The desire to have one’s back “popped” is a common reaction to muscle stiffness and discomfort. Professionally, this action is a highly specific medical procedure called spinal manipulation or an adjustment. This treatment is intended to restore proper joint movement and is performed by licensed healthcare professionals following a thorough physical examination and diagnosis. Understanding the professional titles, the science behind the sound, and the risks involved is necessary to safely seeking this care.
Professional Titles for Spinal Adjustment
The primary healthcare providers who legally perform the high-velocity, low-amplitude thrust associated with a spinal “pop” are Doctors of Chiropractic (DC), Doctors of Osteopathic Medicine (DO), and some specially trained Physical Therapists (PTs). The scope of practice and training philosophy differ significantly among these professions.
Doctors of Chiropractic (DC)
Chiropractors specialize in the musculoskeletal and nervous systems, and spinal manipulation is their core treatment technique. Their education focuses heavily on the biomechanics of the spine and extremity joints.
Doctors of Osteopathic Medicine (DO)
DOs are fully licensed medical physicians who receive training in Osteopathic Manipulative Treatment (OMT). Osteopaths use spinal manipulation alongside a wide range of other manual techniques, approaching the body from a holistic perspective.
Physical Therapists (PT)
PTs primarily focus on restoring movement and function through exercise and rehabilitation. Some PTs receive additional, specialized training to perform spinal manipulation, often called High-Velocity Low-Amplitude (HVLA) thrust, where permitted by regulation.
Understanding the Sound of a Back Pop
The sound heard during a professional adjustment is known as joint cavitation, which occurs within the synovial fluid of a joint. Synovial fluid lubricates joints and contains dissolved gases like nitrogen, carbon dioxide, and oxygen.
When a professional applies a rapid, controlled thrust, it causes a sudden separation of the joint surfaces. This separation creates a rapid drop in pressure within the joint capsule. The pressure change forces the dissolved gases to form a temporary gas bubble or cavity, which quickly collapses. The “pop” or “crack” sound is the acoustic event of this collapse, a process also known as tribonucleation.
The audible sound is a side effect of the joint gapping, but it is not a measure of the adjustment’s success. Many effective manipulations do not produce a sound; the goal is to restore the joint’s proper range of motion and function. The joint space typically needs a refractory period of 20 to 30 minutes before another cavitation event can occur.
Risks of Self-Manipulation and Unqualified Adjustments
Attempting to “pop” your own back or allowing an untrained friend to do it carries significant risks that professional adjustments are designed to avoid. Self-manipulation is inherently uncontrolled because you cannot isolate a single joint segment. This often forces movement in areas that are already hypermobile, which can strain surrounding soft tissues, such as muscles and ligaments, causing instability and pain.
Adjustments performed by unqualified individuals lack the necessary diagnostic screening required by licensed professionals. Without a proper diagnosis, manipulation can easily exacerbate underlying conditions like a herniated disc, potentially worsening nerve compression.
The most serious, though rare, risk involves neck manipulation, which can lead to a tear in the vertebral artery in susceptible individuals. This damage, known as vertebral artery dissection, can restrict blood flow to the brain and potentially lead to a stroke. Seeking care from a licensed professional trained to screen for these contraindications is the only safe approach to spinal adjustment.