Expert: Gerald Anzalone, D.C. - 5/17/2006

Question
Whenever I take a deep breath, my upper back cracks.  Do you suggest I need realigned?  I also cant bend forward or touch my toes in the morning.  Is there a stretching exercise you recommend?

Thank you

Answer

Thanks for your question.

The "cracking" noise that you are describing that occurs with deep breathing is most likely cavitation of the joints of your spine.

Cavitation is the "popping" sound that occurs when a joint capsule (the envelope of tissue that surrounds a lubricated joint) is stretched, creating a negative pressure within the joint, causing the release of the lubricating fluid within the joint (called synovial fluid) as a gas, which most likely is the "cracking" sound that you are describing.

Cavitation is also the "cracking" sound that occurs with manipulation.

In my opinion, hearing cavitation of the joint is not an indicator of spinal "misalignment" (a term that I don't like to use, because joints don't necessarily misalign so much as they may become restricted in motion due to tight -or hypertonic - musculature).

That leads me to the second part of your question, that of being unable to touch your toes in the morning. If you are feeling diffusely stiff and tight upon awakening, you might need a new or better mattress, especially if your current mattress is more than 10 years old.

If you don't feel particularly tight or stiff in the morning, but are concerned about the inability to flex forward, or if doing so causes spinal pain, I recommend consulting a chiropractor who also uses soft tissue techniques. You may also see a physical therapist or massage therapist for additional evaluation. I wouldn't recommend any particular stretching or intervention without knowing more about a patient's particular problem. Stretching is not always appropriate, depending upon the problem.

Thanks again for your question.