Expert: Scott F. Gillman, DC, DACBSP - 3/1/2008

Question
Hello Dr. Gillman,

I would appreciate your advice regarding a persistent popping sound I hear
when turning my head to the right and then to the left.
  The problem began one morning six weeks ago when I woke up to a stiff
neck and a feeling of pressure behind my head. A co-worker attempted to
help me by cracking my neck, which resulted in a second of pain that quickly
subsided. It was on the following morning that the popping sound began,
always when I turn my head to the right and back forward. The sound seems
to emanate from the same spot time after time.
  In the weeks that followed, I consulted with two chiropractors who
informed me that my cervical column was misaligned and manipulated my
neck accordingly. There was no improvement.
  One of the chiropractors then took an x-ray and told me that I was
afflicted with a cervical curvature of the spine, or cervical kyphosis. I am
unsure if this is the cause of the popping noise, or if it is a second, unrelated
issue.
  I am now receiving twice-weekly neck treatments from this chiropractor,
and I have been told this regimen should last a period of one month. As I
write this letter to you, I’m halfway through the treatment with no letup in the
popping.
  Frankly, this is driving me to distraction, and I’d be interested in your
recommendation(s) regarding my problem and potential chiropractic and/or
medical avenues of treatment.
  I’m sure it would be helpful to know that I am a 38-year-old female, and
I work as a hair stylist. This means I am on my feet all day, and my arms are
often raised about shoulder height.
  Thank you.

  Regards,
  Mai Loan Vivian  

Answer
Mai,

First, the cracking sound, called crepitus, is common in artrhtic joints and also following injuries.  In most cases it will resolve over time.   Your cervical kyphosis has no correlation to neck crepitus, and it also is poorly correlated with neck pain.  Therefor, it should not be parameter with which to base your treatment.  If the chiropractor is only performing joint manipulation and not any form of deep soft tissue therapy, then you're missing out...   As a hair stylist, you are prone to stiff neck and shoulder symptoms.  Ask the chiropractor to perform active and passive myofascial release techniques to the muscles in your neck, upper back and shoulders along with joint manipulation.  At the very least you should find pain relief, but I'd suggest simply waiting for the crepitus to fizzle out over time.  

'Hope this helps.

Dr. G