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Neck Cracking, Clicking and Grinding: What Those Noises Mean

Neck cracking noises picture

By Mr Ahmed-Ramadan Sadek, Neurosurgeon · 8 min read

🎧 Listen to this guideAudio version coming soon. Narrated in Mr Sadek’s voice using AI voice technology, from a script he has reviewed.

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Key points

  • Clicking, cracking and grating from the neck are common. On their own, without pain or other symptoms, they are usually not serious.[6]
  • The sharp “crack” is thought to come from a gas-filled space forming suddenly inside a joint as its surfaces are pulled apart. Softer clicks and grating can come from tissues moving over bone or from age-related change in the joints.[6][7][29]
  • Studies of habitual knuckle cracking have not shown that it causes arthritis. There is much less research on the neck.[13][14][15]
  • Neck manipulation may help some people with neck pain, but is not clearly better than gentler hands-on treatment. It has a rare but serious link with neck artery tears and stroke. Experts disagree on whether manipulation causes these tears, or whether people with an early tear seek treatment for the pain it causes.[20][22][24]
  • Noises with pain that does not settle, arm symptoms, clumsy hands, walking problems or stroke signs need medical advice.[1][3]

Call 999 straight away if you or someone else has:

A face that droops on one side, cannot lift both arms and keep them there, or slurred or confused speech. These are signs of a stroke (FAST: face, arms, speech, time to call 999). Call 999 even if the symptoms go away. Also call 999 for new problems walking, loss of bladder or bowel control, or sudden loss of coordination, such as difficulty buttoning a shirt.[1][3] Do not drive yourself to A&E.

What causes the noises?

The “crack”: a gas space forming in a joint

The small facet joints at the back of your neck contain a slippery fluid. For decades people thought the crack came from a bubble bursting. In 2015, Canadian researchers filmed 10 finger joints being pulled apart inside an MRI scanner. The crack came at the moment a gas-filled space suddenly appeared, and the space was still there afterwards. So the sound seems to come from the space forming, not from a bubble collapsing.[7]

You usually cannot crack the same joint again straight away. Estimates of this resting time range from about 20 minutes for finger joints[7] to between 40 and 95 minutes in a small study of lower back manipulation.[11]

The neck is harder to study, and the findings disagree. When 19 people had their upper neck manipulated, pops were picked up on both sides in 34 of 37 manipulations.[9] An X-ray video study found the facet joints opened by just under 1 mm during manipulation,[10] while a CT study of 22 people found no visible gas and no clear widening just afterwards.[8]

Clicks and grating

Not every noise is a gas crack. Clicking or grating as you move your head is called crepitus. It can come from air bubbles, or from tissues and bones moving over each other. Neck noises often sound louder than other joints because they are so close to your ears, and many people notice them more at night.[6]

Grating with stiffness can also come from cervical spondylosis, the normal age-related wear of the neck’s discs and joints. It is very common over 40, and often causes no symptoms.[1] The NHS lists a grating or crackling sound as a possible symptom of osteoarthritis in joints generally.[29]

How common are neck noises?

We could not find good studies measuring how often the neck clicks or cracks in people with and without neck pain. Arthritis UK describes the noises as common.[6]

Knuckles have been studied more: between 20 and 45 in every 100 adults crack their knuckles by habit, depending on the study.[12][14] In a 2024 Saudi survey, about half of adults said they manipulated their own neck, mostly for comfort, often learned from social media.[16]

Is cracking your neck harmful?

What knuckle studies tell us

In a study of 215 people aged 50 to 89, hand arthritis was no more common in knuckle crackers, even after years of cracking.[14] An earlier study of 300 people also found no more arthritis, but did find more hand swelling and weaker grip in crackers.[13] A later study of 40 people found no difference in swelling or grip.[12] A review found no proven link with arthritis.[15] The neck is a different joint, so this is reassuring, not proof.

Self-cracking the neck

Cracking your own neck is usually harmless, but not risk free. A 2026 review found only 24 published cases of harm after people manipulated their own neck. Nine were graded severe and four catastrophic, including two deaths. Almost all happened within two days, and in half the person was cracking a neck that was already painful or stiff. The authors found no evidence that such harm is common, and called the evidence very uncertain.[17]

The urge to crack

Many people crack their neck for comfort,[16] and finger joints do move slightly more straight after a crack.[12] Why the urge builds up is not well studied. If you crack many times a day, deal with the stiffness instead: regular movement, exercise and changing position often are better long-term answers than repeated forceful twisting.

Neck manipulation: benefits and risks

Neck manipulation is a quick, small thrust to a joint, often with a click, used by chiropractors, osteopaths, physiotherapists and some doctors. Our chiropractic and osteopathy guide covers these professions.

Does it help?

NICE’s guidance for GPs suggests physiotherapy combining exercise with some form of manual therapy for neck pain.[5] A Cochrane review of 51 trials found that neck manipulation and mobilisation (slower, gentler movement of the joint) gave similar results. Evidence comparing them with no treatment was limited and inconsistent, while manipulation of the upper back had more support.[20]

The pop itself does not seem to matter. In 78 people with neck pain, the number of pops during upper back manipulation was not linked with improvement.[19] Yet in a Belgian survey, 40 in 100 people thought the sound meant treatment had worked.[18]

In trials, side effects after neck manipulation were mild and no more common than after other treatments, but trials are too small to pick up rare serious events.[21]

Artery tears and stroke

The serious concern is cervical artery dissection: a small tear in the wall of an artery in the neck, which can lead to a stroke. It is among the commoner causes of stroke in younger and middle-aged adults, and can start with pain at the back of the neck or a headache on one side.[22] So someone with an early tear may seek neck treatment because of the pain the tear is causing.

  • Studies finding a link. In a US study of people under 60 with stroke or mini-stroke, those with a vertebral artery tear were more likely to have had manipulation in the previous 30 days (14 in 100 compared with 3 in 100), even allowing for neck pain.[23] The American Heart Association found that most population studies show a link in younger patients, but that this does not prove cause.[22] A 2016 pooled analysis found a small association, with very low quality evidence.[27]
  • Studies finding no extra risk compared with GP visits. In Ontario, people under 45 with this type of stroke were about three times more likely to have seen either a chiropractor or a GP beforehand, which suggests early symptoms of the tear drove both visits.[24] Large US insurance studies found no significant link with chiropractic care,[25] and found recent GP visits were usually more likely than manipulation before an artery tear, with one exception when compared with other stroke patients.[26]
  • The latest review. A 2026 review found that migraine, some inherited factors, recent infection, minor trauma and heart and circulation risk factors were linked with dissection, mostly with low certainty. Neck manipulation was not a significant risk factor. Some authors declared links with chiropractic organisations.[28]

There is agreement on two points: this type of stroke is very rare,[24] and you should be told about the possible link before agreeing to neck manipulation.[22] A new, severe or unusual neck pain or headache needs a medical assessment, not a manipulation. You can ask for mobilisation and exercise instead of a thrust.

When neck noises matter

Noises alone are not a warning sign. What matters is what comes with them:

  • Pain that does not settle, or locking. See a GP if pain or stiffness has not gone after a few weeks.[2]
  • After an injury. If you have injured your neck, get an urgent GP appointment or contact NHS 111 for severe pain, pins and needles, weakness, problems walking or sitting upright, or electric-shock feelings into your arms or legs.[4] See our whiplash guide.
  • Arm symptoms. Pins and needles in an arm with neck or arm pain, or heaviness or weakness in your arms or legs, need an urgent GP appointment or NHS 111.[1] See our cervical radiculopathy guide.
  • Clumsy hands or unsteady walking. These can be signs of pressure on the spinal cord (see our cervical myelopathy guide) and need prompt assessment.[5] Call 999 for new problems walking or sudden loss of coordination.[1]
  • After manipulation or self-cracking. Call 999 for dizziness, a severe headache, changes in vision, slurred speech, or weakness or numbness in your face, arm or leg.[3] One study advised that a big increase in neck pain after manipulation should be checked by a doctor straight away.[23]

What helps a noisy, stiff neck

  • Keep moving. Neck collars are not advised.[2][5]
  • Vary your position. Avoid keeping your neck in one position for long, for example at a desk.[2] Our tech neck guide covers phones and posture.
  • Exercise. Do simple stretching and strengthening exercises every day, starting gently.[6] Yoga, Pilates and Tai Chi can help too.[5] See our stretching guide.
  • Physiotherapy. Many areas let you refer yourself to NHS musculoskeletal services.[2]
  • Sleep. Keep your head level with your body, use a firm mattress and avoid sleeping on your front.[2]
  • Painkillers. A pharmacist can advise what suits you.[1]

When to get help

See a GP if neck pain or stiffness has not gone after a few weeks, or you are worried.[1][2] Ask for an urgent GP appointment or contact NHS 111 if you have severe neck pain that starts suddenly or gets worse quickly, heaviness or weakness in your arms or legs, pins and needles in an arm with neck or arm pain, or pain between your shoulder blades.[1] Call 999 for any stroke sign, new problems walking, loss of bladder or bowel control, or sudden loss of coordination.[1][3]

Frequently asked questions

Is it bad to crack my neck every day?

There is no good evidence that gentle cracking damages the neck, and serious harm is rarely reported.[17] If you need to crack it many times a day, get a stiff or painful neck checked.

Does neck cracking cause arthritis?

There are no studies in the neck. In fingers, studies have not found a link.[14][15]

Why does my neck grind when I roll my head?

Usually tissues moving over bone, or normal age-related change. It is common and not serious without other symptoms.[1][6]

Does a crack mean a bone was out of place?

No. The noise comes from gas in the joint fluid, and in the neck pops often come from both sides at once.[7][9]

Should I see a chiropractor or osteopath?

Some people find hands-on treatment helpful, ideally with exercise.[5][20] Ask about the risks, and say if you would prefer mobilisation to a thrust.

My neck clicks and I get headaches. Are they linked?

Neck problems can cause headaches that start at the back of the neck.[1] A sudden, severe headache is different: call 999 if it comes with any stroke sign.[3]

Further reading

References

  1. NHS. Cervical spondylosis. Page last reviewed 2 August 2023. Link
  2. NHS. Neck pain and stiff neck. Page last reviewed 27 April 2023. Link
  3. NHS. Symptoms of a stroke. Page last reviewed 12 September 2024. Link
  4. NHS. Whiplash. Page last reviewed 19 August 2026. Link
  5. NICE Clinical Knowledge Summaries. Neck pain, non-specific. Last revised April 2023. Link
  6. Arthritis UK. Neck pain: symptoms, causes, treatment and related conditions. Link
  7. Kawchuk GN, et al. Real-time visualization of joint cavitation. PLoS One. 2015;10(4):e0119470. Link
  8. Cascioli V, et al. An investigation into the production of intra-articular gas bubbles and increase in joint space in the zygapophyseal joints of the cervical spine in asymptomatic subjects after spinal manipulation. J Manipulative Physiol Ther. 2003;26(6):356-64. Link
  9. Dunning J, et al. Bilateral and multiple cavitation sounds during upper cervical thrust manipulation. BMC Musculoskelet Disord. 2013;14:24. Link
  10. Anderst WJ, et al. Intervertebral kinematics of the cervical spine before, during, and after high-velocity low-amplitude manipulation. Spine J. 2018;18(12):2333-42. Link
  11. Bereznick DE, et al. The refractory period of the audible “crack” after lumbar manipulation: a preliminary study. J Manipulative Physiol Ther. 2008;31(3):199-203. Link
  12. Boutin RD, et al. “Knuckle cracking”: can blinded observers detect changes with physical examination and sonography? Clin Orthop Relat Res. 2017;475(4):1265-71. Link
  13. Castellanos J, Axelrod D. Effect of habitual knuckle cracking on hand function. Ann Rheum Dis. 1990;49(5):308-9. Link
  14. deWeber K, et al. Knuckle cracking and hand osteoarthritis. J Am Board Fam Med. 2011;24(2):169-74. Link
  15. Rizvi A, et al. Let’s get a hand on this: review of the clinical anatomy of “knuckle cracking”. Clin Anat. 2018;31(6):942-5. Link
  16. Althubait S, et al. Public awareness and perception of risks associated with neck manipulations in southern Saudi Arabia. Cureus. 2024;16(12):e75420. Link
  17. Meyer KW, et al. Adverse events following cervical spine self-manipulation: a systematic review. PM R. 2026;18(8):917-40. Link
  18. Demoulin C, et al. Beliefs in the population about cracking sounds produced during spinal manipulation. Joint Bone Spine. 2018;85(2):239-42. Link
  19. Cleland JA, et al. The audible pop from thoracic spine thrust manipulation and its relation to short-term outcomes in patients with neck pain. J Man Manip Ther. 2007;15(3):143-54. Link
  20. Gross A, et al. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database Syst Rev. 2015;(9):CD004249. Link
  21. Pankrath N, et al. Adverse events after cervical spinal manipulation: a systematic review and meta-analysis of randomized clinical trials. Pain Physician. 2024;27(4):185-201. Link
  22. Biller J, et al. Cervical arterial dissections and association with cervical manipulative therapy: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(10):3155-74. Link
  23. Smith WS, et al. Spinal manipulative therapy is an independent risk factor for vertebral artery dissection. Neurology. 2003;60(9):1424-8. Link
  24. Cassidy JD, et al. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine. 2008;33(4 Suppl):S176-83. Link
  25. Kosloff TM, et al. Chiropractic care and the risk of vertebrobasilar stroke: results of a case-control study in U.S. commercial and Medicare Advantage populations. Chiropr Man Therap. 2015;23:19. Link
  26. Whedon JM, et al. The association between cervical artery dissection and spinal manipulation among US adults. Eur Spine J. 2023;32(10):3497-504. Link
  27. Church EW, et al. Systematic review and meta-analysis of chiropractic care and cervical artery dissection: no evidence for causation. Cureus. 2016;8(2):e498. Link
  28. Jacobs W, et al. Risk factors for cervical artery dissection: a systematic review with meta-analysis. Stroke Vasc Neurol. 2026;11(3):275-85. Link
  29. NHS. Symptoms: osteoarthritis. Page last reviewed 20 March 2023. Link

This article is general information and is not a substitute for advice about your own situation. Please speak to your GP or specialist before making any change to your treatment.

Last checked: October 2026