Precision Chiropractic, Bedford NH

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“All That Noise and All That Sound”

Hey there! Thanks for checking out Precision Chiropractic’s FIRST EVER blog post! 🎉 Though this practice is new, I have over ten years of clinical experience to write and talk about, so stay tuned (and thanks for reading!) 

Lyrics from a Coldplay song (“Speed of Sound”) is what is kicking off this inaugural entry.  Today, we are here to talk about some very common misconceptions that people often have regarding chiropractors and getting adjusted.  More specifically, we are here to talk about “that sound” you know what I’m talking about. 

From time to time, after someone meets me and learns what I do for work, they refer to me as a “bone-cracker,” or worse even, a “back-breaker.” Though I know it’s meant in jest, I cringe inside after hearing this, as it is so far from what I actually do. Not to mention that I’ve meet plenty of people in my years of practice who are terrified of going to a chiropractor because they truly believe that sound is something awful/pathological happening and that we “snap” people into place...eeeekks who would sign up for that? Seeing a chiropractor shouldn’t be compared to a wrestling match. 

Conversely, in my years of practice so far, I’ve had patients tell me: “Doc, I didn’t hear a ‘crack,’ are you sure you got it?” Also on the other end of the spectrum: “Doc, I saw this video on YouTube of a Chiropractor ‘cracking’ someone...can you ‘crack’ me like that?” (This is even more cringeworthy.) If what I’m saying is resonating with you right now, please understand this post is trying to dispel both of these examples as there is still a lot of misunderstanding and miseducation around the “pop” or “crack” that can be heard during a visit with a chiropractor. 

So let’s get into it shall we?

First things first, even if you have never been seen by a chiropractor who focuses on structural correction (like I do,) know that the name for the force specifically applied to your spine is called an “adjustment” not a “crack” or a “snap.” Adjustments are administered to patients after the doctor has closely examined you to determine where and how to properly adjust your spine. (Having your spouse or significant other “walk on your back” or “give you a bear hug” because “it feels good” or “releases pressure” is not the same.)  Chiropractors are highly trained providers who study the intricacies of the spine and how it moves, for no less than four years.  Chiropractic adjustments are specifically delivered to correct structural shifts in the spine. Whenever we deliver a chiropractic adjustment, we are restoring full motion to a spinal joint that has lost its motion in a specific direction or way. 

What does it mean when my back cracks at the chiropractor?

Ok now that we understand that, let’s get to talking about the “crack” what is it? What causes that sound? What happens if it you don’t hear it after an adjustment, did it work? Let’s answer all of these shall we? 

    1. The loud popping sound that occurs with a chiropractic adjustment can often cause people to feel unsettled or anxious. Not to fret! The actual pop is called a "cavitation” that’s the real name for “that” sound. 

    2. The cause of the cavitation is an audible release of gas (thank goodness it doesn’t smell bad 😉.)  When a spinal joint is misaligned, pressure can build in the joint. A gas mixture of oxygen, nitrogen, and CO2 is what “escapes” when we mobilize that spinal joint with a chiropractic adjustment.* So that sound is ultimately caused by a pressure exchange, that’s it.  Still have the child-like inclination of popping bubble wrap? I’m asking because its a great example of cavitation; applying a certain amount of pressure causing a gas exchange. Next time you or your child is playing with bubble wrap, I hope you’ll remember this!

    3. So what happens if you hear nothing? Sometime patient’s wonder if they received an ineffective adjustment, is this the case?  This is by far the biggest misunderstanding I want to clear up. Since cavitation is nothing more than a movement of gas, please understand it holds no clinical relevance.  Meaning, your adjustment is never dependent on hearing a cavitation as a cavitation does not always occur with a chiropractic adjustment, (this can be for a number of reasons.)

      • A research article from “The Journal of the Canadian Chiropractic Association”* has shown that an audible release does not improve the outcome of a chiropractic adjustment.  Additionally, if a chiropractor were to keep repeatedly attempting to move your spine in such a manner to hear a cavitation, it may be harmful and cause discomfort in the surrounding tissues. 

As the study concludes: the bottom line is that a cavitation accompanying a specific adjustment may release a sensation of pressure in a joint but provides no further benefit. An excerpt from the last sentence really sums everything up: “but therapeutic benefits of the audible release are likely to be psychological, and not physiological.”  Meaning, a patient has learned to believe that hearing a cavitation equals an effective adjustment.  You all know now this isn’t the case.

Remember, the goal of the adjustment in our office is to reduce and improve the extent of a structural shift.  When that is accomplished, the nervous system is optimized and works more efficiently, that’s the bigger picture. 

References:

  1. Unsworth A, Dowson D, Wright V. "Cracking joints.”

  2.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769448/