Many people judge a chiropractic adjustment by the sound it makes. If they do not hear joint cracking, they often worry the treatment did not work. This belief is common, and it starts early in training. When I was a student, the focus was often on getting a sound. Over time, research has made it clear that joint cracking is not the measure of a good adjustment.

As a Winnipeg chiropractor, I see this every week. Some people feel disappointed when joint cracking does not happen. Others think they need more care if they did not hear a sound. At the same time, I see many people improve in pain, movement, and confidence even when there is no joint cracking at all.

What Research Shows About Joint Cracking

Research supports this. When researchers compare people who hear the cracking sound with people who do not, both groups improve the same. This includes people with chronic neck pain and people with low back pain. Pain levels drop at the same rate. Disability scores improve at the same rate. Range of motion improves at the same rate. The presence or absence of cracking does not change the outcome.

In one study on low back pain, researchers looked at people who had spinal manipulation of the sacroiliac area. Some heard heard the crack. Some did not. Both groups improved in forward bending, pain scores, and disability scores. There was no difference between them. Joint cracking did not improve results and did not increase the odds of a major improvement.

Does Joint Cracking Affect the Nervous System?

Researchers have also looked at the nervous system. If joint cracking had a strong physical effect, we would expect to see changes in things like stress responses or brain activity. That does not happen.

Studies using pupillometry found no change in autonomic nervous system activity linked to joint cracking. EEG studies found that joint cracking does not change activity in the brain’s auditory centres. Whether a sound happens or not, the brain responds in the same way. Both produce a similar relaxation response.

This tells us that joint cracking is a sound, not a treatment effect.

Why does it feel so Satisfying

So why do people feel better when they hear it? The biggest reason may be psychological. Many people expect to hear the cracking sound. They have seen it online or experienced it before. When they hear it, it feels like something “clicked back into place,” even though that is not what happens.

This expectation can create a strong sense of relief, but the benefit comes from the adjustment itself, not the sound.

What Really Matters After Your Adjustment

As a chiropractor and athletic therapist in Winnipeg, I focus on restoring healthy movement. Sometimes joint cracking happens. Sometimes it does not. The key is how your body responds over the next 24 to 48 hours. Pain should settle. Movement should improve. Daily activities should get easier.

If your pain is not changing or daily tasks still feel stiff or limited, connect with me. We can review your plan and make sure your care is moving in the right direction. You can book a visit online through my Winnipeg clinic.

References

Flynn, T. W., Fritz, J. M., Wainner, R. S., & Whitman, J. M. (2003). The audible pop is not necessary for successful spinal high-velocity thrust manipulation in individuals with low back pain. Archives of Physical Medicine and Rehabilitation, 84(7), 1057–1060. https://doi.org/10.1016/S0003-9993(03)00048-0

Sillevis, R. (2020). The time has come to stop using the audible pop caused by thrust manipulation as a criterion of success. Journal of Novel Physiotherapies Research Reviews, 1(1), 4–6.

Sillevis, R. (2024). The effect of a spinal thrust manipulation’s audible pop on brain wave activity: A quasi-experimental repeated measure design. PeerJ, 12, e17622. https://doi.org/10.7717/peerj.17622

Sillevis, R., & Cleland, J. (2011). Immediate effects of the audible pop from a thoracic spine thrust manipulation on the autonomic nervous system and pain. Journal of Manipulative and Physiological Therapeutics, 34(1), 37–45. https://doi.org/10.1016/j.jmpt.2010.11.007

Originally posted on May 17, 2022 @ 4:38 pm