Symptoms

Cracking in the back / back crack


A crack in the back can be relaxing for those affected or also the beginning of painful back pain. But what exactly is cracking in the back and is the cracking dangerous? Does the cracking cause permanent damage or is it more "a release" of blockages and therefore completely normal?

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 is also described by laypeople as a joint crack in the back or back crack has different names in the professional world - especially since some therapy directions can also be a deliberate cracking in the course of treatment, for example with a so-called tectonic fixation, an HVLA on the back or the dog technique. Giving your back is the slang term here.

Symptoms of cracking in the back

Cracking in the back can occur on one or both sides of the back in all regions. The sound itself can be a clearly audible crack, but also a plop or a rubbing or clicking sound. For example, many people complain of cracking on the middle back when they move the shoulder blades - but listening closely is usually more of a rubbing sound. As varied as the sounds are, the variability of the sensations is also great: some people feel that something jumps over (tendon, ligament or muscle) or "jumps back in" or "jumps out" while others feel that something is jammed come loose again.

The crack can be felt deep in the back or superficially. Many sufferers describe that there are regular creaking when stretching and stretching in the back in the morning or when getting up after long periods of sitting or when leaning forward. However, this is mostly described as pain-free and sometimes even relaxing or loosening. If there is back pain or stiffness in the back after getting up, many sufferers state that it is better after the cracking. In some cases, the cracking in the back can occur at very short intervals and then not over longer periods of time - i.e. it can be quite irregular and asymptomatic. If pain occurs in connection with cracking in the back, then usually immediately after the crackling noise.

Causes of back cracking

For a long time, various theories circulated about exactly how the cracking occurs in the back and in other joints. Today it has been proven that a short-term vacuum in the joint capsule or in the joint gap creates small gas bubbles and that the crackling noise becomes audible when they occur. A study from 2015 had made this clear using the example of cracking fingers and the examination with MRI scans

Cracking in the back does not always mean cracking the joints. The rubbing and snapping noises have a different origin, whereby here the most common theory is based on a noise when a tendon or a ligament jumps over. The tendons or ligaments slide over each other or over a bone protrusion. Furthermore, it could be tendons that run over the joints and change their direction somewhat when the joint is flexed or stretched and produce a sound 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 occur when a joint jumps out of its "socket" or "holder". This is described by those affected in the area of ​​the back sometimes with a herniated disc or with so-called vertebral sliding (spondylolisthesis). Under certain circumstances, such a crack can also result from a vertebral fracture.

In addition, those affected in connection with the back crack describe symptoms such as tight muscles, whiplash, one-sided posture or incorrect posture and overexertion or excessive stress. Sometimes there is also a connection of cracking in the back with diseases such as rheumatism, degenerative diseases of the spine (spondylosis or spondylarthrosis), inflammatory diseases of the spine (spondylitis, spondylodiscitis), ankylosing spondylitis, gout, osteoporosis or broken bones. In no case can the back cracking be mentioned as a typical symptom.

In addition, an hereditary disposition 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 are not aware that they are working with models. These models, which are supposed to provide a basis for practical work (i.e. therapeutic intervention), are only approximations to reality. What reality looks like in a complicated biological mechanism - for example, the human body - can only be partially assumed on the basis of the therapeutic effects.

So if a doctor, alternative practitioner, osteopath or osteopath, chiropractor or FDM user explains the explanations to those concerned about questions about cracking in the back, it is mostly explanations that therapists can effectively use, for example, to visualize their work can use or that they have "worked out" in practice based on the observed effects. The next therapist next door would explain it differently. This also shows why the statements about possible damage from cracking in the back vary so far.

With the many different and widely differing hypotheses, it is understandable that it is unclear what consequences the cracking in the back can have. Here the statements differ widely: some claim that the cracking is harmful to the joints, the intervertebral discs, the tendons and the ligaments, others that it is "totally harmless". It could be harmful because it "wears out" the ligaments or the joint capsules or "stretches" the tendons. As a result, the joints could become permanently unstable and the strength could decrease, according to the theory. It is also often claimed that cracking in the back can lead to microfiber damage (microtraumas) or permanent consequential damage such as water retention or wear on the joints.

The internist and allergist Dr. Donald L. Unger of Thousand Oaks, California, was just as tired of the insecurity as he was about his mother's constant statements that finger clacking was harmful and could trigger arthritis. In a sixty-year self-experiment, he examined the consequences of finger clicking and was awarded the Ig Nobel Prize in 2009 by the journal Annals of Improbable Research. Throughout the decades, he had his left joints cracked twice a day, leaving the right side undisturbed. The examinations showed that he had neither left nor right arthritis.

Raymond Brodeur, an American engineer, doctor of chiropractic and osteopath at the Ergonomics Research Laboratory (ERL, LLC) at Michigan State University (MSU) once made the claim that a gas bubble was visible after a crack in the joint. According to the Brodeurs theory, this occurs when the joint capsule expands due to rapid pulling and the pressure within the joint has to be reduced. The gases change to the bubble shape, giving the capsule the opportunity to expand further. Then, after Brodeur, it takes some time 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 excluded.

Let your back crack

A variety of manual procedures, such as chiropractic or osteopathy, consider the audible crack in the back as an indicator of a successful technique. In the vernacular, this is usually called "restraint". In the therapeutic terminology, it will be "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 tactile barrier by moving the back to a certain position, which, incidentally, is not the limit of movement. A short impulse overcomes this barrier, and the audible crackling noise occurs.

Some therapists or therapeutic directions believe that the small vertebral joints are blocked and that the articular surfaces are loosened again briefly - what one hears is, according to these theories, the penetration of air, gas or the loosening of the meniscus or the joint capsule. Since the build-up of the barrier and the release of the crackling sound lie within the normal limits of movement of the joints and the surrounding tissues, it is more than unlikely that such techniques or the resulting cracking in the back will cause the capsules or ligaments to "overstretch" .

Swiss researcher Dr. Dr. At the International Fascia Research Congress (FRC) 2009 in Amsterdam, Walter Herzog presented the preliminary results of a study that showed that manipulation of the cervical spine caused less stress on the carotid artery than when the head was turned normally. According to the Fascia Distortion Model (FDM) by the American osteopath and emergency physician Stephen Typaldos, D.O. is the "plop sound" or "crack sound" to loosen the so-called folding fascia or so-called tectonic fixations on the joints.

From the FDM's point of view, folding distortions represent a three-dimensional deformation of the fascia near the joint. These distortions no longer protect the joint against compressive or tensile forces because the fascia can no longer fully perform its tasks. Depending on the compressive or tensile forces that have caused the deformation, a distinction is made between unfolding distortions and unfolding 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 block”, which is always accompanied by a restriction of movement.

If patients often "crack" their back and have relaxation or a feeling of relief, the fascia distortion model is based on a so-called tectonic fixation. Those affected complain of stiffness and immobility in the back, but without pain. The fascia surfaces are considered fixed and are said to have lost their lubricity. The techniques for treating tectonic fixation, in which the cracking in the back is wanted, serve to loosen the sliding surfaces and make them gliding again.

Treatment for cracking in the back

If a crack occurs in the back without pain or stiffness, very few people will therefore seek the help of a doctor or a naturopath. Usually, other noticeable symptoms have to be added. In the event of an acute event, those affected, if there are no indications of serious structural backgrounds such as a fracture or herniated disc, are usually given an injection with analgesic, muscle relaxant and / or anti-inflammatory agents. Physiotherapeutic applications are also often part of the therapy, but operations can also be necessary for certain causes of back cracking.

Naturopathy and holistic medicine

Methods such as chirotherapy, chiropractic or, meanwhile, the fascia distortion model, which are more likely to be associated with holistic medicine, are also quite common in orthopedic or emergency medical professions. With their help, experienced therapists can treat the symptoms with manual movements, if necessary.

Furthermore, for example, cupping, in which glasses with negative pressure are applied to specific areas of the skin and thus generate more blood flow, can be used against some causes of cracking in the back. Neural therapy, in which injections with local anesthetics are used for harmonization at the affected and neighboring points, may also be an option here.

From the point of view of the fascia distortion model, the same force must be applied to the affected tissue in the case of a folding distortion as was the case at the triggering moment. For a tectonic fixation, the techniques for loosening the sliding surfaces take the first step towards a basic remedy. Subsequently, pumping techniques or pumping aids such as the master plumber or cupping glasses are usually used. (tf, fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters

Swell:

  • Gregory N. Kawchuk, Jerome Fryer, Jacob L. Jaremko, Hongbo Zeng, Lindsay Rowe, Richard Thompson: Real-Time Visualization of Joint Cavitation; in: PLOS ONE (published April 15, 2015), PLOS
  • Walter Herzog: The biomechanics of spinal manipulation; in: Journal of Bodywork and Movement Therapies, Volume 14, Issue 3, July 2010, page 280-286, sciencedirect.com
  • Donald L. Unger: Does knuckle cracking lead to arthritis of the fingers ?; in: Arthritis & Rheumatology; Page 949-950, May 1998
  • Christophe Demoulin, Damien Baeri, Geoffrey Toussaint, Barbara Cagnie, Axel Beernaert, Jean-François Kaux, Marc Vanderthommen: Beliefs in the population about cracking sounds produced during spinal manipulation; in: Joint Bone Spine, Volume 85, Issue 2, page 239-242, March 2018,, sciencedirect.com
  • Saubade, M .; Karatzios, C .; Léonard, E .; Besson, C .; Gremion, G; Gremeaux, V .: "Mes articulations craquent, c’est grave docteur?" Les bruits articulaires en question; in Revue Médicale Suisse; 2017, Volume 13 (569): 1334-1338., Revmed.ch


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