Is it bad to crack your back? A chiropractor answers

Dr. Lumbago,

My mother who is 68 years of age goes to her chiropractor a few times a year when her headaches and low back pain start to bother her.  She has always been a very active woman having grown up and living on a farm all her life.  She says that the chiropractic adjustment that she gets helps her to sleep better and have less back and neck pain until she pulls something out of place tending to the livestock. 

My mom used to take us to that same chiropractor when we were kids, but I was always scared of the popping noise that I heard when he worked with us. I always called it our trip into town for a back cracking.    When I got old enough I refused to go, even though my older brother who still works on the family farm swears by it.

I tried to do my own back cracking some time ago when I started to get sore and tight down there but it seemed to make it worse.  I sat up straight on a kitchen chair and hooked by ankles around the legs of the chair.  Then I held onto the edge of the table and used it for leverage to twist my low back until I heard popping noises.  Even though I did that the low back pain and tightness never did go away.

Anyway, my medical doctor told me to never go to a chiropractor because it was dangerous.  The Celebrex and Vicodin he prescribes for my back pain do take the edge off the pain for pat of a day or two, but the side effects scare me terribly so I do not take them until I am desperate with pain.

I have been thinking again about going to my Mom’s chiropractor, but I am not at all sure of what to do.  Considering how my chronic back problem is getting worse and I do not know how to get help for it, I do not know what else to do.  Is it bad to crack your back like my medical doctor warned me, or do you think I am being silly?

Thanks for your information,

Shirley

 

Greetings Shirley,

When you ask if it is bad to crack your back, I do not know if you mean receiving a chiropractic manipulation from a trained professional, or if you are referring to what you did to yourself while sitting on that kitchen chair.  I hope you know there is an absolute world of difference between the two!  

Is cracking your back bad?

First of all, I just cringe when people use terms like neck popping and back cracking to describe a chiropractic adjustment.  A chiropractor is a doctor who specializes in non-drug and non-surgical care of the body, primarily by reducing or correcting tiny misalignments of the spinal vertebrae with his hands or special instruments.  When it is done by a doctor of chiropractic the correction is done by a chiropractic adjustment, sometimes called spinal manipulation.   

Just because a popping sound, or as we say in chiropractic, or an “audible release” is heard many times when a chiropractic manipulation is performed, and the fact you can make your back crack when you twist in a certain way, does not mean we are doing the same thing.   

In my office would never allow a patient of mine to say pop or crack about what I do because that is not respectful of a skill so valuable to millions of people each day; this is a highly specialized ability that requires eight years to initially learn and a lifetime to make perfect, as well as being disrespectful to those who provide that service.   Please see, “Should I go to a chiropractor for a back cracking?

Secondly, the popping, clicking or cracking sound you hear when you overstretch your knuckles or your back is called cavitation.  It is caused by the sudden release of gases (primarily nitrogen and carbon dioxide) from the joint fluids that surround each joint, when the joint space is suddenly increased.  The negative pressure created within the expanded joint forces the gases from the liquid.  This is much like what happens when a bottle of champagne is opened and makes a popping sound, followed by the release of gas bubbles from the wine.

Similar joint cavitation often, but not always, takes place when a chiropractic adjustment is directed to an area of slight spinal misalignment.  The difference is that the chiropractor is also applying a corrective force to reduce the offending misalignment at the same time the joint is being moved from the abnormal position. All of this is done quickly and precisely with just the minimum amount of force needed to make the correction – no more and no less than what is required.  This is the art of the chiropractic spinal adjustment.  

Thirdly, I suspect when you popped your back on the kitchen chair you were simply stretching all of the lumbar joint capsules and tendons in the entire low back. You made a lot of noise when several of these joints were overstretched at the same time.  If noise was your goal, you probably got that.  If correction of your problem is what you hoped to do, you were probably disappointed. 

The problem with indiscriminate joint stretching and spinal twisting is that it can easily cause injury and laxity or looseness to the supporting soft tissue structures (tendons, ligaments and joint capsules) if it is done too often or too aggressively.  This is why you will often see athletes on TV who are constantly twisting their necks around; they have gotten into a nasty habit of trying to get relief from their structural problems by frequent overstretching and have only made the supporting tissue of their spines weak. They constantly must do these little neck and back stretching rituals because the ligaments and tendons that hold the vertebrae together have been made lax and weakened.  The more they stretch the more they have to stretch because misalignment becomes easier as the laxity and weakness of supporting tissue increases.

Is it dangerous to go to a chiropractor? 

Next, there is one extremely impartial and very accurate way to determine if your medical doctor is correct about the danger of the chiropractic adjustment.  The insurance companies are intimately and directly involved in the bad things that happen to patients who receive chiropractic care – and medical care. Looking at what the insurance companies charge chiropractors and medical doctors reveals an absolutely accurate and unbiased opinion about the safety of the chiropractic adjustment, which is the primary method of treatment provided by chiropractors.      

Across this country the average malpractice rate charged to different professions is a reflection of the number of lawsuits that are placed against those doctors and the amount of money that is awarded when those doctors  are found guilty of negligence or malfeasance in their field.  Look at the list below that shows the average malpractice insurance rates for doctors in these broad categories:  

  • MD, Orthopedic specialist:  $110,000 – $230,000 annually.
  • MD, General practitioner:  $20,000 – $40,000 annually.
  • DO, Osteopathic doctor:  $20,000 – $40,000 annually.
  • DC, Doctor of chiropractic:  $2,000 – $4,000 annually.
  • OD, Optometrist:  $400 – $600 annually.

Using these figures as a reflection of the relative danger/safety of each group, it seems reasonable to assume that the chiropractic profession, which highly utilizes the spinal adjustment as its primary method of treatment, is indeed very safe. If what chiropractors did day in and day out was really as dangerous as your medical doctor thinks, their malpractice policies would not be as low as they are.  I hope you mention this to your medical doctor the next time you visit him for your bad back. 

Getting low back pain relief

Lastly, I have some practical advice for what you should do about your chronic lower back pain.  Since you, your mother and your brother seem to have chronic and recurrent back pain, I suspect there is a possibility of a congenital back problem in your family. You might have this checked out to explain a few things about the cause of your recurring and resistance back problem.  I suggest you go to your Mom’s chiropractor and explain your concerns and early fear when being adjusted, in addition to having your spine examined.  All good chiropractors have multiple ways to accomplish the same thing; I had a few different methods to use for my “overly sensitive” patients who needed an extremely light adjustment – so everybody was happy.

Say hello to your chiropractor for me, and please do not ask him to crack your back.

Good luck to you.  DL            

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