When neck cracking or grinding sounds are first noticed, it is normal to wonder whether something is wrong in the cervical spine. In general, a doctor should be consulted if neck cracking, also called neck crepitus, accompanies any of the following:

Neck cracking (crepitus) rarely represents anything serious. However, if it occurs with pain or other troubling symptoms, you should schedule a visit with your doctor. Watch: Video: Why Do My Joints Crack?
  • Pain or swelling. Neck crepitus with pain or swelling could indicate osteoarthritis or some other type of inflammatory process in the joints of the neck.

    See Cervical Osteoarthritis (Neck Arthritis)

  • Recent accident or injury. If the neck is making new cracking or grinding sounds after trauma, such as a car accident or a fall, then that could indicate a structural change that needs to be addressed by a qualified health professional.
  • Frequent or constant. If the neck crepitus is constant, such as a sound that can be recreated every time or nearly every time the joint is moved, then that could signal a problem in joint function, especially when accompanied by pain.
  • Recent surgery. Sometimes new neck sounds develop after surgery in the cervical spine. These sounds might show up weeks later, and while they could be normal and nothing to worry about, they should be mentioned to the surgeon just in case.

    See Cervical Spine Surgery

Otherwise, neck cracking and grinding sounds alone most likely do not indicate a health problem. If a person is excessively worried about frequent neck cracking sounds even though there is no pain or other troubling symptoms, it is worth seeing the doctor to rule out a serious underlying condition and regain peace of mind.

Neck Cracking Not Linked with Arthritis

Some people regularly crack their neck on purpose—either due to a nervous habit or perhaps to bring some therapeutic relief from neck tightness. As such, it is common for people to wonder whether repeatedly cracking the neck can wear down the joints and cause arthritis.

A review of the current medical literature indicates that frequent, purposeful knuckle-cracking of the fingers does not increase the risk for arthritis in those joints. 1 Boutin RD, Netto AP, Nakamura D, et al. Knuckle cracking: can blinded observers detect changes with physical examination and sonography? Clin Orthop Relat Res. 2017; 475(4):1265-71. , 2 Deweber K, Olszewski M, Ortolano R. Knuckle cracking and hand osteoarthritis. J Am Board Fam Med. 2011;24(2):169-74. Joint cracking in the neck has not been as thoroughly studied, but there is currently no evidence to suggest that purposefully cracking the neck increases the risk for arthritis.


Can Purposefully Adjusting the Neck Be Dangerous?

While quite rare, and at the time of this article inconclusive, there are reports of vertebral artery dissection in the neck resulting in a stroke after certain types of manipulation of the cervical spine. There is debate whether vertebral artery damage is equally likely to occur in people who do not receive spinal manipulation in this subset of the population. 3 Cassidy JD, Boyle E, Cote P, et al. Risk of vertebrobasilar stroke and chiropractic care – results of a population-based case-control and case crossover study. Spine. 2008;33:S176-83. A review of the medical literature indicates that spinal manipulation of the neck by a qualified medical professional does not appreciably stress or stretch the vertebral artery. 4 Symons B, Herzog W. Cervical artery dissection: a biomechanical perspective. J Can Chiropr Assoc. 2013 Dec;57(4):276–8. , 5 Haynes MJ, Vincent K. Vertebral strains during high speed, low amplitude cervical spinal manipulation. J Electromyogr Kinesiol. 2012;22(6):1017. , 6 Herzog W, Leonard TR, Symons B, Tang C, Wuest S. Vertebral artery strains during high-speed, low amplitude cervical spinal manipulation. J Electromyogr Kinesiol. 2012;22(5):740-6. , 7 Symons B, Wuest S, Leonard T, Herzog W. Biomechanical characterization of cervical spinal manipulation in living subjects and cadavers. J Electromyogr Kinesiol. 2012;22(5):747-51. , 8 Wuest S, Symons B, Leonard T, Herzog W. Preliminary report: biomechanics of vertebral artery segments C1-C6 during cervical spinal manipulation. J Manipulative Physiol Ther. 2010;33(4):273-8.

As a standard precaution, anyone experiencing concerning symptoms such as pain, dizziness, lightheadedness, numbness, tingling, or other troubling symptoms after neck cracking should consult a qualified health professional immediately.

See Understanding Neck Pain and Dizziness

Dr. Michele Perez is a physician specializing in physical medicine and rehabilitation. She is a member of Resurgens Orthopaedics and has more than 17 years of experience with non-surgical spine care and electrodiagnostic medicine.

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