Osteopathic “cracking”

This is a question I often get asked by patients coming in- are you going to crack my back.

They are nervous about it, thinking that it will hurt, and tense themselves. I will never crack anyone’s joint without their permission!

However, rest assured that it doesn’t hurt. It also isn’t your bones cracking - it is the air popping out of the space between the facet joints.

Osteopaths (and also physiotherapists and chiropractors) can use this manipulation technique for treating neck and back pain.

How manipulation works:

The spine is made up of blocks called vertebrae, stacked like blocks. Each vertebrae is separated from each other by a spinal disc that sits in between each one. Each vertebrae has two facet joints attached to it, one on the left and one on the right. The facet joints of one vertebrae connect with the facet joints on the vertebrae above and with the facet joints on the vertebrae below so that each vertebrae are in contact with each other. These facet joints are strengthened by ligaments and muscles and are surrounded by a little joint capsule. Fluid known as synovial fluid sits within the joint capsule and its role is to lubricate the joint so that the facet joints can move smoothly without getting stuck on each other. During an osteopathic manipulation, it is the movement of these facet joints that causes the audible ‘pop’ or ‘crack’ you can hear.

During the manipulation:

I focus a little pressure onto the appropriate facet joint. The manipulation may involve a little twist or pressing thrust movement. During the thrust, the air pressure in the facet joint is suddenly altered. When this happens, gas escapes from the joint and produces a popping or cracking noise. This shouldn’t be painful. When air pressure has changed in the joint, it takes around 20 minutes for the joint to regain normal air pressure again.

What Can Manipulation Achieve?

Manipulation can achieve many things.

This includes:

Relieve back or neck pain

Reduce muscle tension

Increase the range of movement in your neck or back

Release endorphins (modulate inflammatory processes, promoting analgesia).

Stop the swelling of a joint capsule