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Why do people crack their own neck joints?

Paul Ingraham ARCHIVEDMicroblog posts are archived and rarely updated. In contrast, most long-form articles on PainScience.com are updated regularly over the years.
Cartoon of man with a spring for a neck, bending it far to one side and making the sound “sprang!”

Although many joints pop, the neck is the undisputed king of cracking. There’s more “therapeutic” neck cracking in this region than all other areas combined. (Knuckles probably get cracked more, but not with any clinical intent.)

Cracking your own neck joints is often described as “self adjustment,” the DIY version of spinal manipulative therapy for neck pain, but nothing’s being meaningfully adjusted, there’s almost no clinical precision involved, and probably about as much benefit as scratching a mosquito bite. I’ve written about it not because it’s much of a treatment option, but because it’s an odd and interesting sub-topic that many people have questions about.

It’s also something that many chiropractors just looove to warn their patients not to do, because reasons — they are fond of demonizing it, for obvious reasons.

So why do people do it, and is it any kind of problem?

It’s all about trying to relieve sensations of stuckness and stiffness… however briefly

Neck pain in general, and cricks in particular, often involve sensations of stuckness and stiffness (which may or may not involve any actual loss of range of motion). A facet joint pop creates the opposite sensation by producing a literal increase in range of motion, however trivial and fleeting: a momentary blast of extra movement. In other words, it feels like getting un-stuck.

Which is delicious.

For nearly all joint popping, that is probably the end of the story: there’s nothing else to it. It feels like a scrap of relief from an annoying sensation, and that is really all we need (How to Simplify Chronic Pain Puzzles) to explain the value of it and the compulsive way that people do it. It’s not hard to see why the craving to feel un-stuck might get rather fierce.

Is it a problem? What’s the worst case scenario?

It’s almost certainly not a problem in moderation: there’s been quite a bit of evidence over the years that typical joint popping is not associated with any harm to joints. (See Swezey 1975, Simkin 1990, Castellanos 1990, Unger 1998, Deweber 2011, Powers 2016, Yildizgören 2017, Boutin 2017.)

However, like anything, you can probably overdo it: too often and too hard.

And the neck could be a different story. Most of that research is about knuckles. Chances are good the neck is no different, but it wouldn’t be shocking if research proved that the neck was more vulnerable to this… and, if it is, the stakes are also higher. Arthritis in the cervical joints is potentially much more serious than finger arthritis.

I also am sure that it can become a bit of a harmful obsession for some people, like picking at a scab, doing harm not directly to the joints, but by keeping your mind too focused on the frustrating sensation of stuckness.

This is an excerpt from some recently updated content in my neck pain book, inspired by finally getting around to pulling together some citations about joint popping safety. That was on my to-do list for about eight years.

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