Before I even became a physical therapist, I repeatedly heard people say that their back was “out”. I hear people say that their joints are “out of place” and that a chiropractor or PT puts them back. This makes it sound like our spine is very fragile and unstable. Let’s go into what’s wrong with these statements.
The Spine Is Stable. It Does Not Pop In And Out Of Place
You guys, our spines are stable and sturdy. Unless you have a spinal cord injury or specific disease, your joints in your spine are not moving out of place. It is debated if our SI joint, a common joint people claim is “out”, (sacroiliac joint – where the top of the tailbone meets the ‘wing’ of the hip) even moves at all. It is generally accepted that it might move a couple of millimeters when we bend forward or lean back, but even this is debated among clinicians. Our joints do move, but they move as they are supposed to. Aside from a hip or shoulder with a tear, our joints don’t pop in and out. Especially not our spine.
A “Pop” Does Not Mean Your Back Is Out Of Place
Many of our joints have a capsule around them which contains fluid. This fluid nourishes the joint. When we hear a pop/crackle, it is often this fluid moving around. A sign of the fluid moving around in the joint is ‘cracking’ that is not painful. Keep in mind that this is in a healthy person without hardware in their joints or arthritis.
After You Feel A “Pop” It’s A Normal Physiological Phenomenon To Feel Pain Relief
Many years ago, we did think that we were actually moving people’s bones around and putting them “back in place” when performing something referred to as a ‘thrust maneuver.’ Radiographs (x-rays) have shown that there is no truth to this.
Here is what’s actually been found: We can measure muscle activity by putting needles into the tissues. We can then see the electrical activity (or lack of activity) on a screen. Studies have found that before a maneuver that causes those “pops”, the electrical activity of the muscles around the joint is high. After the maneuver the electrical activity goes down, indicating the muscle is relaxing. This is where people report feeling looser.
The joint is not being moved – the muscles around it are relaxing. This makes you feel looser, the muscles are less tight and irritated, and you often feel better. The “pop” we hear is hypothesized to be the fluid moving in the joint. This is similar to when you crack your knuckles and feel relief (good news – it’s a myth that muscle cracking causes arthritis).
We Don’t Know Exactly Why The Muscles Relax After A Thrust Maneuver, But We Know It Happens
To my knowledge, we don’t know exactly why our muscles reset with these maneuvers. You may be reading this thinking that you should go get every joint in your body to pop. Please, don’t do this! When we are going to perform a maneuver on someone (I say “maneuver” because physical therapists call it a joint manipulation, and chiropractors call it an adjustment) there are certain criteria that need to be met. It is not appropriate to perform this on all parts of a person’s body at all times.
Please Keep In Mind That This Post Is Only A Small Summary Of The Vast Information That Exists On This Topic
I could write pages and pages about joint manipulations (“thrust maneuvers”), the different types, etc. This would take a LONG time and frankly you would find this EXTREMELY boring. This post is simply to let you know that no, your spine is not popping in and out of place.
Something to note: sometimes we do see forward movement of the vertebrae at one level. This is called anterolisthesis. Though the joint is actually moving, it doesn’t “pop” back into place. In this situation the vertebrae has moved forward, but it doesn’t slide around – it just stays where it is. This condition can usually be managed non-operatively and can be diagnosed with radiographs or MRI.
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