Noises in the neck

Noises in the neck are a common reporting sign to chiropractors.

Patients often report noisy joints (the sound of ‘clicking’) after they have been in a traumatic event, like that of a motor vehicle accident for example. These noises are not well researched and can concern people if the sounds are related to headaches. There are many anatomical structures in the neck that can make these noises and most do not believe them to be an immediate significant concern but it often indicates disruptions in the cartilage in or around the joint(s). The sound of neck noises can be magnified if one plugs their ears by way of using ear plugs or some other ear protection. This is a way to hear the sounds more accurately. So, what do the sounds mean and where are they coming from? The most classic sound of a joint is a “crack”.  This is traditionally thought to be coming from a formation and subsequent collapse of a gas bubble: cavitation. But a potentially recent discovery believes this sound is more like a snap and thought to be as a result of the release of an elastic-like structure called the synovial fold. This ‘crack’ sound is one that cannot be reproduced immediately after the sound has been elicited. This is similar to a cracking knuckle as one cannot do it again for a period of about 30-60 minutes. This is called a refractory period. We know that after this ‘cracking’ event, the bones are significantly separated–improving the joint space. But there are other noises that people report and these noises include grinding or small clicks or crackling that can be reproduced repetitively. These noises have been reported to sound like a clicking , clunking, or grinding. There are many types of noises that are emitted from synovial joints and corresponding the research to indicate which anatomical structures are causing what kind of noises is very scant. One of the findings that occurs post traumatic accident, is the straightening of the neck. Normally, there is supposed to be a nice lordotic curve associated with the neck.  You can see this in the MRI image.

After a traumatic event to the neck, often the muscles associated with the cervical spine will contract. This will cause the cervical spine’s normal curvature to straighten. And when the cervical spine straightens, it causes disruption in the parallelism of the facet joints. And when these joints are not parallel, the two joint surfaces become asymmetric in spacing  and can cause a rubbing of the cartilage in ways that it normally does not experience. In a normally curved cervical spine, the facet joints are evenly spaced. But what can happen with trauma, is the curve can become straightened and noises can develop as the parallelism of the synovial joints become asymmetric causing the edges of the joints to rub against one another in way that can create noises in the neck. As a creator of these cervical models, I feel it to be important to write about these insights in the better management of neck related conditions to help improve outcomes. Proper management of neck related injuries post motor vehicle accident, like in whiplash, should include treatment strategies to restore the natural cervical curve of the neck.