Question
Hi.  For years, in part to relieve stiffness and pain from very tight muscles, and in part out of bad habit or maybe even a type of addiction, I have been repeatedly moving my neck (without manual assistance) so that in one or two places it "cracks" (sometimes it feels more like a snapping than a crack).  There are days when unfortunately this becomes quite obsessive and I can literally do it hundreds of times.  Is it possible I have done permanent damage to my neck such as hypermobile joints and if so how would that be diagnosed?  Thank you for any suggestions.

Answer
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Hello P.,

Your question is a variation of one of the most common questions chiropractors are asked.  In general, the popping and clicking is ok, and often a very good thing that occurs, so long as you are not forcing it to pop by yourself.  It sounds as though you are not putting any force into the joints, so I wouldn抰 be too worried.  If the popping and clicking occurs just by moving your neck around through the normal ranges of motion, that is fine, so long as there is no pain.  In fact, keeping your neck moving through its normal motions (turning both ways, ear to shoulder both ways, and forwards and backwards) are great range-of-motion exercises.  They keep your joints healthy and mobile.  Joints are made for movement, and often will degenerate if they are severely limited in motion.  When you go through your range-of-motion exercises, and hear the popping sounds, it抯 just releasing from the tension and stress that irritates the joints throughout the day.  However, if there is a painful sensation with the popping, you should definitely seek an evaluation by a physician or chiropractor.  Additionally, doing it 搇iterally hundreds of times?per day is probably a bit too much, so you might want to work on keeping it under control.

You bring up an excellent point regarding hypermobility and damage to the joints.  It is true that hypermobility can damage your joints.  However, going through simple range-of-motion exercises several times per day, and clicking or popping during these exercises do not necessarily indicate a sign of hypermobility.  Generally, hypermotibility is diagnosed simply through range of motion testing/analysis.  If your range of motion is significantly greater than the 搉ormal?ranges of motion, then it is possible your joints are hypermobile.  Keep in mind, ranges that are deemed 搉ormal?may not be normal for you. Also, if you were forcing your neck to pop everyday (which it doesn抰 sound like you are forcing the joints), then that could also create hypermobile joints.  A doctor or chiropractor should be able to determine if hypermobility is present very easily just by assessing your range of motion.  Another possible cause of hypermobility that tends to be missed by many practitioners is if you have any underlying connective tissue or collagen-vascular disorders.  The most common symptoms of these conditions are extreme flexibility (often referred to in lay terms as being 揹ouble-jointed?, saggy skin, easy bruising, and more common in European descent.  (These disorders are broadly classified in this written response, with many other associated symptoms not detailed in this answer.  Also to note, having one or some of these common symptoms does not always indicate a collagen-vascular or connective tissue disorder).  If your joints are hypermobile, the most important thing you can work on are stabilization exercises, which are too numerous to provide here.  A great personal trainer or knowledgeable practitioner will be able to provide you with some neck stabilization exercises.

Overall, I wouldn抰 be too concerned unless there is pain associated with popping, and as long as you are only going through range-of-motion exercises and not forcing the joints to pop.  If these components are not present, there should be no reason for alarm.  Talk to your doctor if you feel any of these discussed associated factors are present.

Good luck!
Dr. JR Strecker, DC