Question- “Why would I need to go to a Chiropractor? I crack myself all the time, and it feels great.”
I’d have to say that of all the questions I receive, this one is by far the most common. Admittedly, it sounds logical, but before answering the question, we should consider some basic anatomy. Most of my patients start out with some fear of being adjusted (“cracked”) because of the resulting sound. Much of this fear is subsequently quelled when I tell them that the “cracking” sound is simply bubbles popping, not bone grinding on bone as many would think. Here’s where the anatomy comes in.
Most of us understand that where two bones join together (articulate), a joint is required. However, most of you might not realize that there are a few different types of joints in the body. One of these is the synovial joint. Synovial joints are a bit different than other joints in that they’re encapsulated. Within these encapsulations is synovial fluid. Examples of common synovial joints include the knee, hip, shoulder, elbow, and the carpal/tarsal joints of the hands/feet. Gases such as oxygen, nitrogen, and carbon dioxide form bubbles inside the synovial fluid. When the joint is taken to its end range, those bubbles pop. Hence the sound that is generated when you bend your fingers far enough and the knuckles “crack.” Once the bubbles have popped, they need a few minutes to reform. This is why you can’t continuously recreate the sound. Many of you may feel compelled, almost addicted, to cracking various joints of your body.
There are differing theories on why this is, none of which have been scientifically proven. Some believe that when a joint is taken to its end range and the sound is made, a signal is sent to the brain causing a small endorphin release. Endorphins are small protein molecules produced in the nervous system that react with sedative receptors to relieve pain. Another theory is that by simply moving a joint and hearing the sound, we start to associate the sound with feeling good. The feeling of euphoria experienced immediately after “cracking” a joint is simply the result of an auditory stimulus, a very Pavlovian response.
Regardless of what theory you may subscribe to, there’s a common thread with most all self “crackers.” They love to do what they do. Your spine is made up of twenty four vertebrae (not including the sacrum). Each of those vertebrae has four facet joints, two on top and two on the bottom. Each of these four facet joints is a fluid filled synovial joint. That gives the spine far more “cracking potential” than any other area of the body. We all can agree that the body is a miraculous physical entity. It’s constantly working to keep everything in homeostasis, or balance. It’s a 24 hour/day, 365 day/year job that doesn’t stop until the day we die. The body has divided these tasks among various systems. The spine and all of its associated muscles, tendons, and ligaments are part of the musculoskeletal system. The musculoskeletal system has some very important responsibilities. These include supporting the weight of the body, keeping various parts of your body in a proper position or posture, providing structural framework and protection for vital organs, and producing controlled, precise movements.
For the purposes of this blog, we’re going to talk about maintaining proper posture. All of the body’s various systems are constantly working towards homeostasis. In a perfect world your musculoskeletal system is keeping your shoulders level, your head centered above them, and your pelvis level so that your legs are of equal length and your gait is fluid. But in our imperfect world, we are constantly bombarding our musculoskeletal system with a variety of factors that test it to its very limits. These range from the extreme, such as car accidents, to repetitive stressors like sitting hunched over at a computer all day. When the body senses that there has been an injury to a certain area from one of these outside influences that it can’t correct easily, it puts that area on “lockdown” - persistent or chronic pain, tightness, immobility, inflammation, and muscle tension in a specific area.
Take the person who does computer work all day for years. Chances are they’ll start to develop some forward head translation and probably severe/chronic lower neck pain with associated upper Trapezius muscle tension. I see these people all the time in my practice. More often than not, they are also “self-crackers”. They complain of a constant pain in the neck or between the shoulder blades that always feels better if they can just get it to “crack.” So again, why would they need a Chiropractor if they can crack their own neck? If we dig a little deeper, we’ll likely find that these same people admit to self-manipulating their necks on a daily basis. Sometimes more than once a day. This begs the question, if they were actually correcting what was causing the problem, why would they feel the need to do it so frequently?
It all goes back to homeostasis. If the musculoskeletal system has decided to put one or two vertebrae on lockdown (hypomobility), it must then allow others near-by, to move more freely (hypermobility) to create balance. So, hypothetically, let’s say this person’s 6th cervical vertebrae has become hypomobile due to the repetitive stress of computer work. This could then mean that the 4th, 5th, and 7th cervical vertebrae would become hypermobile in order to pick up the slack. So when this person “cracks” their own neck, they’re only motioning the joints attached to the hypermobile vertebrae while leaving the ones that really need adjusting virtually untouched. They may feel better after they’ve done it due to the theories previously discussed, but it generally lasts for only a few hours, or maybe a day. This doesn’t even account for the detrimental effects that self-manipulation can cause (such as increased ligament laxity and muscle tension).
There are over 20 different vectors that a vertebrae can be motioned. A Chiropractor is well trained in proper joint motion and flow or biomechanics of the spine. “Self-crackers”, are not. It’s our job to restore proper joint motion to the areas where it’s been lost. In the case of the computer worker, one possible remedy would be to adjust the 6th cervical vertebrae, thus restoring proper biomechanics to that area of the spine. After motion is restored to the affected area, nine times out of ten the “self-cracker” tells me they don’t feel the need to self-adjust anymore.