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What Is Neck Crepitus?

What Is Neck Crepitus?

Cracking, popping, and grinding sounds in the neck are called neck crepitus. They often result from neck tightness and stiffness, poor posture, or arthritis. While neck crepitus is generally not a cause for concern, chronic, repetitive, or painful cracking could be indicative of a more serious problem
What Is Crepitus?
Crepitus refers to cracking, popping, and grinding sounds that can occur within joints with movement. Grinding sounds and sensations are more likely to occur in stiff joints with cartilage damage that interferes with the ability of the bones that make up the joints to glide smoothly over one another. Alternatively, cracking and popping sounds often occur as the result of joint cavitations that cause air bubbles to form within joints with quick movements that release built up joint pressure.


While it was originally hypothesized that cracking sounds within joints result from the collapsing of carbon dioxide air bubbles, newer research suggests that the sounds heard with joint movement actually result from the formation of carbon dioxide air bubbles within the joints from quick distraction, or joint separation.1

Air bubbles can form within stiff joints in a process called tribonucleation, where opposing surfaces separated by a thin layer of viscous liquid resist separation until a certain threshold. Synovial fluid is a thick, viscous liquid that is present within joints that provides lubrication and helps them move smoothly. If joints become stiff, however, synovial fluid can increase the pressure and resistance between joints due to viscous adhesion.1

Once the viscous adhesion, or tension between the surfaces from the liquid, is overcome, the surfaces will then separate rapidly and form a gas cavity as a result of the quick change in pressure within the space between the surfaces. This decrease in synovial fluid pressure allows dissolved gas within the fluid to be released into the joint, causing an air cavity, or bubble. When the resistant surfaces finally separate, a cracking sound is produced.


After a joint is cavitated, the joint is subject to a refractory phase where further cracking or cavitations cannot occur until some time has passed. This refractory period lasts approximately 20 minutes.


Crackling Sounds in the Joints or Lungs Can Be Crepitus
Causes of Neck Crepitus
Neck crepitus occurs with joint damage or stiffness of the vertebrae that make up the cervical spine of the neck. Arthritis of the neck, also called cervical spondylosis, results from cartilage degradation and occurs over time with aging. Loss of cartilage prevents the cervical vertebrae from gliding smoothly over one another with movements of the neck, which can cause a grinding sensation due to increased friction between the vertebral bones with movement.1


Neck stiffness can also result following injury to the neck—especially injury related to a motor vehicle accident, such as whiplash—that causes trauma, inflammation, and tightening of soft tissue structures of the neck. Joint cavitations and cracking are more likely to occur in joints with a greater extent of resistance in surrounding tissues, such as the cervical paraspinal muscles, ligaments, and fascia, that prevent smooth joint movement. Neck stiffness that can limit movement and cause neck crepitus can also result from poor posture.1


When to See a Doctor
While most causes of neck crepitus and cracking with neck movement are normal, excessive neck cracking, popping, or grinding may be indicative of a more serious underlying problem such as instability of the cervical spine. If you experience chronic, repetitive neck cracking every time you move your neck, significant pain, swelling, or have recently experienced a neck injury, make sure to see an orthopedic doctor.

Diagnosis
A diagnosis of neck crepitus is based on your symptoms and a physical exam to hear or feel joint cracking, popping, or grinding with neck movement. Crepitus in the neck can be observed with both active movement of the neck, where you turn your head and bend and extend your neck, or passive movement, where a physician, physical therapist, or chiropractor moves your neck from a resting position.

If your neck crepitus is chronic, repetitive, or painful, your doctor may order an X-ray or MRI of your neck to view the structures of the cervical spine to check for cartilage wear, fractures, bulging or herniated discs, or ligament damage.

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Treatment
Because neck crepitus is most often the result of a stiff neck, treatment is aimed at restoring range of motion and mobility of the cervical spine. Stretching the muscles of the neck, including the trapezius and levator scapulae, and application of a hot pack can help decrease tension in the muscles of the neck. Strengthening the deep neck muscles and improving your posture, especially if you have a forward head and increased rounding of your upper back and shoulders, can help promote proper movement and alignment of your cervical spine.1

If you have significant tightness, it may be helpful to see a physical therapist who can mobilize or manipulate the vertebrae of your neck and upper back to improve your neck mobility. In the rare case where your cervical spine is unstable, spinal fusion surgery can be performed to stabilize the vertebrae of your neck.

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A Word From Verywell
Neck crepitus is a common occurrence from arthritis, neck injury, or poor posture that causes cracking, popping, and grinding sounds and sensations with movement of the neck. Physical therapy and neck stretching and strengthening can help decrease stiffness to improve the mobility of your cervical spine to decrease neck crepitus.

If your neck crepitus is chronic, repetitive, painful, or causes swelling, talk with a doctor to determine if a more serious condition is causing your symptoms.