Neck pain: why is my neck crunching and what should I do about it?

When people come to see a physiotherapist with neck pain, there are often several secondary symptoms. This can include crunching, clicking or cracking in the neck.

If these sounds correlate with the onset of pain, they can be deeply concerning and lead to an increased hesitancy to move your neck. In this blog, our Senior MSK Physiotherapist, James Bainbridge talks about what causes this crunching, what it means and what you should do about it. 

What causes the noise?

Our necks comprise of 7 bones (vertebrae), separated by discs. These vertebrae are able to move across each other via facet joints. Facet joints guide the movements of our necks, allowing us to look up, down, left and right. These joints, like most in the body, are surrounded by a capsule of synovial fluid to lubricate the joints.

This fluid contains natural gas, so when movement occurs at the joints this gas can be released from the fluid. This is even more common with rapid movements like fast turns or impacts to the neck. The release of the gas is what can create a clicking, crunching or popping noise.

In the vast majority of neck noises, this will be the main cause. Generally, it’s mostly unrelated pain, even in those with degenerative changes to the joints such as arthritis. Recent research suggests that between 33% and 80% (age-dependent) of people aged between 20-70 years old with no pain at all had degenerative changes at the neck during their scan.

One of the reasons that this noise can seem particularly loud or uncomfortable is due to the joints of the neck being so close to the ears. Therefore, it’s much easier to hear. This is amplified when neck pain is experienced. Hesitancy to move the neck in the anticipation of pain only heightens our awareness of joint movements.

Should I click my neck?

Despite people often reporting their neck clicking as a symptom, it is also commonly reported that by clicking their neck, their pain is eased. Although the associated noise is mostly harmless, deliberately clicking your neck by applying rapid forces in rotation of the neck can be harmful. In each side of your neck, your vertebral arteries run in between the joints, which are an incredibly important pair of arteries carrying oxygenated blood to the brain. As the primary source of oxygenated blood to the brainstem, comprising these arteries could cause a stroke, paralysis or even death.

The chances of this occurring during “normal” movements of the neck such as looking behind you or looking up and down are incredibly small. However, placing your neck in very extreme positions and applying force to deliberately cause neck cracking carries a greater risk. Healthcare professionals, such as osteopaths, are specially trained in safely performing these manipulations, therefore it is always best to seek professional help if you do wish for these manipulations to be performed.

When should I be concerned about my neck crunching?

As a sole symptom, crunching of the neck is not a problem. However, if you are experiencing any of the following symptoms with or without crunching, then please immediately seek medical advice:

• Dizziness
• Problems with speech
• Double vision
• Headaches
• Vomiting
• Problems with swallowing
• Fainting
• Paralysis in one or both arms

Massage, acupuncture and physiotherapy for neck pain are effective forms of treatment for those suffering with neck pain. If you are still concerned about your neck crunching and neck pain, then please get in touch to seek advice.  Our team of expert physiotherapists are on hand to help you with everything you need to achieve a full and lasting recovery.