- Neck Cracking? 5 Signs it May be a Problem
- Why Does Cracking or Grinding in the Neck Occur?
- What Are the Common Causes of Cracking or Grinding in the Neck?
- When Should You Seek Medical Attention for Crepitus?
- How Can Crepitus Be Treated?
- Clicking in Joints When I Turn
- Clicking Neck
- Neck Cracking and Grinding: What Does It Mean?
- Neck Anatomy Involved in Cracking Sounds
- How Neck Crepitus Feels
- The Course of Neck Crepitus
- When Neck Crepitus Is Serious
- Natural Solution for Neck Grinding and Clicking
Neck Cracking? 5 Signs it May be a Problem
By Krista Elliott
As I sit and write this, the Princess Leia bobblehead on my desk nods her head approvingly with every keystroke. She’s a very encouraging muse, and I have to admire the smooth and silent flexibility of her neck as it supports her improbably large head.
Our own necks aren’t always so smooth and silent. Instead, they sometimes emit an alarming series of cricks, cracks, snaps, and outright crunches. Most times, this is inadvertent and harmless. If your neck cracks occasionally and isn’t accompanied by any pain, odds are it’s simply the popping of nitrogen bubbles. These bubbles form occasionally and harmlessly in the synovial fluid in your joints, and can pop even when a joint stays within its normal range of motion.
But when is neck cracking the sign of something more worrisome?
When it’s Accompanied by Pain: If your neck cracking is accompanied by pain, it could be the sign of arthritis or degenerative disc disease. If you’re experiencing pain, swelling, or a grinding sensation in your neck, you should definitely seek medical attention.
When it Makes you Feel Strange: If your neck cracks and you feel warmth down that side of your neck, or a bit of dizziness or nausea, your cracking may have interfered with the function of one or more nerves.
When it’s Consistent: The odd cracking sound is fine. But does your neck crack every single time you move it a certain way, even if it’s within seconds? At that point, it’s not bubbles, as they haven’t had time to re-form. If your neck cracks almost every time you move it, it could be the sign of a subluxation or restricted joint.
When it’s Post-Surgery or Post-Accident: If you’ve recently had neck surgery or been in an accident (even just a minor fender-bender), any changes in your joint health need to be assessed by a doctor to see if there are major issues or if it is caused by healing muscles pulling on the spine and creating subluxations.
When it’s on Purpose: Moving your neck within its normal range of motion to loosen up the muscles is fine. If that’s accompanied by the odd cracking sound, that’s fine too. What’s not fine is physically twisting or pushing on your own head in order to make your neck crack (or worse, having someone do it for you). Doing this can cause serious damage to your spine and to the ligaments in your neck.
If your doctor has ruled out any serious injuries or conditions, head on over to The Joint Chiropractic! With gentle and precise adjustments, our chiropractors can help resolve your neck pain and help you feel great! And with over 370 nationwide locations and no appointment required, it’s never been easier to make time for a healthier you.
So get cracking — in a good way — and visit The Joint today!
To learn more about your health and wellness, see your local chiropractor at The Joint Chiropractic.
Why Does Cracking or Grinding in the Neck Occur?
There may have been times when you’ve heard random pops or cracks in your neck when suddenly turning your head, or you might have woken up on occasion with a stiff neck, and when you turn to one side you hear a cracking or grinding sound. This is normal, provided it’s not occurring all the time. If you regularly hear grinding or cracking sounds in your neck that is accompanied by pain, it’s likely something more serious than muscle stiffness and will probably not go away on its own, which means you’ll want to make an appointment with a reliable SantaMonica spine surgeon to remedy the situation. Keep reading to learn about the possible causes of neck cracking or grinding and when to pay close attention to it.
What Are the Common Causes of Cracking or Grinding in the Neck?
Crepitus refers to any type of noise or sensation that occurs in the neck. The cervical spine contains many movable joints coated with synovial fluid, allowing for normal, smooth movement. Researchers can’t seem to agree on a single cause of crepitus. Back in the 70s, research indicated a gaseous bubble in the synovial fluid might be the culprit, but a more recent study suggests it’s the creation of the bubble that causes the sound. So far, there’s no evidence supporting the idea that cracking the neck repeatedly affects joint fluid. However, it may loosen the supporting ligaments.
Other possible causes of crepitus include:
- Moving tendons or ligaments – Tendons and ligaments moving over cervical bones and discs may be responsible for some of the noises coming from the neck
- Grinding bone against bone – Cartilage can break down due to trauma caused by whiplash or other injuries or age-related wear that causes bones to grind against other bones
When Should You Seek Medical Attention for Crepitus?
You shouldn’t be too concerned if you’re only experiencing occasional grinding or cracking in your neck, but if crepitus is combined with symptoms such as the following, you might be facing something more serious:
- Swelling or pain in the neck area
- Nerve-related pain that extends to the shoulders
- Muscle weakness or tenderness in the neck
- Painful or limited neck movement
- Crepitus appearingsoon after you’ve had neck surgery
How Can Crepitus Be Treated?
If you’re experiencing pain or limited movement associated with the grinding or cracking in your neck, it’s important to receive a diagnosis and treatment for the underlying cause. You may need a physical examination that involves purposely manipulating your neck to recreate the grinding and cracking sounds you hear. The doctor may also want to perform an MRI or CT scan to view the soft tissues in your cervical spine. Treatment options for crepitus include:
- Anti-inflammatory medications
- Neck stretches, massage therapy, and other types of physical therapy
- Surgery to remove bone spurs caused by bone-on-bone grinding
When swelling, pain, or other abnormal symptoms accompany cracking and grinding sounds in your neck, schedule an appointment with your doctor right away. It’s also important to prevent neck-related issues by practicing good posture. For instance, watch your head-shoulder alignment when using mobile devices, and sleep on a pillow that supports your neck and keeps it aligned with your spine. Also, perform basic neck stretches to maintain flexibility in your neck-supporting muscles.
Chronic neck pain needs to be addressed as soon as possible. If you’re unsure what’s causing your pain or how to effectively treat it, get in touch with The Spine Institute today. We specialize in minimally invasive procedures such as decompression surgery. Santa Monica patients can call 310-828-7757 to take the first steps toward living a pain-free life.
Clicking in Joints When I Turn
I have a persistent clicking noise in my neck every time I turn left or right, and a constant dull pain. What would cause this?
— Mary, Ohio
A clicking sensation in any joint suggests that there may be damage to the cartilage of the joints or that a ligament may be weakened. Cartilage is a special tissue that covers the bone surfaces of a joint and acts as a shock absorber due to its elasticity. The cartilage is made of ground substance, or matrix, and of a network of fibrils (little fibers) that give it strength. The matrix molecules are complex sulfated sugars (mucopolysaccharides) that contain water molecules. This type of structure gives great elasticity to normal, healthy cartilage, and its surface is smooth, allowing for effortless, gliding joint motion.
When the cartilage is damaged, as in osteoarthritis, rheumatoid arthritis, and other types of arthritis, the cartilage loses some of its ground substance and eventually loses fibrils and becomes thin. The surfaces of damaged cartilage become pitted and irregular and no longer allow for the smooth, gliding motion of a normal joint. For this reason, when a joint with structurally damaged cartilage moves, the patient may feel a clicking, grating, or grinding sensation. The grating or grinding, known as crepitus (creaking), can be felt when the physician is examining such a joint. Sometimes patients perceive these sensations as painful.
The cervical spine, which is the part of the spine in the neck, is a very complicated structure with two types of joints, ligaments, several muscle groups, the spinal cord within the spinal canal, the nerve roots emanating from the spinal cord, and a rich supply of blood vessels. The disc joints are between the vertebral bodies (the bones of the spine), while the facet joints are between bony structures extending to the side of the vertebral bodies. The spinal ligaments are strong tissues, made up mostly of collagen, that hold the bones and joints together.
In the case of rheumatoid arthritis (and rarely, in osteoarthritis), there may be a slippage of the joints, known as subluxation, between the vertebrae. Subluxation is the malalignment (misalignment) of a joint. This can happen because ligaments and bones are damaged and weakened by inflammation in RA and do not hold the joints together firmly. This is a potentially serious situation, because if the subluxation is bad enough, it can cause pressure and damage to the spinal cord.
In osteoarthritis, pressure on the nerve roots by bony spurs (osteophytes) is more common than pressure on the spinal cord. At times, however, osteophytes may form inside the spinal canal and press on the spinal cord. A disc herniation may also cause spinal cord compression.
Symptoms of spinal cord compression are neurological: pain in the base of the head, numbness, tingling, jerking motions of the extremities, and even paralysis that, at worst, could affect all four extremities (quadriplegia).
The bottom line is, you need to consult a rheumatologist, who can take a detailed history, do a physical exam, and order screening X-rays of the cervical spine. At times, an MRI (magnetic resonance imaging) is required. A neurology or neurosurgery consultation is indicated when the clinical picture and imaging studies suggest involvement of nerve roots or of the spinal cord. A note of caution: Manipulation of the cervical spine can be dangerous if there is a possibility of subluxation or severe nerve root pressure. So until you are appropriately evaluated, don’t let anyone manipulate your neck.
Learn more in the Everyday Health Neck Pain Center.
Please read how the neck works before reading the following.
Clicking or crunching in the neck can be caused by a number of things.
Most people fear that the clicking is caused by bone hitting bone. However, thankfully nowadays this is rare. If you have this it is likely that for many years you have been suffering severe pain and movement restriction. If this is you please go and see your GP for a referral to an Orthopaedic consultant as soon as possible.If you felt a click with a sudden or traumatic injury like a car accident or a fall you must see an Osteopath, Physiotherapist or doctor as soon as possible for a full assessment, because you may have damaged a vital ligament or bone.
If the noise is not painful it is most likely to be air pockets popping with the changes of pressure that movement causes inside the fluid of the neck joints. A clicking neck can also be caused by small particles swishing around in the fluid of the neck joints.
Painful clicking can be caused by soft tissue damage in the joint like cartilage that has been worn away or has broken off and is floating around in the joint. Clicking or clunking can also be caused by tendons or scar tissue slipping over bony prominences.
In summary – if your clicking neck is also painful you need to get it checked out but if it is not painful you need not worry about it. If in any doubt please get in touch!
Neck Cracking and Grinding: What Does It Mean?
Crepitus or crepitation is the noise that may be heard during joint movements, such as a cracking, popping, snapping, or grinding. These sounds and sensations can occur in the neck as well. Most people at some point have experienced neck crepitus. One example is feeling a cracking sensation in the neck when turning the head to back up a car.
Crepitus refers to any cracking, popping, snapping, or grinding sensation that occurs when a joint moves. There are 3 common causes of joint crepitus. Watch: Video: Why Do My Joints Crack?
Neck crepitus is usually painless and typically does not represent anything serious. However, if crepitus occurs with other troubling symptoms such as pain or following trauma, it could indicate a more serious underlying medical condition is present.
Neck Anatomy Involved in Cracking Sounds
The facet joints in the neck are where the back of adjacent vertebrae join together. There is a smooth surface on the end of each bone called cartilage. Inside the facet joint is synovial fluid, which lubricates the joints. At the front of the adjacent vertebrae is another connection called the intervertebral disc space. Neck crepitus is thought to occur when structures in the spine rub together and make sounds.
See Cervical Vertebrae
Some likely causes of neck crepitus include:
- Articular pressure changes. Tiny gas bubbles can form and eventually collapse within synovial joints, be released and then create the popping sounds, such as in the neck’s facet joints. These are the sounds that are heard when people crack their finger knuckles, which is not harmful. These joint-cracking sounds can happen during natural movement or during manipulations of the spine in physical therapy or by a chiropractor. The medical literature had been conflicted in recent years as to whether these sounds are created by the gas bubbles being created or collapsed. Most in the medical community believe that the sounds are from the bubbles collapsing, but it has yet to be proven conclusively.1-3
- Ligament or tendon moving around bone. Ligaments and tendons both attach to bones. In some cases, it may be possible for a moving ligament or tendon to make a snapping sound as it moves around a bone and/or over each other. This can occur because our muscles and tissues are too tight or because they become less elastic as we age.
See Neck Muscles and Other Soft Tissues
- Bone-on-bone grinding. As facet joints degenerate due to osteoarthritis, the protective cartilage wears down and adjacent vertebral bones can start rubbing against each other, which may cause a grinding noise or sensation. This grinding can also occur due to disc degeneration resulting in less cushioning between the vertebrae.
See Neck Pain Causes
Neck crepitus is thought to occur when structures in the spine rub together and make sounds. One suggested cause of neck crepitus is the formation and collapse of tiny gas bubbles, caused by pressure changes within the joint.
Neck crepitus could be caused by any of these factors, or in some cases it could be a combination of these or other factors. It should also be noted that crepitus can occur in any moveable joint in the body (with common examples including the knees and shoulders).
Read What Is Crepitus? on Arthritis-health.com
In This Article:
- Neck Cracking and Grinding: What Does It Mean?
- Causes of Neck Cracking and Grinding Sounds
- When Neck Cracking Needs Medical Attention
- Video: Why Do My Joints Crack?
How Neck Crepitus Feels
While neck crepitus is commonly painless, it can also be accompanied by various degrees of neck stiffness or neck pain, ranging from dull aches to sharp pains.
See Types of Neck Pain
People who have some degree of pain with neck crepitus may be at a higher risk for having negative thoughts and stress associated with their neck’s cracking and grinding sounds. These negative thoughts might cause people to unnecessarily alter behaviors or worry that the neck has serious structural damage even when it does not. A study that looked at people with painful knee crepitus found that the participants had more worries that their knee-cracking sounds indicated premature aging, and they were also more likely to try to modify movements to avoid making the sounds.4 Similar results might hold true for people with neck pain and crepitus.
The Course of Neck Crepitus
Neck crepitus can occur at any age, but it is more likely to occur as a person gets older. The frequency of neck cracking and grinding sounds can vary greatly. Some people might experience neck crepitus a few times a month, whereas others might experience it every day or even throughout the day with most neck movements.
Neck crepitus may go through some periods where it occurs more often than others. For example, neck cracking and grinding might occur frequently for a few days and then go away. In cases where neck crepitus is the result of bone-on-bone grinding due to facet joint osteoarthritis, the neck cracking and grinding sounds are more likely to occur frequently with movements and not go away.
See Cervical Facet Osteoarthritis Video
While increased neck cracking and grinding sounds can occur with arthritis, there is currently no scientific evidence to suggest that frequent neck cracking can lead to arthritis. As we age, the sounds tend to move from louder and more pronounced cracks to more grinding or crunching sensations.
When Neck Crepitus Is Serious
If neck cracking or grinding is accompanied by pain, stiffness, or other concerning symptoms, it may indicate an underlying medical condition that needs to be checked by a qualified health professional.
- 1.Unsworth A, Dowson D, Wright V. ‘Cracking joints’ A bioengineering study of cavitation in the metacarpophalangeal joint. Ann Rheum Dis. 1971; 30: 348-358.
- 2.Kawchuk GN, Fryer J, Jaremko JL, Zeng H, Rowe L, Thompson R. Real-time visualization of joint cavitation. PLoS ONE. 2015;10(4):e0119470
- 3.Chandran suja V, Barakat AI. A Mathematical Model for the Sounds Produced by Knuckle Cracking. Sci Rep. 2018;8(1):4600
- 4.Robertson CJ, Hurley M, Jones F. People’s beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study. Musculoskelet Sci Pract. 2017;28:59-64.
In most cases, treatment for cervical spondylosis is nonsurgical. Nonsurgical treatment options include:
Physical therapy. Physical therapy is usually the first nonsurgical treatment that your doctor will recommend. Specific exercises can help relieve pain, as well as strengthen and stretch weakened or strained muscles. In some cases, physical therapy may include posture therapy or the use of traction to gently stretch the joints and muscles of your neck. Physical therapy programs vary in length, but generally last from 6 to 8 weeks. Typically, sessions are scheduled 2 to 3 times per week.
Medications. During the first phase of treatment, your doctor may prescribe several medications to be used together to address both pain and inflammation.
- Acetaminophen. Mild pain is often relieved with acetaminophen.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Often prescribed with acetaminophen, NSAIDs such as ibuprofen and naproxen are considered first-line medications for neck pain. They relieve both pain and swelling and may be prescribed for a number of weeks, depending on your specific symptoms. Other types of pain medication can be considered if you have serious contraindications to NSAIDs or if your pain is not well controlled.
- Muscle relaxants. Medications such as cyclobenzaprine or carisoprodol can be used to treat painful muscle spasms.
Soft cervical collar. This is a padded ring that wraps around the neck and is held in place with velcro. Your doctor may advise you to wear a soft cervical collar to limit neck motion and allow the muscles in your neck to rest. A soft collar should only be worn for a short period of time since long-term wear may decrease the strength of the muscles in your neck.
Ice, heat, and other modalities. Your doctor may recommend careful use of ice, heat, massage, and other local therapies to help relieve symptoms.
Steroid-based injections. Many patients find short-term pain relief from steroid injections. The most common procedures for neck pain include:
- Cervical epidural block. In this procedure, steroid and anesthetic medicine is injected into the space next to the covering of the spinal cord (“epidural” space). This procedure is typically used for neck and/or arm pain that may be due to a cervical disk herniation, also known as radiculopathy or a “pinched nerve.”
Epidural injection in the cervical spine.
- Cervical facet joint block. In this procedure, steroid and anesthetic medicine is injected into the capsule of the facet joint. The facet joints are located in the back of the neck and provide stability and movement. These joints can develop arthritic changes that may contribute to neck pain.
X-ray of a cervical facet joint
- Medial branch block and radiofrequency ablation. This procedure is used in some cases of chronic neck pain. It can be used to both diagnose and treat a painful joint. During the diagnosis portion of the procedure, the nerve that supplies the facet joint is blocked with a local anesthetic. If your pain is relieved, then your doctor may have pinpointed the source of your neck pain. The next step option may be to block the pain more permanently. This is done by damaging the nerves that supply the joint with a “burning” technique—a procedure called radiofrequency ablation.
Facet joint injection in the cervical spine.
Although less invasive than surgery, steroid-based injections are prescribed only after a complete evaluation by your doctor. Your doctor will talk with you about the risks and benefits of steroid-based injections for your specific condition.
Natural Solution for Neck Grinding and Clicking
In consulting with patients experiencing the effects of Atlas Displacement Complex, including neck pain, it is not uncommon for them to experience the effects of abnormal mechanics of the joints in the neck. One of the common side effects of Atlas Displacement and instability of the cervical spine is what is known as crepitus, or the clicking, popping, and cracking sound and sensation occurring with normal neck movements.
Often patients will describe a scenario where they turn their head and heard and felt a “clunk” or “pop” in the neck and they experience sharp neck pain. Under normal mechanical circumstances this should not occur with gentle movements. When the upper cervical spine has lost its structural alignment and stability, the mechanics of the joints or “knuckles” of the neck become compromised and as such experience abnormal stresses and strains. As a result of these stresses and strains the supportive connective tissue structures including ligaments, joint capsules, tendons, and myofascial compartments develop adhesions and scarring holding the joints of the neck in abnormal positions. This local irritation is often the cause of both chronic and acute neck pain. Over time the contour of the cartilage and discs between the joints of the segments in the neck become irregular, similar to potholes developing in road surfaces that are not maintained.
In the same way that driving on a road littered with potholes produces a bumpy ride, moving the weight of the head around and on misaligned joints produces gravel like sensations or sounds. Avoiding these movements of the neck is similar to swerving to avoid the potholes in the road; it is a temporary and inefficient solution at best. A reasonable person would appreciate that resurfacing the road is the best option for safe and comfortable passage. In the same way, a restoration of balance, mechanics, and alignment of the neck is the optimal way to eliminate the crepitus that occurs with instability and to find natural relief for neck pain.
A comprehensive NeuroStructural evaluation will reveal which joints of the neck are producing the abnormal sensations and mechanics, and will provide the blueprint for safe and conservative correction. Through image-guided adjusting procedures, structural rehabilitation, and mechanical reeducation, Colorado Springs chiropractor Dr. John Stenberg assist patients in resolving the instability associated with abnormal structural alignment while simultaneously providing natural relief for neck pain. This process is similar to resurfacing the road littered with potholes and provides a long-term strategy rather than a quick fix or Band-Aid.
As the alignment and mechanics of the neck improves, the cartilage and other soft tissue structures supporting the segments of the cervical spine will remodel to support normal movement, weight distribution, and the pain free range of motion. The added preventative benefits of this process include slowing or preventing the onset of Degenerative Disc Disease (DDD), spinal arthritis (DJD), and the poor posture and appearance associated with Anterior Head Syndrome. Not only are these structural conditions causes of chronic neck pain, but they also produce functional limitations with range of motion, balance and stability, and predispose you to greater risk of injury in the instance that you experience trauma to the head and neck such as whiplash, sports injuries, or jolts to the head neck.
The upper cervical spine is the upper neck region and has unique characteristics that implicate Atlas Displacement in conditions such as neck pain, neck grinding, or neck stiffness. The upper cervical spine is the most mobile area of the neck and as such susceptible to injury when forces overcome its inherent stabilizing mechanisms. Factors that predispose a person to Atlas Displacement and its nagging secondary effects include:
- Past concussions
- History of car accident
- Weak neck and shoulder muscles
- Sports injuries
- Falls (off of a bike or horse, down the stairs, slips on ice, etc.)
At first, structural displacements that occur as a product of these injuries to the upper cervical area are no big deal. However, if left uncorrected over time they are likely to cause the onset of secondary conditions (a.k.a. symptoms) including:
- Chronic neck pain
- Headaches (tension and migraine)
- Neck stiffness
- TMJ dysfunction (TMJD)
- Eustachian Tube Dysfunction (EDS)
Structural problems require structural solutions, and attempts at secondary condition management (symptom eradication) are unlikely to be long-lasting if the underlying Atlas Displacement is left uncorrected.
If you experience crepitus (clicks, pops, and cracks with head and neck movements) you may have undetected Atlas Displacement Complex and spinal instability. Early detection is essential for optimal recovery. Reserve a Complimentary Consultation with Colorado Springs chiropractor Dr. John Stenberg to determine if you have this condition and if NeuroStructural Chiropractic will provide a solution for you.
Using precision measurements and advanced adjusting procedures, the Blair Upper Cervical chiropractic approach provides a safe and effective option for correcting Atlas Displacement (upper cervical subluxation) without twisting, popping, or cracking the neck. Dr. John Stenberg is the only Doctor in Colorado Springs trained in the Blair Upper Cervical approach which is a key component of the comprehensive NeuroStructural Chiropractic solution.
Please submit a consultation request and Dr. Stenberg will follow up to reserve your appointment. A consultation is a simple conversation, and not a commitment.