Don’t Crack Your Own Neck, Part 2
Last time, we asked the question, “Is self-manipulation safe?” Now we’ll discuss the second of these 3 issues regarding self-manipulation: 1) Is it safe? 2) Is it useful? 3) Is it a sign of a deeper problem?
Is self-manipulation of the spine useful?
To answer this question requires us to explore the physics of the joints in the neck and back. The spine is made up of 24 movable bones that are connected by over 150 articulations (joints). Each of these joints is surrounded by a capsule of connective tissue and contains fluid. Each joint should move (some more than others). If a joint is moving normally, it typically does not make any noise. If a joint is “stuck” (hypomobile) or if a joint is moved past it’s normal range of motion (paraphysiological space is the fancy term for this), it usually makes a “cracking” sound. The sound itself is simply a bubble of air moving through the joint capsule. So far, we have described nothing harmful.
This is where things get tricky. For most of us, our daily activities of life require lots of sitting, lots of staring at computers, lots of driving, etc. These activities, for the most part, do not promote good spinal posture and motion patterns. Over time, spinal motion patterns can become altered to the point that some spinal joints move very little-to-none (hypomobile), while others compensate by moving too much (hypermobile). Joints that are hypermobile often make “cracking” sounds when they move.
For many, there is a gratification with this “cracking” or “popping” sound (“cavitation” in medical speak). It is easy to interpret this noise as “realigning a misaligned vertebra” or “releasing built-up tension.” In fact, some studies have suggested that joint cavitation releases endorphins, the body’s natural opiates/painkillers.
The goal of a spinal manipulation, performed by a licensed chiropractic physician or osteopathic physician, is to introduce motion to spinal joints that are hypomobile (stuck, or non-moving) while not moving the joints that are hypermobile (move too much). Knowing which joints to move and which ones to leave alone requires a lot of experience. Moving a hypomobile joint without disturbing the hypermobile joints around it is very difficult to achieve, and cannot be performed by oneself because of the limitations of leverage.
When spinal adjusting/manipulation is performed by oneself or someone who is unqualified (and especially by someone who thinks they’re qualified but they’re really not), most of the force of this manipulation is distributed through the joints that already move too much, actually worsening the problem in the long-run. Commonly the self-manipulator feels more and more frequent urges to manipulate – sometimes 20 or more times per day! The frequency of self-manipulation tends to increase with time.
When performed properly, spinal manipulation/adjustments are very effective in alleviating the tension/discomfort in the spine that cause one to attempt to self manipulate in the first place. With quality chiropractic care, the need for manipulation/adjustment decreases as normal motion patterns are restored to the spine.
Don’t Crack Your Own Neck, Part 1
Self-manipulation is the term used for cracking, or popping, one’s own neck or back.
Because this is such a common practice, the question regarding the safety of self-manipulation is often brought up in our office.
In part 1 of this article, we will discuss the first of the following three things regarding self-manipulation: 1) Is it safe? 2) Is it useful? 3) Is it a sign of a deeper problem?
Is self-manipulation safe?
The most common arguments against self-manipulation are that one could fracture (break) a bone, cause a stroke, or cause arthritis.
Honestly, in my 8 years of practice, I am not aware of any particular case where someone has either broken a vertebral bone or caused themselves to have a stroke has a result of self-manipulation. That’s not to say that it couldn’t happen, but it’s highly unlikely. As far as causing arthritis, the clinical literature is not very clear. I’m doubtful that the act of self-manipulation, in and of itself, causes arthritis. Rather, the constant urge to self manipulate is indicative of a condition that can lead to arthritis. More on that later.
The safety hazards of self-manipulation are much more long-term, and that leads us to the second question…which we’ll discuss next time. If at any time you need an answer to a question about your musculoskeletal system, please feel free to call our office at 615-650-6533.
How to Know Whether to See an Orthopedist or a Chiropractor
When people suffer back pain, they may not know whether to call an orthopedist or a chiropractor. Both medical professionals deal with skeletal system abnormalities. An orthopedist, typically an M.D. or D.O., is a physician who treats musculoskeletal conditions that require surgery or medication (fractures, severe back arthritis, severe disc herniations, etc). A chiropractor (D.C.) is a physician who treats musculoskeletal conditions (primarily neck pain, headaches, back pain, sciatica) that do not require drugs or surgery.
For most musculoskeletal conditions, it is best to consult a chiropractor first, as the treatment provided in a chiropractic office is less invasive than treatment provided by an orthopedic surgeon. Most conditions do not require surgery or medication. If your chiropractor determines that you should be referred to an orthopedist, neurosurgeon, or other professional, that referral will be made.
A good analogy would be the relationship between a dentist and an oral surgeon. The dentist can take care of most dental issues, such as fillings, cleanings, whitening, most extractions, root canals, etc. However, sometimes the dentist will find it necessary to refer a patient to an oral surgeon for more complex surgical situations.
Likewise, your chiropractor can treat most musculoskeletal conditions, such as neck pain, back pain, headaches, joint pain. In certain cases, however, the chiropractor may decide that a referral to an orthopedist or neurosurgeon may be the best way to approach the condition.
