Expert: Gerald Anzalone, D.C. - 5/8/2008

Question
Hello doctor. I'm 25 year old, had pain in my back when I take a deep breath, for over 9 months. Also, whenever I take a deep breath, my back cracks. I used to like cracking my back alot, twisting it and stuff, but I think I only liked it when I could do it intentionally!! Now it does not stop. I started exercising hoping the pain would stop and it subsided substantially. But the cracking doesn't seem to stop!! It's problematic for me because I feel a strong "itch" all the time, that only subsides when my back cracks...it's very unconfortable and I need an opinion on what it might be...I've had MRI's, X-rays and a CAT scan, but none of my doctors and physiotherapists know why my back does this. Everything in my exams seem ok, although my physio says my lower back tucks in and my upper thoracic back is flat. My upper back sways back too. I guess i need to know why it won't stop cracking? I'm afraid it won't stop. Thanks in advance.

Answer
Pedro,

Based on the information you have provided, it sounds like there is a segment of your spine that is hypomobile (the joints do not move correctly, probably the ones producing your pain) and areas of hypermobility (joints which move too freely) that are responsible for the cracks (called cavitations).

Self-cavitating tends to increase the mobility of hypermobile joints.

My recommendation would be to see a chiropractor to determine if in fact there are areas of hypermobility.

Since your physiotherapist has observed that the normal curvatures of your spine appear to be reduced, you might benefit from strengthening of core muscles to compensate.

However, it is possible that while the hypermobility and associated cracking may not completely stop, it might be reduced with these measures.