Crepitus Of The Neck

What is Crepitus?

crepitus of the enckA technical term used to describe any type of grating, cracking, popping sound or sensation experienced when moving a joint. Crepitus may occur anywhere in the body, however when it appears in the neck it is known as cervical crepitus.

Perhaps the most well-known example of crepitus however, is the sound of somebody cracking their knuckles. It may also be used however, to describe other illnesses such as the sound of crackling lungs in a respiratory illness – also known as bibasilar crackles or rales, the sound is related to an excessive accumulation of fluid in the lungs. The term Crepitus is sometimes also used to describe the sound of bones grating after a fracture.

Although crepitus may occur at any age, it becomes more common in older people. Alone it is not a cause for concern, however when accompanied by painful symptoms it may be indicative of another underlying condition such as the degeneration of the cervical spine.

What Is Crepitus of the Neck Caused By?

Changes to the synovial fluid

The joint capsules are filled with synovial fluid which serve to lubricate and protect the smooth cartilage of the bones, in some cases as the joint moves, bubbles of gas form resulting in a cracking noise – it is not yet understood if the sound occurs when the gas bubbles are created or as they collapse.

Ligament or tendon movement

As the ligaments and tendons move and stretch over the bones, a snapping sound may be heard as the joints are moved, this may be due to tightness in the muscles and tissues, which have lost elasticity due to the ageing process.

Bone Grinding

The degeneration of the facet joints as a result of osteoarthritis, often leads to the breakdown of protective smooth cartilage, allowing the roughened surfaces of adjacent vertebral bones to come into contact with one another and rub – causing a grinding noise or sensation.

Cervical Osteoarthritis (Cervical Spondylosis)

Crepitus neck is often associated with degenerative changes as a result of the ageing process – cervical osteoarthritis (also referred to as cervical spondylosis), both describe general wear and tear related changes to the joints, cervical discs and bones in the neck.

Such degenerative changes can cause the facet joints to break down and waste away, allowing the bones to come in contact with one another during movement, this is sometimes audible and may also lead to the formation of osteophytes – irregular bony growths.

Degenerative changes may cause the discs to shrink and lose elasticity and in some cases collapse altogether – this can result in changes to the way the facet joints work, causing swelling, stiffness and inflammation and in some cases, provoking the formation of osteophytes. Inflammation of the facet joints may also cause pain, stiffness and difficulties when turning the head, which restricts movement.

Symptoms of Cervical Osteoarthritis

  • Neck pain and stiffness
  • Lack of range of motion
  • Neck cracking/popping sounds
  • Head aches
  • Irritability
  • Numbness/tingling sensations radiating through the arms as far as the hands

When Does Crepitus Need Treatment?

In cases when neck cracking accompanies any of the following, medical advice should sought:

  • Pain, swelling, numbness or a loss of strength in the upper extremities may be an indication of osteoarthritis or another type of inflammatory process.
  • Constant neck cracking and pain – if the neck makes a noise every time it is moved, this may indicate a problem in joint function.
  • A recent injury – if following a recent accident or injury the neck has begun to make a cracking sound, this may be the result of a structural damage. This should be examined by a medical professional.
  • Surgery – The neck may make new sounds following surgery in the cervical spine, anything unusual should be checked by a doctor.

Diagnosis

Diagnosing the cause of crepitus typically involves a medical history and examination – further tests such as MRI or X-Ray can be useful in establishing a diagnosis of cervical osteoarthritis.

Treatment

Any treatment for crepitus will depend very much on the cause.

Medication

Over the counter pain relief medication can help to relieve the symptoms of cervical osteoarthritis initially.

Facet Joint Injections

An injection containing a mixture steroid medication and anaesthetic into inflamed facet joints can provide effective pain relief for up to several months.

Physiotherapy

Physiotherapy and exercise can be extremely useful in the treatment of osteoarthritis – helping to aid pain relief and strengthen.

Red Flags

Crepitus accompanied by any one of the symptoms below may be indicative of another more serious underlying condition and should be thoroughly investigated.

  • High temperature/fever
  • Unexplained weight loss
  • Lack of coordination
  • Problems walking
  • Bladder/bowel control

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