What a Crack-up

[originally published in KCN, June 1999]audible-popcorn

Crack!  Pop!  Click!  Crunch!  These are but a sampling of the many descriptors the public associates with the chiropractic profession in general.  Sure the words are onomatopoetic and fun to say, but they really do not do the chiropractic profession justice.  For these words are merely describing a typical “by-product” of our core method of treatment:  the chiropractic adjustment.

audible-skull-spineIn order to adequately explain the chiropractic adjustment, some background is in order.  We chiropractors have a special interest in your nervous system.  Your nervous system controls and maintains every organ, tissue, and cell in your body.  In fact, your nervous system is so important that the Central Nervous System, composed of the brain and spinal cord, is the only organ fully encased in bone.  The skull protects the brain, and the 24 segmented bones that make up the spine, protect the spinal cord.  When any of these 24 segmented bones, called vertebrae, lose their normal motion or position from abnormal levels of stress — whether they be physical, emotional, or chemical — delicate nerve tissue can become choked or irritated, creating a condition known as the Vertebral Subluxation Complex.  Doctors of chiropractic often successfully treat this condition with chiropractic adjustments by utilizing their hands or specialized instruments to deliver a specific force in a precise direction  — gradually helping to normalize spinal function and nervous system stresses.

chiropractic adjustment IIThere are 100’s of different ways to adjust the spine.  Most chiropractors are proficient in several adjusting styles, enabling the doctor to tailor his treatment  to meet each individual patient’s needs.  Some of these adjusting styles are often associated with a “popping” sound.  The sound itself has little meaning and a variety of conditions can influence its presence such as the patient’s age, condition, unique spinal characteristics, and yes, sometimes even the weather.  The important point for patients to realize is that the “popping” sound should not be used as an indicator for whether or not a particular adjustment was successful.  Many adjusting styles are never associated with such noises, whereas the ones that often are, can be just as successful at achieving their intended outcome without a “pop.”

All that aside.  Many inquisitive patients still want to know exactly what produces the “popping” sound they often hear.  Experience tells me that these patients are asking this question for one of two reasons:   (A) they really want to know, or (B) they want to be reassured that the sound they are hearing is not the breaking or grinding of bones!  Both, very good reasons to ask.

The technical jargon for the joint “popping” or “cracking”  [remember this one for your next audible-champagnecocktail party] is joint “cavitation.”   The joints that guide the movements of our spines are little fluid-filled capsules with cartilage pads called facet joints.  The fluid, like that in the knee, is synovial fluid.  When one of these joints is quickly moved, as in a chiropractic adjustment, a sudden vacuum is created as the joint surfaces separate, causing a liberation of dissolved synovial gases — like those seen with sparkling water or champagne.  This release of gas is what makes the noise.  Studies have shown that these joint gases are primarily carbon dioxide and will resorb back into the synovial fluid within 15 – 20 minutes.  Interestingly, before this resorption occurs, the gas that has been released in the joint can actually be seen on X-ray.

So when the words “crack,” “pop,” “click,” or “crunch” find their way into the next conversation your having about chiropractic, remember what these noises really are — just noises.  Chiropractors don’t “crack” or “pop” backs;  they adjust spines.  The purpose of this safe and natural procedure is improved spinal function, improved nervous system function, and improved health.   I’ll never forget what one patient remarked after I explained the technicalities behind the joint popping:  “Oh, I understand now.  So what your telling me is that my joints have gas!”

Exactly.

____________

Sources used for this article:
Adjustments. The Chiropractic Lifestyle (brochure).  Back Talk Systems, Inc.  1993.
Frequently asked questions about chiropractic (brochure).  Back Talk Systems, Inc.  1996.
Gaterman, Meridel.  Foundations of Chiropractic Subluxation.  Mosby.  St. Louis.  1995.
Leach, Robin.  The Chiropractic Theories:  Principles and clinical applications. 3rd ed.   William and Wilkins.   Baltimore, 1994.
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