What causes cricks in the neck?

Do you ever wake up in the morning with a stiff neck and hear popping or cracking noises? Whether you slept like a rock in a contorted position or uncomfortably tossed and turned all night, waking up with neck pain can be debilitating to everyday life. As an orthopedic specialist, patients will often visit my office to ask whether their neck pain is normal and where it is coming from.

The good news is that majority of the time the cracking and popping is typically benign and not serious. But if it’s persistent and associated with pain, you may need medical evaluation.

Imagine balancing a 10 to 11 pound bowling bowl on a stick.

Imagine balancing a 10 to 11 pound bowling bowl on a stick. The cervical spine (neck) similarly carries a tremendous amount of stress from the weight of your head all day long! The cervical spine is made up of seven cervical bones called vertebra, which are supported by a soft tissue envelope made up of ligaments, tendons and muscles. The vertebras are separated in the front by disk, which are made of different kinds of collagen matrix.

There can be many different factors behind crepitus, the crunching sound you might hear from your neck. One perpetrator could be arthritic joints. Joints allow you to flex, extend, bend and rotate your neck. Capsules around your neck joints help provide lubrication to facilitate movement and decrease stress within the joints. The fluid within the joints also contains gas that can form bubbles. Moving the joints in the neck in certain positions can increase the pressure of the gas, causing a cracking or popping sound.

Ligaments help attach two bones (making up a joint) and assist with mobility and stability of the joint. As we get older, our joints sustain normal wear and tear, which can lead to increased stress within the bone, which in turn can create bone spurs. These spurs are like growths off the bone where the joints intersect — the body’s way of trying to stabilize joints. Ligaments can rub or slip over these projections and could also be the cause of a “cracking” sound.

Arthritis of the joints occurs as a result of degeneration of the cartilage surfaces that cover the two ends of a joint to allow for mobility. As people age, these joints sustain expected wear and tear and thinning of the cartilage occurs. Arthritis of the neck is called cervical spondylosis. This can cause neck stiffness and pain. When bone spurs enlarge along with thickening of the ligaments and protrusion of the disk, the nerves in the neck can become narrowed and develop stenosis, which can pinch nerves and cause radiating arm pain. Seek medical evaluation if develop consistent radiating arm pain, weakness, pins/needles, coordination difficulty, gait imbalance or other symptoms that are progressively worsening.

Neck cracking can have serious negative side effects if done habitually. It can cause increasing neck pain by increasing inflammation. It can increase stress on the neck joints leading to stretching of the ligaments, progressive joint instability and arthritis. Neck cracking can cause injury to blood vessels in the neck, leading to tearing of arteries. This can lead to bleeding and formation of blood clots that can travel to the brain, causing a stroke or transient ischemic attack. Seek immediately emergency treatment if you develop dizziness, confusion, weakness, blurry vision, slurred speech, severe headache, trouble speaking.

Treatment for neck cracking is typically conservative. Physical therapy can help teach appropriate neck exercises and muscle strengthening exercises to the support the joints in the neck and provide relief. Over-the-counter nonsteroidal anti-inflmmatory drugs (NSAIDS) and other non-narcotic medications can be used to reduce pain and inflammation. Consult your doctor if neck symptoms are persistent, severe or associated with radiating arm pain, numbness or tingling.

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