Is Cracking Your Neck Bad? Understanding the Potential Risks and Benefits

Do you ever sit at your desk for hours, then have the sudden urge to twist your neck hoping for that sudden release of tension? It feels so good in the moment, but is cracking your neck bad for you? Like most health habits, cracking your neck isn’t a problem in moderation. But for many people, neck cracking can cause or exacerbate cervical spine issues. And while very rare, cracking your neck — or having your neck cracked by a chiropractor—can tear an artery and potentially lead to a stroke.

Let’s take a look at exactly what is happening when you crack your neck and when it’s bad for you.

There are seven bones in your neck called vertebrae. These bones are connected by small joints, called facet joints, that help you move your head. Like any other joint in your body, the facet joint contains a mix of gasses—nitrogen, carbon dioxide and oxygen—as well as fluid. When you crack your neck, that feeling of relief is caused by releasing some gas bubbles which relieves some of the pressure inside the joint.

And you might feel good after cracking your neck for another reason, too. There is some research that shows cracking your neck releases a small amount of endorphins, one of the chemicals in your brain that makes you feel good. No wonder you’d want to do it again!

Signs That Cracking Your Neck Is Bad

Before we talk about when neck cracking is a problem, it’s important to note that scientific research on this topic is limited. Based on the information available, I tell all of my patients that they should not crack their necks. I’m not talking about that occasional cracking that you might feel when you simply stretch and turn your neck, like the woman in this photo.

In general, neck cracking is bad and potentially dangerous if:

• you’re using your hands to turn your neck, like the woman in the second photo
• you crack your neck daily or multiple times a day
• if you hear a loud pop when you crack your neck
• you crack your neck and can do it again within 10 minutes
• you feel any pain when you crack your neck
• you’ve been diagnosed with a spine condition, such as degenerative disc  disease or osteoarthritis

The Problems Created by Cracking Your Neck

Cracking your neck under any of these conditions is bad for you because it can strain or stretch the ligaments in your neck that help to keep your spine in place. The strain on the ligaments can cause inflammation, which causes pain. Loose ligaments also can allow the vertebrae to move, which can put additional pressure on discs and nerves.

A more immediate problem is the risk of arterial dissection and stroke. Arterial dissection is a tear in the inner lining that can occur in the vertebral arteries, which run along your neck and feed into your brain circulation. Blood clots can form where the tear occurs. If a blood clot breaks free and travels to your brain, it can cause an ischemic stroke. Vertebral artery dissection is one of the most common causes of stroke in people under age 45.

When Is Cracking Your Neck a Sign of a Serious Problem?

If you’re cracking your neck to try to relieve pain or discomfort, that’s likely a sign that there’s something wrong. Rather than trying to get momentary relief by cracking your neck, you should be seen by a healthcare provider for an assessment. In most cases, we’ll want to do imaging, such as an X-ray or MRI, to look for any issues that can be treated. And, by the way, treatment doesn’t necessarily mean spine surgery. In fact, very few people with neck pain will need surgery. Sometimes, some ibuprofen and a few exercises are all you need to tame the pain.

At Neurosurgery One’s Spine Center, physician assistants such as myself can see new patients within 3-5 days for that assessment and get you started on conservative treatments or referred to one of our Denver spine surgeons or interventional pain medicine physicians if appropriate.

Is It OK to Have Your Neck Cracked by a Chiropractor?

I know some people swear by their chiropractors and this is a touchy subject, but I will give you my opinion as a neurosurgical expert. If your chiropractor is massaging you and your neck cracks without any force, that’s the same as the occasional neck cracking you might feel when stretching and is probably not harmful. However, if your chiropractor is manipulating your head and neck to intentionally cause it to crack, I don’t recommend this for the same reasons you shouldn’t be cracking your own neck.

My biggest concern is vertebral artery dissection and stroke risk. It is rare, but I’ve seen it and it’s pretty awful. My bottom line is that you can see a chiropractor for massage or acupuncture but as far as manipulation in the neck, there is too much risk.

Laine Housand is a certified physician assistant at Neurosurgery One. She worked in spinal cord injury research for five years before becoming a PA specializing in spine, brain, and movement disorders. She works on the clinical team of Dr. David VanSickle and sees patients in the Neurosurgery One Littleton and Neurosurgery One Lone Tree clinics.