Question
Dear James

For years there often have been a cracking or popping sound from my joints when I move, especially from the hips and knees.  Recently, the occurence has increased noticeably, sometimes with multiply pops, and from other areas such as the back and shoulders.

I have read on the web and been told by my physiotherapists that the sound comes from air escaping from crevices in the joints.  However, why so often?  And what causes the crevices?  Are materials around the joints or the joints themselves being worn down so creating the crevices and allowing air to get in?

As background information, I am a 45 year old female, and have been suffering from back problems for over 15 years such as degenerative disc disease, scralization at L5 and S1, and have had bulging disc problems a couple of times in the past.  My mother suffers from osteoarthritis.

What can I do about it this condition?  Currently I am taking omega 3, glucosamine, and calcium as supplements.  And I also exercise regularly but not strenuously.

I look forward to hearing from you.

Yours sincerely
Katherine


Answer
Dear Katherine,

Thank you for your question about popping noises.  Your question is similar to some that I have heard from others who are investigating chiropractic.  In order to answer you properly, I抣l first need to give you some background on the chiropractic profession.

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation.  This is not reliably revealed by popping noises, as in your question, though the two may exist together.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as being born, physical activity such as exercise, sleeping posture and mattress condition, sneezing, falling down, even seemingly insignificant movements, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, etc.), which are, unfortunately, regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  The reason is that most of what goes on inside you happens without your awareness.  As an example, try to "feel" your liver.  What's it doing right now?  You can't know, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  The branching of the nerve pathways is complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  For this reason alone, it is impossible for anyone to give you reliable answers as to what may cause the noise you describe in your question or if it may be related to a vertebral subluxation.  Even if it were possible to guess at what may be causing the noises, though, it is not pertinent to the matter of whether you will benefit from being free of vertebral subluxations.  In order to know if someone has a vertebral subluxation, it is necessary to have that person抯 spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible through a procedure called 揳djustment.? 

Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about your pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

A key question to ask for your purposes, then, would be, Is someone who has had the complaints of popping or the other matters in the history you describe better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.  It抯 not that you should see a non-therapeutic straight chiropractor FOR this problem ?you should visit one in an effort to be free of vertebral subluxations, even WITH such complaints.  Non-therapeutic straight chiropractic is not about diagnosing and/or treating this or any therapeutic-model or medical condition.  It is entirely separate in its goal.  

As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  You need to understand very clearly that the practice objectives of therapeutic mixed chiropractic and non-therapeutic straight chiropractic are quite different, as described above.  What I can tell you must not be interpreted from the mixed viewpoint.  

It is impossible to tell you why these noises are occurring or if there is cause to be concerned in this format.  I have never met you.  In addition, there are several lines of reasoning to explain how or why such noises may occur, ranging from movements of joint fluid to actual physical compromise of the joint, without universal agreement as to which is the most likely.  The one that was proposed to you so far, apparently described as air in the joint, needs a bit of clarification.  It抯 not actually a situation of air leaking into your joints through crevices.  It抯 a situation of cavitation, wherein sudden pressure changes in the joint fluid, as may occur with joint movement, allows dissolved gasses to 揵ubble out?for a brief moment and then be reabsorbed into the fluids.  It is thought that the sudden closing of these bubbles then becomes audible as they are amplified, in a sense, by the dense surrounding tissues much like it is easier for you to hear the sound of someone knocking at your door with your ear pressed against the wall as the vibrations are conducted so much better through the dense wall than they are through the much thinner air in the room.  So, to summarize, it may be that the noises you hear are harmless or they may indicate something that needs attention.  It would be irresponsible for me or anyone else to guess about your situation in this through this type of interaction.  

All that said, it certainly would be wise for you to be checked for vertebral subluxations for the reasons described above, even if you still also elect to pursue the matter of the noises or any other therapeutic issues.  If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area so you may know if you have vertebral subluxations, please contact me at this site again or directly at [email protected].  

Katherine, I wish you the best in understanding what non-therapeutic straight chiropractic has to offer.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.