Chiropractic Adjustments Do Not Have to Make a Popping Sound to be Effective

A study published by the journal Chiropractic & Manual Therapies on October 4, 2022, may have laid to rest the argument by both patients and some chiropractors as to the need for a popping sound when an adjustment is given.

The study begins by giving an overview of the issue of the popping sound with adjustments, which in this study is referred to as SMT or spinal manipulative therapy. "Many chiropractic patients are familiar with hearing a popping or cracking sound when receiving SMT and this is often seen as a factor that differentiates mobilization and manipulation. To the clinician delivering SMT, this sound is frequently associated with the perception of a successful intervention and when it does not occur, some clinicians may apply another treatment thrust.

One of the additional issues is that there are some people who are fearful of the popping sound and avoid chiropractic adjustments saying that they do not want to have their "back cracked." Although the popping sound is absolutely not the cracking or breaking of bones, the harmless sound that sometimes occurs has been the subject of a lot of confusion. This study helps lay some of the misconceptions to rest.

Researchers at the AECC University College, in Bournemouth, United Kingdom, performed a meta-analyses of previous studies to see if there was a link between the popping sound heard during some types of chiropractic adjustments and the results those patients got as it related to their perceived pain.

The researchers looked at 69 studies to see if the information in them could add to this study. Of all of those, five were selected as meeting the criteria for inclusion into this study. The data from the five original studies was then reviewed by the researchers.

The study researchers reported their results by stating, "All studies reported similar results: regardless of the area of the spine manipulated or follow-up time, there was no evidence of improved pain outcomes associated with an audible pop." They followed up in the study conclusion by noting, "Whilst there is still no consensus among chiropractors on the association of an audible pop and pain outcomes in spinal manipulative therapy, knowledge about the audible pop has advanced. This review suggests that the presence or absence of an audible pop may not be important regarding pain outcomes with spinal manipulation."

Dr. Robert Braile, a chiropractor in Georgia and past president of the International Chiropractors Association commented, "There are many forms of chiropractic adjustments that do not make any sound at all. The presence or absence of a popping sound has never been the determining factor as to the effectiveness of a chiropractic procedure. I’m glad to see scientific analysis, such as in this study, confirming what we have clinically known for years. Popping sounds are not necessary, and are not needed for chiropractic adjustments."