What's the 'Crack'?!

Ever wondered what actually is the 'cracking' thing Osteopaths and Chiropractors do? Well read on..

We as Osteopaths call the technique a 'Spinal Manipulation' or a 'HVLA technique' (high velocity low amplitude). Chiropractors call the technique an 'adjustment'. They are the same thing. This can be done all over the body but commonly in the lower and upper back, and neck.

So what is a manipulation? This is where a controlled thrust is applied through an area of the spine to increase movement and mobility at a specific segment!

What is the noise? You often may hear a “popping/cracking” noise when having a manipulation. If you do, the most accepted theory at the moment is the sound is generated from the popping of gas bubbles (thought to be carbon dioxide) in the synovial fluid that surrounds each joint in the spine. When the joint is gapped, the synovial fluid moves through a pressure gradient and therefore the gas bubbles have space to “pop”. It is completely normal, like a champagne bottle releases gas when the cork comes out! 🍾

Are there any risks? Well firstly.. It is unsafe for anyone who isn’t professionally trained to attempt these techniques! There is speculation surrounding cervical (neck) manipulation risks of causing vertebral artery complications, however, stresses and strains on the vertebral artery during spinal manipulation of the neck have been found to be much smaller than those produced during passive range of motion testing and diagnostic procedures. Meaning, these techniques are no more dangerous than other techniques to the necks we perform, and that danger is extremely small. Your practitioner shouldn’t perform this technique if they feel you’re unsafe to receive it!

Does it feel good? I tend to leave manipulations ‘til the end of the treatment as that is when the patient is most relaxed and the muscles / spine respond the best (in my opinion). You wouldn’t do your one rep max before warming up would you? Research suggests that spinal manipulation can cause an small increase in endorphins and oxytocin release, which can explain why it feels so good (E.B Lohman et al, 2019; H.T Vernon et al, 1986). Another reason to finish the treatment with manipulation (if appropriate and safe to do so)!

Found this interesting? Please leave us a comment!

Thanks and see you in our next post!

Anna

References

Herzog, W. (2010). The biomechanics of spinal manipulation. Journal Of Bodywork And Movement Therapies, 14(3), 280-286.

NCCIH. (2019). Spinal Manipulation: What You Need To Know. Retrieved 21 September 2019, from https://nccih.nih.gov/health/pain/spinemanipulation.htm

Schomacher, J. (2013). Spinal Manipulative Therapy for Acute Low Back Pain. Manuelletherapie, 17(05), 200-200.