Neck crepitus is clicking, cracking, popping, and grinding sounds in your neck. The neck clicking at the base of your skull can be alarming, but it’s often caused by common problems like tightness and stiffness, poor posture, orarthritis.
Occasional neck crepitus isn't generally something to worry about. But chronic, repetitive, or painful cracking could point to a more serious problem.
This article will walk you through what crepitus is, and what causes neck clicking at the base of your skull. You'll also learn when to see a healthcare provider about the noises in your neck and how neck crepitus is diagnosed and treated.
What Is Crepitus?
Crepitus is cracking, popping, and grinding sounds in your joints. You may hear and feel it when you move. These grinding sounds and sensations are often tied to stiff joints that havecartilage damage.
The cartilage in joints helps your bones glide smoothly over each other. But cartilage can be damaged or worn away, especially as you get older. When this happens, bones grind against each other.
Cracking and popping sounds are often the result of air bubbles that form in the empty spots within the joints. This is called cavitation. Scientists used to think the crackling sounds came from the bubbles popping, but research has suggested it may actually be from the bubbles forming.
When you suddenly force the joint to move a certain way, different parts of it will briefly come apart, and open up cavities where the bubbles can form.
Either way, you'll hear a popping sound when you make quick movements. These sounds could be the cracking of your knuckles or the bending or twisting of your neck. Once you pop a joint, it won't pop again until the pressure has time to build up (usually after about 20 minutes).
Crepitus in Your Joints and Lungs
Causes of Neck Crepitus
Cracking, popping, and other neck noises can be caused by many different conditions, but here are some of the most common:
- Arthritis: Joint damage and stiffness in the cervical (neck)vertebrae can cause crepitus. A common type of neck arthritis is called cervical spondylosis, and it comes from the cartilage degrading over time.
- Loss of cartilage: Without the cushion of cartilage, the cervical vertebrae can't glide smoothly over each other. When you move your head, the friction causes grinding in your neck
- Injury: Auto accidents andwhiplashare common causes of neck problems, but any injury or trauma that affects the neck can lead to inflammation and tight muscles and connective tissues.
When to See a Provider
Excessive neck cracking, popping, or grinding can be a sign of a more serious problem, and even instability of your cervical spine. See a healthcare provider if you have:
- Neck cracks with every movement
- Significant pain or swelling
- A recent neck injury
The Muscles in Your Neck
Joint cavitations and cracking are more likely in joints that get more resistance in surrounding tissues, such as:
- Cervical paraspinal muscles: These run from the base of your skull down to vertebrae in your upper back and form a "V" shape.
- Ligaments: These connect bones to each other and keep them stable.
- Fascia: A thin, body-wide web of connective tissue, fascia holds organs, bones, muscles, nerves, and blood vessels in place
Poor posture can also cause neck stiffness and limit movement, which can lead to neck crepitus.
Most Common Causes of Neck Pain
How Neck Crepitus Is Diagnosed
Your regular healthcare provider, an orthopedic doctor, aphysical therapist, or achiropractor can usually figure out what's causing you to have neck crepitus.
In general, neck crepitus can be diagnosed using:
- Your symptoms
- A physical exam
- Imaging studies
During an exam, a healthcare provider will listen for neck crepitus when you do certain movements. If crepitus is chronic or causing pain, your provider may want to do imaging of your neck, like X-raysor magnetic resonance imaging (MRI).
Here's what they're looking for on the tests:
- Cartilage wear
- Fractures
- Bulging or herniated discs
- Ligament damage
Causes and Treatments of Neck Pain
Treatments for Neck Crepitus
Neck crepitus is usually caused by a stiff neck, and the treatment goal is to restore the range of motion and mobility of your cervical spine. If there's a specific underlying cause, like an injury that needs to heal or a chronic condition that needs to be managed, your provider might recommend a treatment that's targeted to that condition.
These general treatments might be recommended to help with neck crepitus:
- Heat: A hot pack can relieve tension in your muscles and ease pain.
- Stretches: Stretching can relieve tension in thetrapeziusandlevator scapulaemuscles.
- Resting: Taking it easy, especially after you’ve been busy or doing a lot of activity, can help protect your neck from strain.
- Strengthening exercise: Exercises that make deep neck muscles stronger can give your neck joints support.
- Improving posture: If you tend to stand with your head forward and upper back and shoulders rounded, working on correcting your posture can make a world of difference if you have neck pain.
- Physical therapy: A physical therapist can show you ways to work the muscles in your neck and those in the rest of your body that support your neck to ease tightness.
- Medication: Medications used to treat pain and inflammation are available over-the-counter (OTC) and by prescription. Muscle relaxants are another option; these medications are prescribed by a provider to help relax the muscles around the bones in the neck that can get tense and contribute to symptoms.
- Massage therapy: Some people find that having massages on the muscles that support their neck and back helps with neck crepitus.
- Chiropractic adjustments: Seeing a chiropractor about your neck can help you manage symptoms.
- Acupuncture: Some people find that alternative treatments like acupuncture help with neck symptoms like crepitus.
- Surgery: In rare cases where the cervical spine is unstable,spinal fusion surgeryis an option.
Is It Normal to Feel Neck Pain With a Cold?
Summary
Neck crepitus can be heard and felt if you have worn-away cartilage or gas bubbles inside the small cavities inside your joints. Poor posture, injury, or arthritis can also cause neck crepitus.
Your symptoms, a physical exam, and imaging of your neck can help a provider figure out why you have crepitus. Treatments like heat, stretching and strengthening, and improving posture can usually help with neck crepitus. For specific conditions that are more serious, surgery might be an option.
Try These Neck Stretches
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Library of Congress. What causes the noise when you crack a joint?
Kawchuk GN, Fryer J, Jaremko JL, Zeng H, Rowe L, Thompson R. Real-time visualization of joint cavitation.PLoS One. 2015;10(4):e0119470. doi:10.1371/journal.pone.0119470
Cedars-Sinai. Is knuckle cracking bad?.
American Academy of Orthapaedic Surgeons. Cervical Spondylosis (Arthritis of the Neck).
Mahmoud NF, Hassan KA, Abdelmajeed SF, Moustafa IM, Silva AG. The relationship between forward head posture and neck pain: a systematic review and meta-analysis.Curr Rev Musculoskelet Med. 2019;12(4):562-577. doi. 10.1007/s12178-019-09594-y
Johns Hopkins. Spinal arthritis.
American Academy of Orthopedic Surgeons. Cervical sponylosis.
Additional Reading
Kawchuk GN, Fryer J, Jaremko JL, Zeng H, Rowe L, Thompson R. Real-time visualization of joint cavitation. PLoS One. 2015 Apr 15;10(4):e0119470. doi:10.1371/journal.pone.0119470
By Kristen Gasnick, PT, DPT
Dr. Gasnick, PT, DPT, is a medical writer and physical therapist at Holy Name Medical Center in New Jersey.
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