Neck Anatomy Involved in Cracking Sounds

The facet joints in the neck are where the back of adjacent vertebrae join together. There is a smooth
surface on the end of each bone called cartilage. Inside the facet joint is synovial fluid, which lubricates
the joints. At the front of the adjacent vertebrae is another connection called the intervertebral disc
space. Neck crepitus is thought to occur when structures in the spine rub together and make sounds.

Some likely causes of neck crepitus include:

Articular pressure changes. Tiny gas bubbles can form and eventually collapse within synovial joints, be
released and then create the popping sounds, such as in the neck’s facet joints. These are the sounds
that are heard when people crack their finger knuckles, which is not harmful. These joint-cracking
sounds can happen during natural movement or during manipulations of the spine in physical therapy or
by a chiropractor. The medical literature had been conflicted in recent years as to whether these sounds
are created by the gas bubbles being created or collapsed. Most in the medical community believe that
the sounds are from the bubbles collapsing, but it has yet to be proven conclusively.1-3

Ligament or tendon moving around bone. Ligaments and tendons both attach to bones. In some cases, it
may be possible for a moving ligament or tendon to make a snapping sound as it moves around a bone
and/or over each other. This can occur because our muscles and tissues are too tight or because they
become less elastic as we age.

Bone-on-bone grinding. As facet joints degenerate due to osteoarthritis, the protective cartilage wears
down and adjacent vertebral bones can start rubbing against each other, which may cause a grinding
noise or sensation. This grinding can also occur due to disc degeneration resulting in less cushioning
between the vertebrae.