A crack in the back can be relaxing for those affected or it can be the beginning of painful back pain. But what exactly is cracking in the back and is it dangerous? Does the cracking cause permanent damage or is it rather “a release” of blockages and therefore completely normal?
- Symptoms when cracking in the back
- Causes of Back Cracks
- Damage from cracking in the back
- Crack your back
- Treatment for cracks in the back
- Naturopathy and Holistic Medicine
Almost everyone knows the cracking in joints, although this is sometimes perceived as more threatening in the back than, for example, with cracking fingers . What laypeople also describe as joint cracking in the back or back cracking has different names in the professional world – especially since some therapy directions can also be a deliberate crack in the course of the treatment, for example with a so-called tectonic fixation, an HVLA on the back or the dog technique. Adjusting the back is the colloquial term here.
Symptoms when cracking in the back
Cracking in the back can occur on one or both sides in all regions of the back. The sound itself can be a clearly audible crack, but also a pop, rubbing or clicking sound. For example, many people complain of cracking in their middle back when they move their shoulder blades – but if you listen carefully, this is more of a rubbing noise. As different as the noises are, the variability of the sensations is just as great: Some people feel as if something is jumping over (tendon, ligament or muscle) or “jumping back in” or “jumping out”, while others have the feeling that something is jammed come off again.
The cracking can be felt deep in the back or superficially. Many sufferers describe that the back regularly cracks when stretching and stretching in the morning or when getting up after sitting for a long time or when bending forward. However, this is usually described as painless and sometimes even as relaxing or relieving. If there is back pain or stiffness in the back after getting up , many of those affected indicate that it tends to be better after the cracking. Sometimes the cracking in the back can occur at very short intervals and then not for longer periods of time – i.e. it can be quite irregular and symptom-free. If pain occurs in connection with cracking in the back, it is usually immediately after the cracking noise.
Causes of Back Cracks
For a long time, various theories have been circulating about how exactly the cracking occurs in the back and other joints. Today it is proven that a short-term negative pressure in the joint capsule or in the joint space creates small gas bubbles and the cracking noise becomes audible when they arise. A study from 2015 made this clear using the example of cracking fingers and the examination with MRI images
However, a crack in the back does not always mean a crack in the joints. The rubbing and snapping noises have a different origin, although the most common theory here is based on a sound when a tendon or a ligament is skipped. The tendons or ligaments slip over one another or over a protruding bone. Furthermore, it could be tendons that run over the joints and change their course slightly when they are bent or stretched in the joint and generate a noise when returning to the neutral position. Other theories see, for example, a lack of synovial fluid as a possible cause of audible bone rubbing or cartilage rubbing.
A cracking noise can also arise when a joint jumps out of its “socket” or “holder”. This is described by those affected for the area of the back, sometimes with a herniated disc or with so-called vertebral sliding ( spondylolisthesis ). Under certain circumstances, such a cracking can also be the result of a vertebral fracture.
In addition, those affected primarily describe complaints such as tense muscles, whiplash, one-sided posture or poor posture and overexertion or excessive stress in connection with the back cracking. Occasionally, a connection between the cracking in the back and diseases such as rheumatism, degenerative diseases of the spinal column ( spondylosis or spondylarthrosis ), inflammatory diseases of the spinal column ( spondylitis , spondylodiscitis ), ankylosing spondylitis , gout , osteoporosis or broken bones can be assumed. Under no circumstances can the back cracking be named as a typical symptom.
Hereditary predisposition also seems to play a role in some of those affected, because in practice it is not uncommon to say that “my father already had that”.
Damage from cracking in the back
A fundamental problem in medicine is that most therapists do not realize that they are working with models. These models, which are intended to provide a basis for practical work (i.e. therapeutic intervention), are only approximations to reality. What the reality looks like in a complicated biological mechanism – for example the human body – can in part only be assumed on the basis of the therapeutic effects.
So when doctors, naturopaths, osteopaths, chiropractors or FDM users explain their explanations to those affected when they have questions about cracking in the back, these are mostly explanations that the therapist effectively uses, for example to visualize their work or which they have “worked out” themselves in practice based on the observed effects. The next therapist one door further might explain it completely differently. This also makes it clear why the statements about possible damage from cracking in the back have varied extremely so far.
Given the many different and strongly differing hypotheses, it is understandable that it is unclear what consequences the cracking can have in the back. Here the statements diverge strongly: Some claim that cracking is harmful to the joints, the intervertebral discs, the tendons and the ligaments, others that it is “completely harmless”. It could be harmful because it “wears out” the ligaments or the joint capsules or “overstretched” the tendons. This in turn could make the joints permanently unstable and the strength could decrease, according to the theory. It is also often claimed that cracking in the back can lead to microtraumas or permanent consequential damage such as water retention or wear and tear on the joints.
The internist and allergist Dr. Donald L. Unger from Thousand Oaks, California, was tired of the uncertainty as well as the constant statements from his mother that cracking fingers was harmful and could cause arthritis. In a sixty-year self-experiment, he examined the consequences of cracking fingers and in 2009 was awarded the so-called Ig Nobel Prize by the Annals of Improbable Research magazine. Twice a day for decades he had his left-hand finger joints cracked and the right-hand side unmolested. The tests showed that he had neither arthritis left nor right.
Raymond Brodeur, an American engineer, Doctor of Chiropractic and osteopath, at the Ergonomics Research Laboratory (ERL, LLC) of Michigan State University (MSU) once made the claim that a gas bubble was visible after a crack in the joint. According to Brodeurs theory, this occurs when the joint capsule is stretched by pulling quickly and the pressure within the joint has to be reduced. The gases change into the bubble shape, allowing the capsule to expand further. According to Brodeur, it then takes a while before the gases dissolve again and the cracking can be triggered again. Exactly this theory was confirmed in the aforementioned study from 2015. No damage to the joints was found, but it could not be ruled out.
Crack your back
A large number of manual procedures, such as chiropractic or osteopathy, evaluate the audible cracking in the back as an indicator of a successful technique. In the vernacular, this is usually called “straightening”. In the therapeutic jargon it becomes “manipulation”, “HVLA technique”, “thrust”, dog technique (on the thoracic spine), “lumbar roll” (on the lower back), “Kirksville crunch” or “impulse technique” called. HVLA stands for “High Velocity, Low Amplitude” (high speed, low deflection). With these techniques, the therapist builds a palpable barrier by bringing the back to a certain position, which, by the way, is not the limit of movement. This barrier is overcome with a short impulse, and the audible cracking sound occurs.
Some therapists or therapeutic directions mean that the small vertebral joints are blocked and the technique briefly loosens the joint surfaces – according to these theories, what you hear is the penetration of air, gas or the loosening of the meniscus or the joint capsule. Since the building up of the barrier and the triggering of the crackling sound is within the normal limits of movement of the joints and the surrounding tissue, it is more than unlikely that such techniques or the resulting cracking in the back lead to “overstretching” of the capsules or ligaments .
The Swiss researcher Dr. At the International Fascia Research Congress (FRC) 2009 in Amsterdam, Walter Herzog presented the preliminary results of a study that showed that manipulating the cervical spine placed less stress on the carotid artery than normal turning the head. According to the fascia distortion model (FDM) of the US osteopath and emergency physician Stephen Typaldos, DO, the “plop” or “click” is a release of the so-called folding fascia or of so-called tectonic fixations on the joints.
From the point of view of FDM, fold distortions represent a three-dimensional deformation of the fasciae near the joint. These distortions mean that the joint is no longer protected against compressive or tensile forces because the fascia can no longer fully fulfill its tasks. Depending on the compressive or tensile forces that caused the deformation, a distinction is made between unfolding distortions and folding-in distortions. Typaldos had observed in patients that they complained of pain deep in the joint without restriction of movement. This contradicts the usual model of a “joint blockage”, which is always accompanied by restricted mobility.
If patients often “crack through” their backs themselves and experience relaxation or a relieving feeling, the fascial distortion model is based on what is known as tectonic fixation. Those affected complain of stiffness and immobility in the back, but without pain. The fascia surfaces are seen as fixed and should have lost their ability to slide. The techniques for treating tectonic fixation, in which the crack in the back is wanted, serve to loosen the sliding surfaces and make them slippery again.
Treatment for cracks in the back
If the back cracks without pain or stiffness, very few people will seek the help of a doctor or a non-medical practitioner. Usually other noticeable symptoms must first be added. In the case of acute events, if there is no evidence of a serious structural background such as a hernia or a herniated disc, conventional medicine is usually given an injection with analgesic, muscle-relaxing and / or anti-inflammatory agents. Physiotherapeutic applications are also often part of the therapy, but operations can also be necessary for certain causes of the back pain.
Naturopathy and Holistic Medicine
Even in orthopedic or emergency medical professions, methods such as chirotherapy, chiropractic or, in the meantime, the fascial distortion model, which are more part of holistic medicine, are quite common. With their help, experienced therapists can treat the symptoms manually if necessary.
Furthermore, for example, cupping, in which glasses with negative pressure are applied specifically to certain areas of the skin and thus generate increased blood flow, can also be used against some causes of cracking in the back. Neural therapy, in which injections with local anesthetics are placed at the affected and neighboring points for harmonization, may also be an option here.
From the perspective of the fascia distortion model, the same therapeutic force must be applied to the affected tissue in the case of a fold distortion as was the case at the triggering moment. For a tectonic fixation, the first step towards fundamental elimination is made using the techniques that loosen the sliding surfaces. Afterwards, pumping techniques or pumping aids such as the master plumber or cupping glasses are usually used.