Do More 'Popping' Sounds Mean a Better Adjustment? Explained by a Georgetown Chiropractor

Many patients lie on the treatment table and wonder: If I hear more pops, did I get a “better” adjustment? As a Georgetown chiropractor, I often see people trying to judge how effective their treatment was by the number of cracking sounds. The short answer: no, more popping does not mean a better adjustment.

What Causes the Popping Sound?

The “pop” you hear during a spinal adjustment is usually cavitation, a small, safe change in pressure inside the joint fluid (synovial fluid) that causes gases such as nitrogen and carbon dioxide to rapidly form and collapse tiny bubbles (Cannon Chiropractic, 2025; Sillevis et al., 2024). This bubble burst produces the familiar cracking or snapping noise, similar to the sound you hear when you open a soda can. The noise is not bones breaking or grinding; it’s a normal physiological response to a quick, controlled movement of the joint (Shift Clinic, 2024).

The number of pops can vary based on how many joints were mobilized, how long the joint has been restricted, and even the amount of fluid and gas present in that area. In other words, a spine that feels stiff or locked up may produce more cavitation sounds, but that doesn’t automatically mean the adjustment worked harder or fixed more (Delaware Back Pain, 2022).

Why Patients Think “More Pops = Better Relief”

For decades, many clinicians and patients have treated the audible pop as a marker of a “successful” adjustment (Sillevis et al., 2024). This belief has turned into the common myth that if you don’t hear a pop, the adjustment wasn’t effective. However, modern research shows the relationship between the sound and the actual therapeutic effect is far weaker than most people imagine (Bialosky et al., 2011; Newell et al., 2022).

In fact, a systematic review on audible pops found little high‑quality evidence that the presence or absence of a pop directly predicts pain reduction or improved function (Newell et al., 2022). This suggests that measuring an adjustment’s success by how many times your back “cracked” is not scientifically justified.

What Does the Research Really Say? A Georgetown's Chiropractor's Interpretation

A recent study by Sillevis and colleagues (2024) looked at what happens in the brain when a lumbar (low‑back) adjustment produces an audible “pop” versus when it doesn’t (Sillevis et al., 2024). In this study, researchers measured brainwave activity with EEG before and after a side‑lying lumbar thrust manipulation in healthy volunteers. About half of the participants heard a clear pop; the other half did not.

The key findings were:

• Brainwave changes occurred in both groups, mainly in low‑frequency bands associated with relaxation.

• There was no clear difference between the “popping” and “non‑popping” groups that would suggest the sound itself improved the outcome (Sillevis et al., 2024).

• The researchers concluded that the audible sound during a lumbar thrust manipulation did not reliably produce a measurable placebo or extra benefit in the brain’s response. Chiropractic artic

In simpler terms: the adjustment changed the way the nervous system felt after the thrust, but the crack itself wasn’t the reason for that change.

What This Means for Your Care

As a Georgetown chiropractor, I tell patients that adjustments are judged by how you feel, not by how noisy they are. Relief, improved movement, and decreased stiffness are far better indicators of a successful adjustment than the number of pops. The Sillevis study and similar work reinforce that the mechanical and neurological effects of the thrust, not just the sound, are what matter most (Sillevis et al., 2024; Newell et al., 2022).

If you’ve been putting off chiropractic care because you’re afraid of “popping” sounds, this research should be reassuring: the sound is a normal by‑product, not a requirement for healing.

If you’d like to see how gentle, evidence‑based chiropractic care can help you move and feel better, book an initial assessment with Thomas Back and Body. We’ll perform a detailed exam, explain your diagnosis in plain language, and create a personalized chiropractic care plan tailored to your goals and lifestyle.

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Disclaimer

The information provided in our blog posts and articles is for educational and informational purposes only. It is not intended to replace individualized medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional for personal health concerns or before starting any new wellness, exercise, or treatment program.

References

Bialosky, J. E., George, S. Z., & Robinson, M. E. (2011). The relationship between perceived and manipulated treatment effectiveness and the magnitude of pain reduction in patients presenting with low back pain. Manual Therapy, 16(2), 177–182. https://doi.org/10.1016/j.math.

Newell, D., et al. (2022). Impact of audible pops associated with spinal manipulation on perceived pain: A systematic review. Healthcare, 10(9), 1783. https://doi.org/10.3390/healthcare10091783

Sillevis, R., de Zayas, T., Hansen, A. W., & Krisinski, H. (2024). Do audible sounds during a lumbar spine thrust manipulation have an impact on brainwave activity? Healthcare, 12(17), 1783. https://doi.org/10.3390/healthcare12171783