Question
Hello,

I was just  wondering what do the cracking sounds mean when a chiropractor manipulates the spine?  I notice a chiropractor I've recently been seeing manipulated my neck and the upper and middle back area and they all cracked.  However, when he manipulated the lower back, no cracking sounds came out.

Answer
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Hello S.,

There are a variety of possibilities causing the 揷racking?sounds in your spine.  It is a question that patients commonly ask chiropractors.  And unfortunately, there isn抰 always a clear answer as to the cause in certain situations.   There is speculation that of the most commonly accepted reasons why joints crack is from nitrogenous gases releasing that can build up in the joints or connective tissue.  However, this is still debated, and there isn抰 a great deal of research on the matter because it doesn抰 have a clinical impact on healthcare and it抯 an unprofitable topic for researchers to develop further.  However, sometimes certain areas of the body will crack for known reasons.  Some of the known reasons causing 損opping sounds?in the joints can come from scar tissue, degeneration, tendons stretching, or joint subluxation.  There really isn抰 a great deal of concern unless you notice it worsening in a progressive manner over time.

As for your low back not 損opping,?again, I wouldn抰 be too alarmed.  Sometimes the area that doesn抰 損op?may have more stability, less scar tissue, or more smooth joint mobility.  Another possibility is the low back is tighter; the muscles may be restricting the low back motion.  It抯 just too difficult to tell, there are too many variables, and there aren抰 many scientific methods, procedures, or tests to determine which is causing your situation that can give you a clear-cut answer.

And lastly, there are anatomical differences from patient to patient.  For example, I have some patients that require a moderate to significant thrust to adjust their spines to achieve a 損opping?sound while others only require a tiny push to do this.  It just varies patient to patient, and there is no way for me to know until I adjust the patient.  Just realize your question is a very common question and concern patients have, and the varying degrees of some people popping more than others is extremely wide-ranging with no clear understanding of why.

I hope this helps answer your question!

Dr. JR Strecker, DC