BETTER CARE

Is the Pop in Your Neck Worth It?

The traffic is crawling down Interstate 35. You glance at your watch and realize you will be late. Late for a presentation to a company preparing to spend several million dollars with your company. You reflexively rub your neck. It feels like someone used your muscles to tie a bow around your neck. After what feels like an hour, traffic begins to move. But not fast enough. Finally, you arrive and race into the building only to find yourself too late. The company cancelled the meeting. Even though you had called.

You trudge back to your car, slide into your seat and stare ahead. “Man my neck hurts. Agghhhh! I can’t believe this!” as you pound the steering wheel. You bend your head as far as you can to the right while at the same time twisting it to the left. And, then you hear the cascade of popping and snapping like a Chinese firecracker going off in your neck. Ahhh…relief. The neck pain and tightness fades. At least you have control of your neck pain. Or so you think.

When you get back to your office, your boss has already left you a message to speak with her at once. As you read the note, the tightness in your neck begins to creep back in. By the time you cross the threshold of your boss’ door, your neck feels so tight and painful you can barely move. You manage to avoid getting fired but the meeting was not at all pleasant. As you walk out of your boss’ office you turn and twist your neck again. Snap. Crackle. Pop. Relief. But, on the drive home, you hurt again. And so it goes, day after day after day after day.

The allure of neck popping is the nearly instantaneous relief from pain and tightness. It is the cocaine of neck pain. And just like cocaine, you need more and more to achieve the same high. The firecracker sound means relief. Somewhere in a corner of your mind though, a small voice quietly asks, “What is making that noise? Is it normal? Is it ok? Why can’t I stop?” but you ignore it. The relief over rides everything. For now.

The firecracker sound made by popping a joint comes from two things: cavitation and snapping. When you twist and bend your neck, you stretch the joints. Inside each joint is a liquid called synovial fluid that contains gases like nitrogen, oxygen and carbon dioxide. This liquid exerts a certain amount of pressure against the ligaments around the joint (called the joint capsule). The stretching causes the pressure inside the joint to drop. When the pressure drops, the ligament gets sucked into the joint and a bubble of carbon dioxide forms. The formation of the bubble creates a popping sound as it comes out of the synovial fluid (cavitation) and increases the volume of synovial fluid temporarily (by about 15%). The increase in volume pushes the ligament back into place creating another popping sound (these occur so fast you hear only one sound). You cannot repeat the snap, crackle, pop for about twenty minutes or until the bubble dissolves back into the synovial fluid (ref.1-3).

But, are you helping or hurting yourself? As you bend and twist the neck, you approach the danger zone. You are on the edge of injury each and every time pressing the joint to its very limit. Although the forces created by popping a joint are not high enough to damage the joint surface, two things happen. First, when done repeatedly you damage the ligaments and second you get weaker. The weakness may be from ligaments that are too loose or it may be due to microdamage of the joint surface. To date, researchers know you get weak but are not sure of the cause (ref. 2). But, you can conclude, long term joint popping is not good for you. So, why do you do it?

Sometimes you make poor choices because you do not know any better. Your neck feels tight, you start turning and twisting your neck and suddenly it pops. Or maybe a friend showed you how to pop your neck. Or maybe someone else popped it for you. But chronic joint popping is a temporary fix for an underlying problem. Muscles are slaves. They do what they are told. Something in you neck is telling your muscles to tighten: things like disc disease, joint disease, segmental instability or just being out of control (as in hating your job but feeling like you cannot quit – a real “pain in the neck”) to name a few. When the real problem is under control (and you can get control of all of these problems), the need to pop your neck will subside.

You will find it much easier to stop the snap, crackle, pop of your neck when you know why you are doing it. All physical problems are composed of three things: pathology (injury or disease), pathomechanics (the way you stand, sit or move) and psychodyamics (the way you respond to emotional stressors in life). The need to pop your neck may be from one or, more likely, all three. Unfortunately, you cannot self-diagnose. But, in the meantime, you can choose to stop popping your neck. To help you get started, try this drill. Purchase a small (9-12″ diameter) inflatable beach ball. Put a small amount of air in the ball. Lie down on your back and place the beach ball under your head or neck (whichever feels best). Close your eyes. Slowly turn your head side to side. Turn only as far as you feel comfortable. Do not strain. Easy motion is the objective. The motion is slow, fluid, and soothing. Do this for at least three minutes every two hours or whenever you feel the urge to pop your neck. After about a month, the urge to pop your neck will be significantly less.

Now you know. You know popping your neck is not good for you and you know what to do to get started overcoming the urge. You now have a choice. Make a wise one. Stop popping your neck.

Make today count.

Doug Kelsey

[1] “The audible release associated with joint manipulation”. Journal of Manipulative and Physiological Therapeutics. 18(3):155-64, 1995 Mar-Apr.

[2] Castellanos J., Axelrod D., “Effect of habitual knuckle cracking on hand function”. Ann Rheum Dis 1990; 49:308-309.

[3] Unsworth, Dowson, & Wright, 1971, “Cracking Joints: A Bioengineering Study of Cavitation in the Metacarpophalangeal Joint,” Ann. Rheum. Dis., 30:348-358.