Is “cracking your back” to relieve backache a good idea?

Dear Cecil: A few months ago my boyfriend started cracking my back. I lie on the floor and he applies brute force up and down my spine which produces horrible crunching and cracking noises. After this ritual is over, my aching back feels much better. The only trouble with this procedure is that I need it done every night or my back hurts while I lie in bed. My question is, what causes the Rice Krispy noise in my back? Is it harmful over the long run? And why do I seem to need to have my back cracked nightly? Is this how chiropractors stay in business? Your wisdom on this matter will be greatly appreciated. Karen K., Evanston, Illinois

Cecil replies:

Cecil has heard many variation on this basic line of treatment, each one more revolting than the last. I know of one fellow, for instance, who has his wife walk on his back, producing a sensation he claims is on a par with orgasm. Clearly this guy has kinks in places other than his spine. At any rate I should point out that his wife is somewhat on the petite side. This is not something I would want to try with Rosie O’Donnell.

You’re right in suspecting that what your boyfriend is doing to you is basically amateur chiropracting, more commonly known as spinal manipulation. Many people claim it can produce miraculous results, and while claims of permanent cures are almost certainly exaggerated, the medical establishment has begun to come round to the view that it can help. A 1981 study published in the Journal of the American Medical Association found that “rotational manipulation” (a twisting maneuver favored by osteopaths that is performed with the patient on his or her side) definitely appeared to provide short-term relief. The chances for long-term improvement, however, are doubtful.

Why the treatment works is unclear. According to one writer, “the chief benefit is to stretch shortened muscles and tendons, or those that are in spasm, or adhesions or scar tissue that tend to otherwise tighten.” Some osteopaths and chiropractors also claim they’re helping unclog blocked nerve impulses somehow. Sounds like baloney to me, but who knows?

Cracking noises are common in such treatments. It’s not known exactly what causes them, but most suspect they’re the result of bony projections or ligaments sliding by one another, or bubbles forming in stretched joint capsules (as with cracking your knuckles). The noise, while unsettling to listen to, is generally harmless. But there is some danger. Spinal manipulation, even when performed by qualified practitioners, remains a controversial technique, and there have been cases of people who have been severely hurt during treatment. For instance, if the cause of your back problems is a protruding disk, manipulation could cause the disk to break open and herniate. If your man really throws himself into his work, you could end up with cracked bones, torn ligaments, or worse. Your back is one place where finesse counts for more than youthful enthusiasm. If you plan to keep this treatment up for a while (or hang on to the same boyfriend), it’d probably be wise to have what you’re doing checked out by a back doctor or physical therapist.

Cecil Adams

Send questions to Cecil via cecil@straightdope.com.