Cracking or popping sounds that result from joint manipulation are mostly considered harmless.
However, medical help must be sought if the noise is accompanied by pain. The spine is an important part of the human skeletal system. It comprises twenty-four vertebrae that are separated by intervertebral discs.
Popping or clicking sounds could sometimes be a sign of excessive strain on the lumbar region. The lumbar spine, which is commonly referred to as the lower back, is the lowest section of the spine. Just below the lumbar spine, lies the weight-bearing joint known as the sacroiliac joint.
Problems are most likely to arise if the lumbar vertebrae or the sacroiliac joints are strained beyond tolerable limits.
What Causes the Back to Crack or Pop?
It is believed that cracking or popping in the back arises when the gas that is trapped within the synovial fluid in the joint is released. This fluid is present between the joints in the body and acts as a lubricant and shock absorber, surrounding the vulnerable edges of our bones.
The synovial fluid prevents the bones from rubbing against each other because increased friction between bones may lead to degeneration, a condition called osteoarthritis, or simply arthritis. The noise is also heard when the tendon that has moved slightly out of place returns to its original position.
Such sounds may arise due to strain to the joints or supporting structures such as the ligaments, tendons, or cartilage. These supporting structures work in tandem, to provide the maximum range of motion of a joint. For instance, the cartilage, which is the connective tissue that covers the ends of the bones, prevents friction between bones.
Certain degenerative conditions could also be responsible for causing misalignment of the bony segments of the spine, which in turn may cause clicking noises in the lumbar region.
Osteoarthritis is a medical condition that is associated with the degeneration of the articular cartilage. Clicking sounds may arise if the cartilage gets worn out, called crepitus. As a result, the bones start rubbing against each other.
What is Crepitus?
Any grinding, cracking, creaking, crunching, grating, or popping that happens when moving a joint is referred to as crepitus. Crepitus can strike at any age, although it grows more prevalent as individuals become older.
When cartilage in a joint degenerate, it no longer protects the joint from friction and impacts. Furthermore, cartilage loss can change the biomechanics of a joint, causing bones to grind against one another. Crepitus can occur as a result of these alterations.
Common causes of crepitus include:
- Air bubbles popping inside the joint (does not cause pain).
- Tendons or ligaments snapping over the joint’s bony structures (sometimes causes pain).
- Osteoarthritis (often results in pain).
Although the sound can be alarming, crepitus itself is no cause for concern. It’s pretty normal for a person’s back to sound like it is cracking and popping. However, one should be concerned if this comes with pain. When pain becomes unbearable or begins to impact daily activity, it is time to consult with a medical professional.
Causes of Osteoarthritis in the Lower Back
Internal injury to the facet joints is the most common cause of osteoarthritis of the spine. Smooth cartilage lines the surfaces of the facet joints to allow for mobility as the two sides of the joint rub against each other. However, the following procedures can cause discomfort in the joint:
- One side of the facet joint’s cartilage is injured. The damaged cartilage grinds against its neighbor every time the spine flexes, producing friction and additional inflammation on both sides.
- Inflammation is caused by joint injury and friction.
- The inflamed facet joints provide a pain signal through a single nerve (the medial branch) that travels through the facet joint.
- The back muscles spasm as a result of this signal.
- Low back pain is caused by a combination of muscle spasms and joint inflammation.
Osteoarthritis is a condition that affects the lower back’s facet joints. When compared to the amount of bodyweight they support, the joints are fairly small. The accompanying tension and strain put them at risk of cartilage damage and injury. The joints degrade as a result of the accumulation of damage throughout a lifetime.
Torn discs can also result in facet joint failure. The spine’s discs serve as shock absorbers. They feature a hard exterior and a soft inside. The stress is absorbed by the soft inner section. Degeneration or damage can cause the rigid outer layer to tear. Due to the inability of torn discs to absorb tension and strain, excessive force is delivered to the facet joints.
The degeneration process is comparable to that of an automobile. If the shocks fail and are not changed, the springs will break next.
The facet joints in the lower back go out once the ruptured disc quits absorbing the stresses and strains of ordinary living. When the facet joints are damaged, they become inflamed and trigger muscular spasms, perpetuating the back pain cycle.
Symptoms of Osteoarthritis
Osteoarthritis symptoms such as back pain and stiffness tend to progress gradually. Many people initially attribute these symptoms to a lack of exercise or getting older. Others may dismiss early arthritis symptoms as muscle pain until the pain worsens and interrupts their enjoyment of everyday activities.
Common signs and symptoms of spinal osteoarthritis include:
- Back crunching or popping: When bending or arching the back, you may feel crunching or hear a popping sound, which indicates that cartilage has worn away and is no longer shielding the facet joints from friction.
- Back pain: Arthritis-related back pain is dependent on several factors, including the extent of joint degradation and where it has grown on the spine. Lower back discomfort, as well as pain in the groin, buttocks, and back of the thighs, are common symptoms of lumbar spine arthritis.
- Back stiffness: The spine may become stiff and less flexible as a result of bone friction and swelling in the facet joints, especially after sleeping or sitting for an extended length of time.
- Numbness, tingling, or weakness in limbs: Osteoarthritis can trigger muscular spasms, bone spur formation, or other degenerative variances that compress the spinal cord or its nerve roots (spinal stenosis). When the spinal cord or a nerve root is compressed, it can influence the entire area it travels through. Numbness, tingling, or weakness that extends from the low back to the buttocks, groin, or thighs is possible.
- Swelling: The bones might rub together as the cartilage in the facet joints wears away, causing pain and swelling. Swelling might be minor and go unnoticed by the patient.
The symptoms of spinal osteoarthritis are usually, but not always, intermittent. Over months or years, they may worsen and become more common. Early detection and treatment of osteoarthritis symptoms can significantly decrease or stop the course of symptoms.
How Is Osteoarthritis Diagnosed?
The best way to confirm a diagnosis of osteoarthritis is by X-ray and possibly an MRI. The doctor will consider the patient’s medical history and perform a physical exam to see if the person has pain, weakness, and/or loss of motion involving the neck or lower back. Magnetic resonance imaging (MRI) is necessary to show possible damage to the discs and the soft tissue.
The most effective step toward controlling the symptoms of osteoarthritis is obtaining an early diagnosis and starting treatment as soon as possible. Non-surgical treatments are often sufficient for the management of physical symptoms and the preservation of daily functioning.
Osteoarthritis treatment programs typically include a combination of medication and exercise therapy.
- Physical therapy: Physical therapy involves targeted exercises that help maintain the ability to perform everyday tasks such as walking, bathing, and dressing. Although rest is an important part of the healing process, it is important to keep up with moderate levels of activity to strengthen the muscles surrounding the damaged joint. Stronger muscles provide greater stability, which in turn helps reduce stress on the joint.
- Steroid injections: These are often performed if the pain is moderate to severe and especially if the pain symptoms limit the patient’s ability to participate in exercises. When combined with physical therapy, steroid injections can help aid the patient to better participate in exercises to maximize effectiveness. This increased participation may stretch and strengthen important muscles around the affected joint(s) and thereby decrease the load experienced by the joint(s) so that the inflammation and pain do not return.
- Regenerative Spine Procedures: Osteoarthritis is associated with the degeneration of the cartilage. Regenerative Medicine can potentially reverse or improve cartilage degeneration, give a potent anti-inflammatory effect and stimulate a healing cascade all leading the patient back to health. Treatments such as mesenchymal stem cell therapy and platelet-rich plasma (PRP) therapy are effective options for healing damaged tissue.