Another Blog Article by David E. Smalley, M.D.

This article is on a principle of pain relief that is covered much more in depth in the book, The Miracle of Pain.  The content is educational and should not be used as medical advice.
The photos below emphasize the wonders and miracles of nature around us and within us.
March 1, 2021 — Is Popping Good or Bad?

Snaps, pops, cracks and crunches can often be associated with chronic pain in joints and surrounding muscles.  Can popping help?  Occasionally it can feel good.  Can it hurt anything?  The general medical term that includes all those sounds is crepitus, however there is a wide range of abnormal things that can cause the sounds.  Some popping can also be normal if there is never any pain, pressure, discomfort, tightness and if it is not repetitive.

Popping can be in joints, tendons, muscles and bones among many other parts of the body.  Popping or crunching can be signs of a broken bone.  Less worrisome, though still a common, concerning problem, is popping in the neck or back.  If there is pain and popping, the concern is multiplied.  Each is abnormal.  Repetitive popping can add to problems if not dealt with well and resolved.

Here are a few pertinent excerpts from my book, The Miracle of Pain.  [Edits are in brackets.]

Normal Cervical Spine X-ray, Lateral View

“Deep massages are popular with some individuals and health practitioners because they occasionally feel good, especially when they stop.  Just like scratching [and popping], they are counterproductive.  Deep massages are more irritating [to muscles] than they are helpful.  That is why tightness or other symptoms will tend to keep coming back.”

Normal Lumbar Spine X-ray, Lateral Spot View

The Miracle of Pain book cover, with apricot tree blossoms and a blue sky and fluffy clouds background

The Miracle of Pain book cover, with apricot tree blossoms and a blue sky and fluffy clouds background

“When doing an exercise, cracking or popping is not good.  They are less of a warning sign than pain, but when noticed, we should modify or stop the exercise.  It is damaging or at least irritating to the structures involved.  If 1 or 2 of the 3 knee exercises still hurt or crack after all modifications, use only 1 or 2 of the 3 knee exercises at first.”

Normal Knee MRI Lateral View, Sagittal T1 Image

“Repetitious bending and straightening of the knee often causes a knee to crack, pop or hurt.  It tends to wear out joint surfaces.  That motion causes more problems than it helps.  It may be okay for a normal knee, but even a normal knee can crack with that type of movement.  Cracking or popping are warning signs that we should not ignore.”

Normal Left Ankle X-ray, Front View

“Hyperflexibility movements, sudden movements and cracking are all irritating to the soft tissues and joints.  Doing it right only takes a few more minutes each time, but better movements and habits are always worth it.  That way the patient has control of the stretch, and they can continue learning what to do and what not to do.  Full resolution of the popping and recurrent pain is much more likely.”

* * * * *

Normal Right Foot X-ray, Oblique View

“[Joint surfaces] … need an easy, small amount [of motion] often.  If an exercise contributes to pain, popping or cracking, we need to modify it or stop it.”  Movements that pop are a sign of abnormal tightness in the muscles, joints, ligaments or tendons like the sound a string on a bow makes when it is plucked.


Normal Left Hand X-ray, Front View