Most of us that suffer with chronic neck pain have frequent episodes of cracking, popping or grinding as we move our head. Actually, it happens occasionally to those who have no pain issues.
WHY IS MY NECK CRACKING?
Crepitus, sometimes called crepitation or cavitation, is the term used for the sounds that are audible under the skin and are made by the joints and tissues of the neck. The sound occurs when two rough surfaces in the neck collide or grind against each other. This can happen in conditions where the cartilage has worn away – leaving the joints themselves to rub against each other. It can also occur where fractured bones scrape across each other. Crepitus can occur in any moveable joint in the body and there are many movable joints in the neck.
The neck joints are bathed in an oily-like substance called synovial fluid… which allows motion to freely occur in between the bones.
If the sounds are painless, usually there is nothing to worry about. However, if the neck cracking is accompanied by pain, swelling or some other concerning symptoms, then it may be prudent to consult a qualified health professional.
POSSIBLE CAUSES OF NECK CRACKING
Some of the likely causes of neck cracking include:
- Synovial joint fluid pressure changes: various studies have been performed purposely cracking the synovial joints of the fingers, but the conclusions in medical literature as to what is actually making the noise have been inconclusive. A study published in 1971 indicated that the cracking sound of a joint was caused by the bursting of a gaseous bubble in the joint’s synovial fluid. However, a study published in 2015 reported that the cracking sound was actually from the bubble being created. Here’s the conclusion: the underlying cause of crepitus in the neck is still not fully understood.
- Ligament or tendon moving around bone: another possible factor in neck cracking could be the snapping sound of ligaments and/or tendons as they move over bones… or other muscles or tendons located in the neck region.
- Bone on bone grinding: while this is a less common cause of neck cracking, it’s possible for bone to grind against bone if the cartilage has worn down. Osteoarthritis is an example of this bone-on-bone grinding. It occurs gradually with the normal aging process or it can be accelerated if there has been a traumatic injury such as whiplash or a sports-related injury.
- Whiplash: this type of crepitation is usually accompanied by pain, limited neck motion… and the cracking sound is repeated over and over with each movement of the neck. This phenomenon is different from the typical gas bubble formation cracking – it usually takes about 20 minutes before the cracking, or cavitation can occur again.
WHEN DOES NECK CRACKING NEED MEDICAL ATTENTION?
In general, most neck cracking does not indicate a problem. However, you should consult a doctor if any of these symptoms occur:
- Pain or swelling: Neck crepitus with pain or swelling could be a sign of osteoarthritis or some other type of inflammatory process in the joints of the neck.
- Recent accident or injury: If your neck is making new cracking or grinding sounds after some kind of trauma – such as a car accident or a fall – then that could be due to a structural change that needs to be evaluated by a qualified health professional.
- Frequent or constant: if the neck cracking is constant… if the sound can be recreated every time or nearly every time the joint is moved… then that could signal a problem in joint function – especially when accompanied by pain.
- Recent surgery: sometimes new neck sounds develop after surgery in the cervical spine. The sounds might show up weeks after the surgery – and while they could be normal and nothing to worry about – mentioning it to the surgeon just incase is always smart.
CAN CRACKING YOUR NECK CAUSE MORE SERIOUS PROBLEMS?
Some people regularly crack their neck on purpose… either due to a nervous habit or perhaps to bring some therapeutic relief from neck tightness or pain. With this in mind, it’s common for people to wonder whether repeatedly cracking their neck can wear down the joints… and cause arthritis… or worse.
The medical literature says that repeatedly cracking your neck… or any of the synovial joints throughout the body, does not increase a person’s risk for developing arthritis in those joints (remember when your mother warned you that cracking your knuckles would make them swell and you wouldn’t be able to get rings on and off?). However, some studies point out other negative effects – such as loosened ligaments.
Some physicians suggest that chronic neck cracking can cause a lack of elasticity in the neck muscles… allowing them to become fatigued much more rapidly than usual and eventually lead to hypermobility. Hypermobility is when the joints are continuously forced outside the normal scope of motion. Over time, this prevents them from returning to normal – with consequences such as problems supporting the head without pain. It is very unlikely for the neck to become hypermobile… other joints in the body are much more likely to be affected.
It is possible to boost the health of the synovial fluid in the joints and ameliorate or slow down the degeneration of the connective tissue capsule. Supplements such as hyaluronic acid, glucosamine, chondroitin, MSM and type-II collagen may be beneficial.
Alternative therapies, such as yoga and pilates may help in lengthening and relaxing the joints in the neck so as the reduce number of popping and cracking sounds. An excellent video demonstrating stretching exercises (with yours truly) is available here.
A rare and inconclusive result is reports of vertebral artery dissection (tearing) resulting in a stroke after certain types of manipulation of the cervical spine. There is much debate if the vertebral artery damage is equally likely to occur if the patient seeks treatment from a health care professional who does not practice spinal manipulation. The general consensus of recent medical literature is that spinal manipulation does not appreciably strain, stretch or sprain the vertebral artery.
As a wise precaution… anyone having symptoms such as pain, dizziness, lightheadedness, numbness, tingling or other issues should consult a qualified health professional immediately.
The bottom line is that for most people, the downside risk of daily neck cracking appears to be minimal. However, the process is not fully understood and continues to be studied by medicine.