the gas is reabsorbed.

In the case of cracking your back or neck, it occurs at the facet joints where a vertebra makes bone-to-bone contact with neighboring vertebrae.

In my personal experience, joint-cracking feels good! No wonder people happily pay money to chiropractors to crack their backs during “adjustments,” even if there is no scientifically demonstrated medical benefit.

From Chirobase.org:
http://www.chirobase.org/05RB/BCC/06.html
While the popping itself is quite meaningless, this influence might possibly be used to advantage in curing psychosomatic conditions—provided the patient is informed that the bone is “back-in-place” and will stay there. By the same token, however, such treatment used on the mentally unstable and nervous person can cause a great deal of harm; that is, by perpetuating a psychosomatic condition or even creating a new psychological illness.

College_girl's avatar

Actually @gasman there are medical benefits. I’m a testimony to that. I used to get crouP all the time since I was a baby and once my chiropractor saw my spine was out of aligent, and after the first couple adjustments, my cough was completely gone and now as long as I get an adjustment at least once a month I rarely get sick. When your spine is in alignment so is your body.

Also, I don’t know if the sound of your neck being adjusted bothers you @auhsojsa, but you can always ask them to use an activator instead. In my opinion it doesn’t work as well but it still works.

Rarebear's avatar

We just had a patient who had a stroke as a result of a neck adjustment.

wundayatta's avatar

@Rarebear and @College_girl Can you establish proof of a causal link between the neck cracking and the alleged benefit or harm?

Rarebear's avatar

Patient had vascular disease. She had an adjustment. 2 hours later she presented with a stroke. Reason for stroke was a artery dissection that started in the carotid artery in the neck.

dabbler's avatar

@Rarebear I see no demonstration of a causal link there. That is coincidence.
Your own citation says “To be fair, not all current chiropractors still believe in these concepts. Read more about chiropractic” And generally that web page reads like an ambulance chaser ad. There are plenty of cases of “malpractice” with all sorts of medicine. Accidents will happen.

Chiropractic treatment is about restoring proper alignment, not magic. If your vertebrae are out of alignment the correct thing to do is straighten them out, and a chiropractor will do that for you. The AMA offers no good alternatives. They will let it get way more serious than it should then do surgery. That’s malpractice if you ask me.

College_girl's avatar

@wundayatta it isn’t neck cracking. It’s called an adjustment. Maybe you should go talk to an actual chiropractor instead of just reading or hearing about them. I’m sure you haven’t because most people who are so naive about the subject never actually take the time to hear their side.

@Rarebear I completely agree with @dabbler They aren’t some voodoo M.D.s

Rarebear's avatar

Ok, well you guys are true believers and have obviously drunk the kool aid. For everybody else though I encourage you to do some reading on chiropractic history and you’ll see how frighteningly unscientific it is. Reference provided on request.

Personally, if I’m going to have a guy wretch my neck around violently I would want to make sure that there is solid basis of scientific benefit first. But hey, that’s just me.

dabbler's avatar

@Rarebear Sorry you’re the one who has drunk some koolaid and needs to read some history. Yes, chiropractic used_to_be a very haphazard practice, typically done by the town barber. Anyone could hang out a shingle and claim to know what to do. There were definitely misconceptions and mishaps and little science. And that was a century ago. Don’t stop reading the history there.

The Palmer College of Chiropractic was founded in 1897. And there are several other fine chiropractic schools existing now. In the meantime it has become apparent that the practice required training and skills to avoid the horrors of the past. Most states (all?) have regulations requiring proper training if you wish to claim to be a chiropractor.
Take a look at the history of AMA-style allopathic medicine and you will no less tragedy in its past and the same kind of progress of science leading changes in the practice.

These days a chiropractor is a skilled professional. If your spine gets out of alignment you need one, there is no better way to get that straightened out.

College_girl's avatar

@dabbler I would give you five great answers if I could :)

@Rarebear You know a manual adjustment of the neck isn’t the only option that people have. Try reading up on activators. You seem to have a very bias and rote perception of this all and you appear unwilling to learn more about the benefits and other ways chiropractors adjust their patients besides manually. I have opened my thinking to both sides (however still believe that adjustments are beneficial) and have indeed read up about risks and the history of it. However, you are choosing only articles based on poor promotion of chiropractic work. Try finding positive articles about it and see the benefits instead of finding only its flaws.

Rarebear's avatar

@College_girl I have no bias. I only look at the science. And in looking at the science I see no benefit with high risk of harm. If you can show me some well designed clinical trials where chiropractic has benefit then I’d be happy to read them. I also have no idea what activators are, but I’d love it if you would educate me.

I have no doubt that there is some subjective short term relief for some patients with some forms of spinal manipulation. That’s just unlicensed physical therapy. What I have a problem with is sending people to chiropractors for treatment of conditions completely unrelated to musculoskeletal problems—such as asthma. There is no science basis, whatsoever, of how manipulating a spine will improve asthma, and it’s just simply dangerous. Also, I have a problem with chiropractors treating infants and children, the philosophy of “you have a spine, you need a chiropractor”, and the fact that unlike physical therapists, who teach you how to do exercises at home, chiropractors encourage you to continue to come back so they can pay for their boat.

Oh (later edit), just looked up activators. Found this article, which is a chiropractic journal. http://www.jmptonline.org/article/S0161-4754(05)00002-3/abstract

All this article says is that the people who use it use it the same way, but there is little evidence of clinical efficacy. So chiropractors are using it without having any idea whether it really does anything or not.

dabbler's avatar

Ok, Rarebear go ahead and believe the opinion you read on the webertubes of some AMA hack regarding “subluxation” and other mystical plop. That is an ignorant impression of modern chiropractic, whether or not your AMA hack can find some moron out there who believes that is the guiding principle of it.

If you get parts of your spine out of alignment i.e. vertebrae not where they are supposed to be, what are you going to do? Your AMA hacks will not help you until you are a cripple and then they will cut you open and fuse your vertebrae, because you are not on their radar until then. Good luck with that.
When I need such help, due to a recurring problem caused by a rearend car accident many years ago, I see someone who has specialized in specific manipulations designed to get them back lined up where they are supposed to be. That is not in the AMA curriculum. Chiropractors know how to do that.

auhsojsa's avatar

@Rarebear I’d like to know what makes you trust this site. http://whatstheharm.net/chiropractic.html

I can’t find where it gets its sources from, which raises my eyebrows.

*mind you I’m not trying to disprove your opinions stated amongst the current thread! As a matter of fact I’m leaning toward your argument in correlation to scientific proof. But spine adjustments do feel good. And I would like to know why it does feel good as if pressure is dissipated upon neck rotations and when I get my spine “popped” I don’t know if that per say is pseudo science, because there is obviously some kind of chemical sensation released in my body that tells me that area of the body feels better than it did before the tight feeling.

Rarebear's avatar

@dabbler Wow, talk about an ad hominem attack. Good luck with going to a chiropracter and avoiding the AMA hacks next time you have an asthma attack, a fractured tibia, or a myocardial infarction.

@auhsojsa I agree with you. I trust Whats the harm because I trust the sites creator, but only because I know of him and have been reading him for years, but there is no reason why you should. You’re correct in that it is a site full of anecdotes and is not scientific.

dabbler's avatar

I don’t go a chiropractor for “asthma attack, a fractured tibia, or a myocardial infarction.” why would I? They don’t treat that kind of thing. And I know AMA types who aren’t hacks, including superb cardiolgogists. I’d see one of them. Any of them is smart enough to send me to a chiropractor if I need my spinal alignment corrected.

You haven’t answered the question, what are you going to do when your vertebrae get out of alignment?

Rarebear's avatar

@dabbler I go to a physical therapist.

College_girl's avatar

@Rarebear but if you are seeing someone else for the same reason…..wouldn’t they also be manipulating your spine? Just in a different way? Sounds like a silly counter point to me

Rarebear's avatar

@College_girl To be clear, the idea of spine going “out of alignment” is a chiropractic term, and one that I think is hokum. I answered @dabbler like I did to be polite.

College_girl's avatar

@Rarebear um I would be surprised if that wasn’t a medical/form of medical term. I mean it’s pretty much like a doctor saying you have scoliosis. Either way your back is not in proper alignment, meaning it isn’t straight.

Rarebear's avatar

@College_girl My being laconic is getting me in trouble as I’m not being clear. I’m assuming that people know what I’m talking about, so let me back up a little.

Of course there is stuff like scoliosis, and orthopedic subluxations and the like. But that’s not what chiropractors are treating. Chiropractors believe in a term called vertebral subluxation which is very different than the medical term of the word “subluxation”. Chiropractors believe that this vertebral subluxation affects energy fields in the body, and that manipulating the vertebra can affect many other health problems, such as asthma.

Orthopedic subluxations are anatomic displacements of one vertebra against another. This isn’t what chiropractors say they treat, though.

wilma's avatar

@College_girl, did you know that @Rarebear is a physician?

Rarebear's avatar

A remarkably good one, I might add…:-)

College_girl's avatar

@wilma I did not, but that now explains a lot about his/her (sorry I’m not sure which you are based on your name) views on the subject. Almost all physicians are against chiropractic work. But honestly, I do have better things to do than try to educate someone who won’t take the time to really look at the good aspects of it. Also, I’m not trying to change anyone’s view on the matter, I’m just trying to educate you and share my experience of how beneficial seeing a chiropractor has been for me.

Rarebear's avatar

You misunderstand. I’m not “against” chiropractic work in particular. I’m against any therapy, medical, chiropractic or otherwise, that has no basis science and evidence of effect. As I said, if someone were to show me a good randomized study on chiropractic benefit I’d be the first in line to recommend it.

Actually, I am delighted every time I see an alternative medicine therapy that actually works. It doesn’t happen very often, but occasionally I see it.

For example, there was a recent study on the effect of Vitamin E on nonalcoholic steatohepatitis. Once I read that I was convinced, and now I put all my NASH patients on a course of vitamin E.

dabbler's avatar

@Rarebear If you believe all chiropractors base their work on some mystical principles of “subluxation” you are typically misinformed.

Like any other dislocation in any other skeletal joint in the body, where vertebrae are not in the right places relative to each other they respond well to being put back in the right place.

Your physical therapist might accidentally do that, but your physical therapist is not trained to put vertebrae back into proper alignment with each other and that is unlicensed chiropractic practice.
Vertebrae certainly do get dislocated, often due to traumas like car accidents.
Just like going to your respiratory specialist, your orthopedist, your cardiologist, Rely on someone trained to do exactly what you need, why not?

Rarebear's avatar

@dabbler So you deny that chiropractors use the theory of vetebral subluxation to treat medical illnesses like asthma?

As I’ve said, (now for the third time, I believe), show me a good, well designed study showing benefit for chiropractic therapy and I’ll read it. But until then the null hypothesis is that it is no better than placebo sham therapy and has a high risk of harm.

Rarebear's avatar

Oh, and in answer to the original question the popping is gas cavitation caused from the violent movement of bones moving next to your very fragile and irreparable spinal column.

dabbler's avatar

@Rarebear “Chiropractors believe in a term called vertebral subluxation”? that was a hundred years ago. I can see why one might object to such an approach to medicine.

None of the chiropractors I’ve met talk like that. But yes I bet you found one someplace trying to drum up business. No better, as an example, than the typical MD-run diagnostic clinics where patients are routinely hurried through first tier testings like cardiac ultrasounds so the results are inconclusive. The patients get booked for a more expensive (more profit!) test to properly diagnose them. Yep there are charlatans in all kinds of white lab coats.

I’ve defended above consistently chiropractic for treatment of dislocations of the vertebrae. Chiropractors are trained for that and are very good at it. I make no claims that chiropractic is good for asthma or acne or hangnails or depression.

The AMA has nothing to offer for vertebral dislocation and routinely do disservice to their patients denying the possibility the vertebrae are dislocated and prescribing muscle relaxers and pain killers while the “very fragile and irreparable spinal column” endures constriction and pressure unnecessarily – it can be fixed. No excuse for that.

wundayatta's avatar

@College_girl I am like @Rarebear in that I, too, am merely interested in evidence. I tried to phrase my comment neutrally, asking for evidence of both harm and benefit. @Rarebear chose to provide some evidence of harm. You chose to ignore my request for data, and instead attacked the terminology I used, which was copied from prior comments.

In addition, you attacked me and accused me of ignorance. You seemed to be assuming I have never experience chiropractic. Well, you know what they say about assuming. How it makes an “ass out of u and me?” I do hear you braying, you know. That’s what it sounds like, anyway.

I am actually quite experienced with chiropractice. I have been to three different ones over my life. It’s a little disconcerting in that the first two quit not so long after they started seeing me. But they didn’t want to deal with the hassles of private practice, I guess.

I don’t go see chiropractors any more because they taught me something that works quite well for me. They taught me how to stop the muscle spasms with ice. That’s all I need: an ice bag.

Rarebear's avatar

And like @wundayatta I’ve been to chiropractors myself. But that’s before I became a skeptic and started looking at real and not anecdotal evidence.

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