Does it need to go pop ?
Niseko Chiropractic research update
There are 2 questions that Chiropractors get asked a lot
What is the cracking noice ?
Does it matter ?
The first question is lot easier to answer than the 2nd one.
In a health joint the joint is essentially a sealed cavity occupied by a small amount of synovial fluid that acts as a lubricant and also carries nutrients around the joint. This is why it’s important to stay hydrated but that’s a topic for another blog !
When you rapidly expand a joint, as happens in spinal manipulation and ” cracking ” your knuckles the space suddenly gets much larger. Becuase the pressure in the joint and fluid drops very rapidly gas comes out of the liquid which causes a ” popping sound ” . Think of it a bit like the bubbles in a can of Coke. when you pop the lid you decreased the pressure and gas comes out.
What the noise certainly isnt is bones cracking. If that was to occur we are going to have to call our malpractice insurer but in 20 years of doing this and over 20,000 treatements delivered I am happy to say this has never happened !
Does it matter ?
Short answer is probably not.
In a meta- review published Octber 2022 Morman and Newell reviewed 5 quality studies on the subject and concluded that the presence or absense of a ” pop ” did not have any measurable outcome on patients pain levels after a series of treatments.
Most chiropractors ( and patients ) including myself would propably prefer to hear it as it let’s us know that we have provided the joint with the right amount and direction of thrust to create a neurological response that is only seen in high velocity low amplitude thrusts otherwise known.
What is more important is that the joint ” free’s up ” a bit after a therapuetic intervention and this can be achieved by many different methods. So there is good news too if you are one of those people reading this that prefers the lower force techniques. It’s quite possible that techniques not incorporating the “pop ” are still just as effective.
This is probably yet another example of why Chiropractic needs to attapt and change in light of new evidence. There are plenty of the ” old guard ” that will go noise hunting to make that joint sing rather than bother to retest the joint and see if there has been a change in tone and range of motion.
And once again that old cavete. There are probably times when it probably really does matter too we just don’t have any good way of indentify what those clinical presentations may look like and how to correctly identify them.
The good news is it’s your body and that puts you in a unique to postition to help practioners understand what works best for you.