Popping Sound During a Chiropractic Adjustment: What It Is and Whether It Matters

The popping sound during a chiropractic adjustment is the first thing most new patients ask about. The short version: it’s a joint making noise. It isn’t a bone grinding, and it isn’t something sliding back into place.

What causes the popping sound during a chiropractic adjustment

For decades the standard explanation was a bubble collapsing in the joint fluid. A 2015 study put that to the test with real-time MRI. Researchers pulled on ten finger joints inside the scanner and filmed the moment of the crack. What they saw: a cavity appeared in the joint as the surfaces separated, right when the sound happened, and it stayed visible afterward. The authors concluded joint cracking is tied to cavity formation, not bubble collapse.

Finger joints aren’t spinal joints. Researchers still have plenty to work out about what happens in the spine. But nothing in that work suggests the sound means a bone moved back into place.

Do you need to hear a pop for the adjustment to work?

No. In a 2003 study of 71 patients with low back pain who got a sacroiliac region manipulation, an audible pop occurred in 50 of them. Both groups improved, and the two groups didn’t differ in range of motion, pain, or disability. A 2006 analysis of 70 patients found the same thing: no difference in outcome whether or not a pop was achieved.

Both studies were small and both were done in physical therapy clinics, so take them as a reasonable signal, not a rule. They do back up something worth knowing. Chasing a louder crack isn’t the goal of care.

Is it bad to crack your own back or neck?

Knuckles are the best-studied case. A 2011 study of 215 adults found habitual knuckle cracking wasn’t a risk factor for hand osteoarthritis, in any joint.

Nobody has studied habitual self-cracking of necks and backs the same way, so there’s no equivalent reassurance. Forcing a sore neck is a poor idea, and our list of when not to get an adjustment explains why neck symptoms deserve an exam first. If you feel a constant urge to crack the same spot, that stiffness is worth bringing up at a visit.

When a pop isn’t normal

A painless pop is just noise. A pop with sharp pain, swelling, a joint that locks, or new numbness or tingling is different, and you should say so right away. Soreness the next day is common and usually mild. Our guide to being sore after a chiropractic adjustment covers what’s normal.

At Brooklyn Chiropractic Care, your first visit starts with a consultation and an orthopedic and neurological exam before the first adjustment. And not every technique is a thrust. Flexion-distraction, the technique Dr. Patel uses for disc-related problems, is gentle, hands-on, and non-thrusting.

Frequently Asked Questions

References

1. Kawchuk GN, Fryer J, Jaremko JL, Zeng H, Rowe L, Thompson R. Real-time visualization of joint cavitation. PLoS One. 2015;10(4):e0119470. PubMed: 25875374
2. Flynn TW, Fritz JM, Wainner RS, Whitman JM. The audible pop is not necessary for successful spinal high-velocity thrust manipulation in individuals with low back pain. Arch Phys Med Rehabil. 2003;84(7):1057-1060. PubMed: 12881834
3. Flynn TW, Childs JD, Fritz JM. The audible pop from high-velocity thrust manipulation and outcome in individuals with low back pain. J Manipulative Physiol Ther. 2006;29(1):40-45. PubMed: 16396728
4. Deweber K, Olszewski M, Ortolano R. Knuckle cracking and hand osteoarthritis. J Am Board Fam Med. 2011;24(2):169-174. PubMed: 21383216