Added on September 8, 2017
As a clinician who specializes in the treatment of spinal disorders, one of the most common questions that my patients ask is whether or not the noises heard with movements of the neck are normal. While there could be many reasons why someone experiences noise in the neck, or cervical spine, the three main reasons can be summarized by the tagline of a famous breakfast cereal: Snap, Crackle, and Pop.
If you look at a picture of a Cervical Spine, you will see 7 individual vertebrae (designated C1 through C7). Each of these vertebrae contains numerous bony prominences which serve as anchor points for numerous tendons and ligaments. Tendons connect the muscles that move the neck to the bone, while the ligaments connect bone to bone and serve to maintain the neck's stability.
As the neck moves, the tendons and ligaments may rub over the bony prominences, resulting in a snapping sound. This is a normal process, and should not result in any pain. The snapping noise typically occurs when the head and neck moves in one direction. With repetition, the snapping will eventually subside as the tendons and ligaments loosen and settle into their ideal position.
Just like our knees, hips, and shoulders, the neck is subjected to the same type of degeneration. As we age, our joints begin to lose the lubrication and cartilage which protects them from wear and tear. In the neck, we have numerous joints between each of the seven cervical vertebrae. The joints are often referred to as "facet joints".
When we move our head and neck, the facet joints glide and slide over one another. As the lubrication begins to wear away and decrease over time, the surfaces of the facets can rub or grind over each other. The movement often is associated with a crackling or grinding sensation. While the noise or sensation can be unnerving, as long as there is no pain associated with the crackling, then it should be no cause for significant concern.
We've all seen it. We may have even been guilty of it ourselves. I'm talking about the loud popping sound that is produced by pulling or twisting the neck to the side. To some, the pop brings relief. To others, it brings disgust or annoyance. In the grand scheme of things, popping of a joint is a natural, physiological response.
The prevailing theory as to why the pop happens involves the internal structure and physiology of the joint itself. The facet joints, as described above, are surrounded by a sheath of tissue. Within the sheath is a liquid matrix, called Synovial Fluid. This fluid helps to lubricate the joint to prevent wear and tear of the articular surface.When the joints are stretched to their end range, the theory suggests that a vacuum is created, and some of the fluid rapidly forms into a gas. As the gas expands, it forms a bubble, which pops at a certain point. This pop can be quiet, only heard by the person. On the other hand, it can be rather loud, annoying the person sitting next to you. This whole process is known as "Cavitation".
Popping that is associated with cavitation is a normal occurrence. I do warn people about forceful thrusting, or the so-called "self manipulators". Forcefully yanking on the head and neck to cause it to pop can be more harmful than good. By forcing the neck to a point beyond its maximal range can lead to a sprain/strain of the ligaments and tendons. If you are one of those chronic poppers (like myself), make sure that the force is slow and gradual.
Noises associated with snapping and crackling in the neck are normal! What I suggest to my patients is to monitor the noises as they happen.
If you're experiencing neck pain and/or the noises are suddenly and consistently associated with local or referred pain, then you should visit one on our many physical therapist first.
Click here to request an appointment at any of our clinics across the east coast or midwest. Remember that you do not need a prescription. In most states, you can begin treatment without a prescription. For states with limited direct access laws, you can still come in for a free consultation with one of our physical therapists without a prescription.
Aaron Gewant, PT, MSPT, cert MDT
Ivy Rehab of Chester, New Jersey