Nerve Pain in the Neck & Shoulder

The facet joints in the neck are where the back of adjacent vertebrae join together. There is a smooth surface on the end of each bone called cartilage. Inside the facet joint is synovial fluid, which lubricates the joints. At the front of the adjacent vertebrae is another connection called the intervertebral disc space. Neck crepitus is thought to occur when structures in the spine rub together and make sounds.

Some likely causes of neck crepitus include:

• Articular pressure changes. Tiny gas bubbles can form and eventually collapse within synovial joints, be released, and then create the popping sounds, such as in the neck’s facet joints. These are the sounds that are heard when people crack their finger knuckles, which is not harmful. These joint-cracking sounds can happen during natural movement or during manipulations of the spine in physical therapy or by a chiropractor. The medical literature had been conflicted in recent years as to whether these sounds are created by the gas bubbles being created or collapsed. Most in the medical community believe that the sounds are from the bubbles collapsing, but it has yet to be proven conclusively.
• Ligament or tendon moving around the bone. Ligaments and tendons both attach to bones. In some cases, it may be possible for a moving ligament or tendon to make a snapping sound as it moves around a bone and/or over each other. This can occur because our muscles and tissues are too tight or because they become less elastic as we age.
• Bone-on-bone grinding. As facet joints degenerate due to osteoarthritis, the protective cartilage wears down and adjacent vertebral bones can start rubbing against each other, which may cause a grinding noise or sensation. This grinding can also occur due to disc degeneration resulting in less cushioning between the vertebrae.

Neck crepitus could be caused by any of these factors, or in some cases, it could be a combination of these or other factors. It should also be noted that crepitus can occur in any moveable joint in the body (with common examples including the knees and should

People who have some degree of pain with neck crepitus may be at a higher risk for having negative thoughts and stress associated with their neck cracking and grinding sounds. These negative thoughts might cause people to unnecessarily alter behaviors or worry that the neck has serious structural damage even when it does not. A study that looked at people with painful knee crepitus found that the participants had more worries that their knee-cracking sounds indicated premature aging, and they were also more likely to try to modify movements to avoid making the sounds.⁴ Similar results might hold true for people with neck pain and crepitus.

Neck crepitus can occur at any age, but it is more likely to occur as a person gets older. The frequency of neck cracking and grinding sounds can vary greatly. Some people might experience neck crepitus a few times a month, whereas others might experience it every day or even throughout the day with most neck movements.

Neck crepitus may go through some periods where it occurs more often than others. For example, neck cracking and grinding might occur frequently for a few days and then go away. In cases where neck crepitus is the result of bone-on-bone grinding due to facet joint osteoarthritis, the neck cracking and grinding sounds are more likely to occur frequently with movements and not go away.

While increased neck cracking and grinding sounds can occur with arthritis, there is currently no scientific evidence to suggest that frequent neck cracking can lead to arthritis. As we age, the sounds tend to move from louder and more pronounced cracks to more grinding or crunching sensations.

If neck cracking or grinding is accompanied by pain, stiffness, or other concerning symptoms, it may indicate an underlying medical condition that needs to be checked by a qualified health professional.