Why do my joints make ‘clicking’ noises when it is manipulated?

Manipulation techniques or adjustments (also known as ‘high velocity, low amplitude thrust’ – HVLVT ) are very useful and can provide excellent therapeutic benefits, in breaking down adhesions and improving the range of motion between facet joints within the spine and elsewhere.

It is especially useful for the more acute type of injury or very chronic conditions. HVLVT however, is by no means the only way or indeed the treatment of first choice.

The audible 'clicking' or 'popping' sound is the result of a phenomenon known as Cavitation occurring within the synovial fluid of the joint. When an adjustment is performed, the applied force separates the surfaces of the encapsulated synovial joint. This stretches the joint capsules and intra-articular tissues, which in turn creates a negative pressure within the joint capsule and a release of mainly carbon dioxide gas (CO2) which are dissolved within the synovial fluids. The CO2 will eventually get reabsorbed back into the joint fluids, a period of time termed the 'refractory period'.

If a technique is going to be used which might produce a clicking noise or sensation then this will be discussed with you first as you have the choice at all times.