What Causes the Popping Sound in a Chiropractic Adjustment?


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Hey Dr. McNamara here at McLaughlin Care, and I'm coming at you guys with a Wellness Wednesday, and today I'm going to be answering a question that I get pretty much every single day in practice. What is that cracking noise in my joints when you pop them?

Now for many years it wasn't really well understood. And a big reason is because we didn't really have diagnostic imaging that could take a look at what is actually happening within the joint realtime during an adjustment or a type of traction that will produce that type of crack that we hear when you receive a chiropractic adjustment.

But, in the late seventies, that's when the MRI was invented and there was a cool study done in 2015, that looked at the real time visualization of joint cavitation. Now this title is a little bit of a misnomer. It's because of the use of the word joint cavitation. Now that's been a long used word to describe the actual popping noise of when you get an adjustment, but that is not the correct term.

So a cavitation is when there's a gas bubble within two solid spaces and pretty much you've removed that gas bubble. That's what we thought for a long time was going on with the chiropractic adjustment. But it's actually the opposite effect that's happening and what that phenomenon is known as is tribonucleation.

Tribonucleation is defined as when two solid surfaces that are immersed in a liquid. So for spine purposes, we're talking about our Fossette joints for example, and those are these joints right here, two solid surfaces. You've got the superior, the inferior vertebra they're in contact. And then they're immersed in that synovial fluid, which is a liquid.

I'm going to take my little fake synovial fluid here, and we're going to put it in that joint. So you can see kinda how that water's kind of holding its place between that joint. So with tribonucleation, that is when there's enough tension brought between the two solid surfaces, immersing the liquid to where it actually creates a gas bubble within the joint.

They found this out using magnetic resonance imaging, MRI, and they did pre and post images of the actual joint in question and what they saw on the pre was there's no actual gas bubble in there that could get cavitated. And looking at the post adjustment now we can see there's a good space that is now formed within that joint.

The definition of tribonucleus is two surfaces that are solid, that are immersed in water. And when they get to a certain point of tension, that pressure is released and it causes dissolved gas bubbles within that fluid to serve as nuclei to actually form gas bubbles. So we're actually creating space within the joint and relieving the pressure that is within the joint, which is why it helps with your symptoms of pain. It improves motion because we're not cramming and pressuring those joints together. We're actually giving it more space, which is giving more room for your spinal cord, as well as your blood vessels and everything else to have room so they can work properly and not be congested.

Hope you learned a cool new word today, tribonucleation. Next time you come in, we'll give you an adjustment and you'll hear some nice tribonucleation and you'll be feeling better. So when you get a chance, give us a call and we can help you.

References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4398549/pdf/pone.0119470.pdf

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