(1) Hi Alice,

I read the information on your website about knuckle cracking, and I was wondering if it applies to cracking backs and necks. I know that people often have their backs cracked by friends, etc. because it feels good and seems to relieve tension. Also, when my neck feels tight, I often turn it from side to side until it cracks and feels better. I've heard that chiropractors do some version of this, and call it "realignment." Is this safe? Is there a right or a wrong way to crack a back or neck? Is cracking your back/neck actually therapeutic in some way?

(2) Dear Alice,

As a college student, I sometimes spend long hours reading books or looking at computer screens, and often my neck gets stiff. Like many of my joints that get stiff, sometimes I crack my neck, like I would crack my knees or fingers when they feel stiff. I often wind up doing this several times a day.

My question is, could I do irreparable damage to my spinal system if I continue using this method to soothe a stiff neck? Could I wind up a paraplegic if I continue to crack my neck? Leak spinal fluid, etc.?

Sincerely,

Stiff-Necked Student

Dear Reader and Stiff-Necked Student,

It’s not dangerous to gently pop your joints from time to time in most cases. But, before you decide to crack that achy-breaky neck or back of yours, consider this: there are plenty of other preventive and treatment strategies that you could use in combination with or instead of always opting for popping. Stretching and strengthening the muscles, using heat or ice, or getting a good ol’ back rub are just a few of the options to consider. However, if you're still feeling the urge to get crackin’, there are a few rules of thumb when it comes to back and neck popping. First, it’s recommended that you seek a professional chiropractor (more on that option in a bit), osteopathic health care provider, or physical therapist instead of asking your amateur (but well-meaning) buddy or trying to do it yourself. Second, if cracking your joints causes you pain, or if your limbs feel numb or lose strength, it’s best to consult with your health care provider. Third, if you do want to crack you joints yourself, consider doing so gently.

So why do joints crack, anyway? Just like with your knuckles, that snap, crackle, and pop is usually due to the perfectly harmless escape of gasses from the joints. It’s also possible that the cracking you hear is happening when ligaments or tendons pop into place, or when a rough patch of your joint is scraping against itself. In general, as long as the popping isn’t painful, you probably don’t need to worry. But, if your popping or cracking is aggressive, if you’re overextending the joints, or if you do feel pain, numbness, or loss of strength, it's wise to seek out some medical advice. When it comes to an area like the back and neck — a major highway for nerves and blood vessels — it’s safer to err on the side of caution if anything feels amiss.

One route that some people choose when they need a release of tension in their back or neck is paying a visit to a chiropractor. If this route is of interest to you, it's good to know a bit more before making an appointment. Although the effectiveness of chiropractors has been debated over the years, the consensus now tends to be that professional spinal or cervical “manipulation,” as it’s called, is likely safe for most people, and it may even reduce symptoms of migraine, neck pain, low back pain, or joint conditions. However, some risks still do exist. If you have risk factors for stroke, osteoporosis, cancer in your spine, or unstable joints, chiropractic adjustments are not recommended. If you have any other underlying health conditions, be sure to give your provider a heads up about those too, to be safe. Even if you’re otherwise healthy, you might still experience fatigue, headache, or discomfort after your session. Also, don’t forget to check out your chiropractor’s joint poppin’ cred: it's wise to only pay a visit to a chiropractor who has a degree and has been licensed (read: not that random friend who keeps offering to walk on your back).

Now, how can you avoid ending up all stiff and tense in the first place? You could start by checking out the tips in Stress is a pain in the neck — literally! or Lower back pain? In the Go Ask Alice! archives. Here are some other prevention and treatment ideas you can get crackin’ on to avoid having to crack that back or neck of yours in the future:

  • Consider getting a professional massage or a gentle back rub from a friend.
  • Try some over-the-counter pain medications.
  • Try a firmer mattress on your bed or a new sleeping position.
  • Practice a little neck and back stretching and strengthening throughout the day.
  • Use ice or heat on the area that’s in pain.
  • Carry a lighter load in your bag or backpack.

While a little gentle joint cracking from time to time doesn't seem to pose too much of a risk to your health, taking care of your back, neck, head, and shoulders (and knees and toes) now can help you save yourself major aches and pains later on down the line. 

Alice!

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