The pop or crack we feel in our back or neck is a common experience and gee it can feel good. So what is it, and is it bad for me?

What is it?

Our spinal joints are called synovial joints. A synovial joint, not surprisingly, is a joint filled with synovial fluid. So the marvellous design of joints in our body is such that we have two bones that meet, are bound together with ligaments and separated by a pressure-packed fluidy substance (synovial fluid). Now mechanically this is pure genius. Pressurised fluid creates a perfect friction-free ball bearing, so to speak, between the bony surfaces.

Now when a joint has suffered a sprain or strain, or if the mechanical forces acting on the joint are uneven then that fluid undergoes unusual traction and pressure which leads to, for want of a better explanation, a pressure build-up in the joint space. If you then force that joint through a significant range of movement, it will pop or click as the pressure within the joint space is equalised. This is why you can only pop it once, then you have to wait hours or days for the pressure to build again before it will pop again. (Repetitive clicking is something different – for another day and another article.)

Is it bad?

Essentially it is not a bad thing. We all know how good it feels when that pressure is released. When it is released then surrounding muscles relax somewhat and it all feels nice.

This sensation of pressure, and the associated pop or click, is a pretty normal function of synovial joints. BUT … in an ideal world it would not happen. See, healthy synovial joints do not build up pressure. There is always a reason. Usually that reason is either: the joint has a degree of wear or damage or, as I said before, the mechanical stress on the joint (such as the forces imposed on it by the muscles) is uneven or poorly balanced.

So what I am saying is the pop or click in the joint is rarely the real problem. It is a symptom and a symptom only. So when someone sees me for treatment they will often present with neck pain, headache, stiffness and joints that want to pop all the time. The reality is that the pain, stiffness and popping are all simply symptoms – not the real issue.

The real issue is always joint damage itself or that muscular imbalance affecting posture and movement. In the majority of cases, if I address the muscular imbalances and correct posture and movement patterns then the stiffness, the pain and the pressure feeling and the wanting to ‘pop’ all decrease or resolve completely. They are all simply symptoms.

Do Myotherapists perform joint manipulation?

Often during a course of treatment with a new patient who has had pain for a long time they will either experience lots of clicking or less than normal. In other words things are changing. As the body adjusts its posture and movement in response to the treatment, even though the treatment is only on muscle and tendon, joints are adjusting to positions they have not been used to. So some people say ‘my joints are clicking all the time’ and others will say ‘this joint that always used to want to crack doesn’t feel like it needs to any more’. This is all good. It is transition. Successful treatment leads to pain relief, resolution of stiffness and the cracking resolves.

Should I need to crack my neck and back all the time?

No.

Because cracking a spinal joint releases pressure and provides some pain relief we are tempted to conclude that it must be good for us. However, if you have to do this all the time, you really need to figure out why that joint is building pressure all the time and address that.

Something that patients often need to be reminded of, once they are well, is not to crack their neck or back just out of habit. Even though treatment may have resolved pain and joint pressure so that the joint no longer wants to click, sometimes patients will do it anyway. Not because they need to but just because that is what they have done for 10 years! So be aware, clicking your neck or back is no big deal if you need to, but don’t just do it out of habit.

What about therapies that perform joint manipulation?

Personally, I have found that skilful soft tissue manipulation is very effective at correcting posture and movement, making the need to perform joint manipulation rare.

There are however some situations where joint manipulation is required. Your sacroiliac joint in the lower back can lock out of place and require manipulation. Facet joints – smaller joints that are part of the vertebrae – can also lock out of place and require adjustment. In these situations I, as a Myotherapist, refer patients to an Osteopath or Chiropractor. Having said this, in my experience, cases where joints are locked out of place like this are quite rare.

A fallacy!

In the case of the sacroiliac joint and the facet joints which can lock out of place (which is rare) an adjustment will ‘relocate’ the joint. But … in every other case, in other words, just about all the time that you or your chiropractor is ‘popping’ a vertebral joint they are NOT, in fact, putting it back in place. The joint releases pressure, it feels good, but it has not moved. It is in the same place. So as popular as the phrases ‘my back is out’ or ‘I just got my back put back in’ are, technically no such thing is happening.

So what about therapies that do joint manipulation every session?

There are many ways to stimulate a healing response in the body and mobilising a joint is certainly one of them. In reality many conditions that will respond to either skilled joint manipulation OR soft tissue manipulation. There is more than one way to skin a cat. In my experience I have found that adjusting posture and joint position by manipulating the soft tissues does not get as instant a result but seems to get a more permanent change after several sessions, thus requiring less ongoing treatment.

So … I’m a fan of Myotherapy, but why wouldn’t I be?

 

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Cheers,

Tim