Anatomy of the Neck
The neck contains the cervical spine, which consists of seven vertebrae labeled C1 through C7 (top to bottom). These vertebrae provide structure and support for the head and neck. Between the vertebrae are intervertebral discs, which act as shock absorbers. The vertebrae also contain two facet joints in the back that enable flexibility and rotation of the neck.
The major muscles of the neck are the sternocleidomastoid, which enables turning of the head, and the trapezius, which stabilizes and moves the shoulder blades. Tendons, ligaments, blood vessels, nerves, and lymph nodes also run through the neck region.
Some key parts of the neck anatomy related to neck clicking include:
- Cervical vertebrae – Bones C1-C7
- Intervertebral discs – Shock absorbing pads between vertebrae
- Facet joints – Paired joints located between vertebrae that provide flexibility
- Muscles – Sternocleidomastoid, trapezius, scalenes
- Ligaments – Provide stability to the cervical spine
Causes of Neck Clicking
There are a few common causes of neck clicking or crepitus:
Facet Joint Cavitation
The facet joints in the cervical spine (neck) are lined with synovial fluid to allow smooth movement. When the joint surfaces separate, it creates a vacuum and pops. This is called cavitation or joint cracking, and causes the clicking sound (source).
Muscle or Tendon Slipping
The muscles, tendons and ligaments around the cervical spine can slip or slide over bony surfaces as the neck is moved, causing a clicking or snapping sensation (source).
Cervical Spondylosis
Age-related wear and tear called cervical spondylosis can cause bone spurs that rub against each other and produce neck clicking noises. In severe cases, inflammation narrows the spinal canal (source).
Facet Joint Anatomy
The facet joints, also known as zygapophysial joints, are located on the posterior side of the spine between each vertebra. Their role is to guide and restrict movement between the vertebrae.
Each facet joint is surrounded by a capsule and contains synovial fluid, which lubricates the joint surfaces to reduce friction during movement. The joint surfaces are coated in cartilage and separated by a small space. When the joint moves, the cartilage surfaces glide over each other, allowing smooth motion.
There are two facet joints between each pair of vertebrae, one on each side of the spine. In total, there are 56 facet joints from the top of the spine (C1) to the bottom (S1). The orientation of the facet joints in each spinal region controls the type of motion allowed. For example, in the neck they are oriented to facilitate rotation, while in the low back they restrict rotation but allow flexion, extension, and lateral bending.
The main functions of facet joints are to guide motion between vertebrae, provide stability, bear and distribute loads, and protect the intervertebral discs from excessive motion. They play an important role in maintaining overall spinal alignment and preventing injury.
Cavitation
Cavitation refers to the formation of vapor cavities in the synovial fluid present in joints such as the facet joints in the spine. When pressure changes occur rapidly in a joint, the synovial fluid vaporizes forming small bubbles or cavities. When these cavities collapse, they create a popping or cracking sound.
During spinal manipulation therapy, the facet joints are stretched slightly beyond their normal range of motion. This causes the pressure in the joint to drop rapidly, allowing synovial fluid to vaporize and cavities to form. When the joints return to their normal position, the cavities collapse creating an audible popping or cracking sound. This is referred to as a cavitation event or joint cavitation.
Research indicates that cavitation occurs frequently in lumbar facet joints during spinal manipulation therapy and is likely the cause of the audible popping sounds. One study found cavitation events in distal facet joints as frequently as in the targeted joints during manipulation [1]. Cavitation is thought to be an indication that the joint has moved properly during manipulation [2].
Muscle Tension
Muscle tightness and tension in the neck can lead to clicking or cracking sounds when turning the head. The neck contains many small muscles that connect the cervical vertebrae and allow movement. When these muscles become tight or strained, it can put pressure on the facet joints of the vertebrae.
As you turn your head, the tight muscles pull on the cervical facet joints, creating a vacuum effect within the joint capsule. This causes the joint surfaces to quickly separate, producing a popping or cracking sound, known medically as crepitus or cavitation.
Poor posture is a common cause of muscle tightness in the neck. Slouching at a desk or looking down at phones and devices strains the neck muscles. Injury, whiplash, stress, and simple muscle tension from daily activities can also lead to tight neck muscles.
Gentle stretching, posture correction, massage, and relaxation techniques may help relieve muscle tightness. If neck cracking persists, see a physical therapist or doctor to address possible underlying joint or muscle problems.
Source: https://www.verywellhealth.com/neck-crepitus-5114111
Cervical Spondylosis
Cervical spondylosis, also known as degenerative arthritis of the neck, is a common cause of neck clicking and grinding sounds. It occurs when there is wear and tear on the cervical spine, including on the facet joints and intervertebral discs. As we age, the discs lose hydration and thickness, and bone spurs can form on the vertebrae. These changes narrow the space within the spinal canal, putting pressure on the spinal cord and nerves.
The wearing down of the facet joints from cervical spondylosis causes the joints to not align properly, leading to grinding or crunching sounds, also known as crepitus, when turning the neck. The bone spurs formed can also catch on one another, causing popping or cracking noises with neck movements.
Cervical spondylosis symptoms include neck pain and stiffness, decreased range of motion, headaches, and grinding or clicking sounds in the neck. While neck cracking and popping from cervical spondylosis is often harmless, this condition can compress nerves and lead to numbness, tingling, and muscle weakness in severe cases.
When to See a Doctor
Neck cracking or crepitus is usually harmless and requires no medical intervention. However, there are certain “red flags” where you should seek medical advice:
- If neck cracking is accompanied by pain, swelling, stiffness or reduced range of motion in the neck – This could indicate an underlying injury or condition like arthritis, requiring evaluation.
- If neck cracking leads to headaches or neurological symptoms like numbness, tingling, weakness in the arms or legs – This suggests nerve compression and needs prompt medical care.
- If you experience dizziness, loss of coordination or difficulty with balance along with neck cracking – Go to the emergency room, as it indicates a potentially serious problem.
- If neck cracking is followed by inability to move the neck or turn the head – Seek emergency care, as a vertebral artery dissection is possible.
- If loud cracking noises start suddenly and are markedly different than usual – Consult a doctor to rule out any underlying cervical spine issues.
While occasional neck cracking without symptoms is harmless for most, new onset or associated neurological symptoms warrant an urgent visit to a spine specialist or emergency care. Early diagnosis and management is key to prevent any permanent damage or disability.
Exercises and Stretches
Certain exercises and stretches can help alleviate neck cracking and popping sensations. Focusing on stretching the neck muscles gently can relieve muscle tension that contributes to cavitation in the cervical spine.
Chin tucks are a simple neck stretch to try. Sit or stand tall, then tuck your chin in toward your chest. Hold for 5-10 seconds, then relax. Repeat 5-10 times. This stretch lengthens the back of the neck slowly and safely.
Shoulder rolls can also help. While standing or sitting, roll your shoulders up, back, and down in a smooth circular motion. Repeat 5-10 times in each direction. This mobilizes the shoulder joints and relaxes the surrounding muscles.
When performing any neck stretches, move slowly and cautiously. Avoid over stretching or forcing the range of motion. Proper form is important to receive benefits without strain. Consult a physical therapist if unsure about exercises for your specific condition.
Regular stretching keeps muscles flexible, relaxed, and less prone to spasms that could lead to popping sensations. But modification of activities that highly tension the neck may also be necessary for relief in some cases.
Source: https://www.livestrong.com/article/405289-exercise-for-a-neck-that-makes-popping-sounds/
Lifestyle Tips
There are some simple lifestyle adjustments you can make that may help reduce neck clicking and pain:
Proper posture – Maintaining proper posture when sitting and standing can help reduce strain on the neck. Avoid slouching or hunching over, and try to keep your ears aligned above your shoulders.
Use a supportive pillow – Choose a pillow that keeps your neck aligned and avoids over bending. Consider a cervical pillow or one that provides reinforced support.
Stay active – Light exercise can strengthen the muscles supporting the neck and improve range of motion. Try gentle yoga or stretches to open up tight neck muscles.
Take frequent breaks – If you are in one position for long periods, make sure to regularly get up, stretch, and move your neck. This can reduce tension build up.
Manage stress – Stress and emotional tension can manifest as neck tightness. Relaxation techniques like meditation may help.
Improve ergonomics – Ensure your workstation setup, including chair height, monitor position, and desk height, allows you to maintain proper posture.
When Clicking Isn’t Normal
In most cases, neck clicking is harmless. However, there are some instances when neck clicking may indicate an underlying medical issue that requires further evaluation.
Injuries such as whiplash from a car accident or sports injury can cause damage and inflammation in the cervical spine. This can lead to abnormal neck clicking or popping when turning the head [1].
Tumors or cancer in the cervical spine, though rare, may also cause popping or grinding noises in the neck. The growth of abnormal cells can irritate the facet joints and restrict normal range of motion [2].
Infections such as meningitis can cause inflammation in the membranes surrounding the brain and spinal cord. This inflammation and swelling puts pressure on the neck vertebrae and can lead to clicking or cracking when turning the head [3].
Inflammatory forms of arthritis, like rheumatoid arthritis or ankylosing spondylitis, can also affect the cervical spine. The inflammation of the facet joints and vertebrae can cause abnormal grating or cracking sounds when moving the neck [1].
If neck clicking is accompanied by severe pain, muscle weakness, tingling or numbness in the extremities, or loss of bladder/bowel control, it requires prompt medical attention to check for serious injury or neurological conditions.