Is It Safe To Crack My Back?

The possibilities of joint or nerve damage.

By Henry S. Lodge, M.D.

Q. Because my back often gets stiff and tight, it feels good to crack my back. Is this ok?

A. In general, yes. People have been doing it for thousands of years, and it’s unlikely you can apply enough force to your own spine to cause nerve or muscle damage. Chiropractic back manipulation creates problems so rarely, you can consider it safe, too. (But do see a pro and avoid having your cousin Joe crack your back.)

You might wonder what, exactly, is cracking in there. Your vertebrae may be changing position as they slip back into alignment; in other cases, the sudden pressure shift inside a spinal joint forms gas bubbles, as when you open a bottle of seltzer. The bubbles reabsorb into the joint fluid quickly, so it’s weird but harmless. Still, long-term studies on joint damage are lacking, and you can overdo anything. If you need to crack your back often, or if you experience pain, weakness or numbness anywhere, go to your doctor right away.

Can I wear my joints out?

Consider Your Hands

Perhaps the best argument against a direct connection between use (or overuse) and osteoarthritis is when OA affects the hands. Finger joints with OA look very similar to the knees with OA, yet we don’t bear weight on the hands — at least I don’t. There’s also the observation that “handedness” doesn’t play a part in osteoarthritis. If 90% of people are right-handed and if osteoarthritis were purely use-related, there ought to be a lot more right-hand arthritis compared to left-hand involvement. That’s simply not the case.

Hand OA is a good example of genetics at work: If your parent or other first-degree relative has OA of the hands, it markedly increases your risk of the condition.

Protecting Your Joints From Stress Versus Disease

“Use it or lose it” is certainly a concept that applies to the joints. The fact is, joints were meant to be used. A condition appropriately called “frozen shoulder” can develop within a week or two if the shoulder doesn’t move, even if there was no injury involved! That’s a good reason to avoid using a sling for prolonged periods and why range of motion exercises are so important after an injury or surgery. It’s also why people who already have arthritis are encouraged to keep moving.

The concept of “joint protection” is typically applied to people who have arthritis as a way to encourage use while avoiding excessive stress on the joints. For example, rather than carrying a heavy load with your hands, rest it on your forearms and use your arms rather than hands to carry it. The same concept is applied to exercise — swimming or biking provide excellent cardiovascular exercise that is easier on the joints than jogging.

These measures may lead to less pain or stiffness — that is, they may protect you from joint pain by avoiding stress to the joints. Unfortunately, that’s not the same as protecting the joints from deterioration, which joint-protection measures cannot reliably accomplish.

What Causes OA?

If OA is not caused by wearing out the joints, what causes it to develop? The answer varies, depending on whom you ask and whose joints you ask about. In fact, there is often no single cause that can be identified. There may be several potential explanations. Often there is no reasonable explanation at all.

The most common risk factors for osteoarthritis include:

  • Advanced age
  • Obesity
  • Family history – Up to 50% of osteoarthritis is thought to be related to inherited tendency to develop joint degeneration
  • Injury – especially a fracture that involves the joint)
  • Rheumatoid arthritis (or other diseases that cause chronic joint inflammation)

However, these are risk factors, not causes. Plenty of older, overweight people never develop OA.

The Bottom Line

If you’re worried about “using up” your joints, remember that there is not a limit on the number of times you can make a fist and there is no “shelf-life” for the knees. From my reading of the available research, it’s much better to be physically active than to hold back to protect your joints. If they aren’t bothering you with the activities you’re doing, it’s unlikely you are harming them. Perhaps someday you’ll have 90 year-old knees that serve you well and feel just fine. But if you do develop arthritis, don’t blame the exercise. In the absence of significant injury, it might make more sense to blame your parents.