Whenever a patient comes for their first treatment, they always ask why their back makes a cracking / audible sound when I perform a manipulation.
The main one that causes temporary alarm is neck manipulation, as its closest to the ears !!
I am, by nature, a gentle manipulator, especially of the neck, where over-zealous manipulation, could ( although very rarely ) cause injury. In over 30 years of practice, I have never caused injury by manipulation and want to keep it that way!!!
However, even the most prudently performed manipulation will generally cause a cracking sound.
CAVITATION is the term used to describe small areas of vacuum that occur within the joint fluid, and these literally burst emitting a popping sound.
The gases that pop are formed of carbon dioxide. There is much evidence to support this theory and this is the most popular of theories used to explain the audible sound to patients by osteopaths and chiropractors.
There is a period of time before the gases are re absorbed back into the synovial fluid which explains why we cannot generally get the same cracking sound if we re manipulate again for quite some hours.
Patients who are hypermobile or loose ligamented tend to make a more audible sound. I feel this is because the joints move that little bit more during manipulation and force more gases out. However, one theory I have of this is that hypermobiles tend toward being very slim, and this extra loud noise is actually because there is much less fat to cover and muffle the sound before we hear it .
The other theory is that we break intra articular adhesions when we manipulate, and this particular theory would explain why patients always feel so much looser after manipulation.
As a finishing note, if anyone worries about long term effects of joint cracking, there was a Doctor named Donald Unger who cracked the knuckles of his left hand for sixty years, never cracking his right. No ill effects were recorded in his left hand whatsoever. He was awarded the Nobel prize for medicine in 2009 ( maybe theres hope that my pioneering the arnica injections to replace hydrocortisone could see my nobel prize sometime soon !!!!!!!!!) www.prlog.org/...arnicathe-
About Dr Les Bailey phd,DO, acopm.apta(int part) Les Bailey
Direct phone number 07801418080 (evening and weekend emergency appointments available)
Dr Les Bailey started in physical therapies in 1981,qualifying in remedial massage,and going on to qualify as an osteopath.
He gained his phd from OIUCM for a thesis on the treatment of plantar fasciitis.
He was awarded a teaching/lecturing diploma from the northern school of osteopaths in 1993.
He also holds a diploma in foot biomechanics .
Dr Les Bailey works from his clinic near woodmansterne, Banstead in surrey.