Chiropractors are commonly known as the professionals who “crack bones or joints”. This is a topic our chiropractors discuss daily with our new patients at ABC Clinique Santé, in order to debunk the myths surrounding this famous crack. This cracking is also often known as “cavitation”.
Our aim is to make you (almost) professionals in the field of “cracking” and its “importance”. Here are a few examples of common myths on the subject:
Myth 1: Bones “crack” after a chiropractic adjustment (i.e. high-speed joint manipulation)
No, it’s not! The noise you regularly hear during a chiropractic adjustment is simply the result of a “gas” cavity that forms in the fluid surrounding your joints. When sufficient traction is exerted on a joint, a cavity forms and, consequently, the famous “cracking” sound can be heard.
Myth 2: “Cracking” is necessary for treatment to have the desired optimum effect. In other words, “It has to crack”.
This is not the case. Research has repeatedly shown that various manual therapy techniques used by chiropractors, including lower-speed mobilizations, which more rarely produce a “snap”, can thus lead to pain relief and a temporary improvement in ranges of motion, just like techniques that generate “cavitation”. What’s more, chiropractic adjustments often produce little or no audible noise, without detracting from the known “neurophysiological” effect of the intervention. On the other hand, some studies have shown that patient beliefs about the efficacy or otherwise of an intervention have a significant influence on clinical outcomes. So, if you firmly believe that “cracking” is necessary to get better, you may find less relief from manipulation without audible cracking. In other words, if you want to get the most out of your chiropractic care, don’t worry too much about “cracking” – it’s only important to the extent that you believe it is. Yes, our beliefs can have impressive effects on the nervous system!
Myth 3: During a spinal adjustment, cracking always occurs at the precise point where the manipulation is applied.
While this may seem logical at first glance, this myth continues to be widely propagated to this day. For example, it’s not uncommon for the audible sound not to come from the joint(s) targeted by your chiropractor, while at other times, the sound may appear to come from the exact spot where the chiropractor has placed his or her hand contact. Recent studies have also shown that it’s often difficult to be certain without sophisticated and expensive equipment, but rest assured, this in no way means that the manoeuvre was “missed” if there wasn’t a nice “crack”! As mentioned above, your chiropractor doesn’t necessarily need the “crack” to achieve the desired effect. It’s just something that happens, without having any significant impact on our treatments.
Visit the clinic nearest you:
- Chiropractic – Chelsea Gatineau (secteur Hull)
- Chiropractic – Vaudreuil-Dorion
- Chiropractic – Mirabel
- Chiropractic – Valleyfield
- Chiropractic – Québec (Duberger-Les-Saules)
- Chiropractic – Boucherville
- Chiropractic – Trois-Rivières
References
Kawchuk GN, Fryer J, Jaremko JL, Zeng H, Rowe L, Thompson R. Real-time visualization of joint cavitation. PLoS One. 2015 Apr 15;10(4):e0119470. doi: 10.1371/journal.pone.0119470. PMID: 25875374; PMCID: PMC4398549.
Bialosky JE, Beneciuk JM, Bishop MD, Coronado RA, Penza CW, Simon CB, George SZ. Unraveling the Mechanisms of Manual Therapy: Modeling an Approach. J Orthop Sports Phys Ther. 2018 Jan;48(1):8-18. doi: 10.2519/jospt.2018.7476. Epub 2017 Oct 15. PMID: 29034802.
Ross,J.K.,Bereznick,D.E.&McGill,S.M.Determining cavitation location during lumbar and thoracic spina lmanipulation:Is spinal manipulation accurate and specific?. Spine 29, 1452–1457 (2004).
Beffa, R. & Mathews, R. Does the adjustment cavitate the targeted joint? An investigation into the location of cavitation sounds.
- Manipulative Physiol. Ther. 27, 118–122 (2004).
Dunning,J.etal.Bilateralandmultiplecavitationsoundsduringuppercervicalthrustmanipulation.BMCMusculoskelet.Disord.
14, 24 (2013).
Nim CG, Downie A, O’Neill S, Kawchuk GN, Perle SM, Leboeuf-Yde C. The importance of selecting the correct site to apply spinal manipulation when treating spinal pain: Myth or reality? A systematic review. Sci Rep. 2021 Dec 3;11(1):23415. doi: 10.1038/s41598-021-02882-z. PMID: 34862434; PMCID: PMC8642385.
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Dr Charles Bélanger
Chiropractor and owner
