Hearing a clicking sound from the back or pelvic area while walking is common. This noise, medically called crepitus, is the general term for joint sounds ranging from a subtle rubbing sensation to an audible pop or snap. While alarming, the clicking is usually a benign mechanical phenomenon that does not indicate a serious injury. It typically originates from the movement of soft tissues or the release of gas bubbles within a joint, becoming noticeable during repetitive motions like walking.
Pinpointing the Location of the Clicking
Pinpointing the source is important, as sensations from the lower back, pelvis, and hips can be easily confused. Clicking originating from the lumbar spine often occurs during movements involving rotation or arching the back and is typically felt deep in the center of the spine.
A lower, slightly off-center sound, especially when shifting weight or stepping forward, may relate to the sacroiliac (SI) joint. The SI joint connects the sacrum to the hip bones (ilium) and is a frequent source of pelvic noise. Hip clicking often happens when lifting the leg or swinging it forward or to the side, and can easily radiate to feel like lower back noise. For instance, a click heard when lifting the knee high is likely a hip issue, while a click during a trunk twist points toward the spine.
Common Causes Related to Soft Tissues and Gait
The most frequent causes of clicking during walking relate to soft tissue movements and are usually not associated with long-term damage. This often involves tendon or ligament snapping, known as external snapping hip syndrome, which can be perceived as lower back noise. This occurs when a tight tendon snaps over a bony prominence as the joint moves.
The iliotibial (IT) band, running along the outside of the thigh, can catch and snap over the greater trochanter of the femur during gait, producing an audible pop. Similarly, hip flexor tendons, such as the iliopsoas, can snap over the front of the hip joint when the leg is brought forward. These snaps often signal muscle imbalance or tightness around the hip and pelvis, causing the joint to move slightly out of optimal alignment.
Another potential source of noise is joint cavitation, the quick release of gases dissolved in the synovial fluid that lubricates the joints. Although more characteristic of manual adjustments, this gas release can spontaneously happen in the facet joints of the spine when the joint capsule is rapidly stretched during movement. Muscle imbalances or weakness in the core and hip stabilizers can contribute by allowing temporary, excessive joint movement.
Structural Issues Requiring Medical Attention
When clicking is accompanied by pain, instability, or a grinding sensation, it can signal an underlying structural issue that requires professional diagnosis.
Facet Joint Arthritis
The small, paired facet joints located at the back of each vertebra are prone to degeneration. Facet joint arthritis or dysfunction can cause friction or catching sounds as worn-down cartilage allows bone to rub against bone during walking.
Sacroiliac (SI) Joint Dysfunction
Sacroiliac (SI) joint dysfunction is another common structural cause, where the joint may be either too mobile (hypermobility) or too restricted (hypomobility). If the SI joint is unstable, the clicking can be an audible sign of the joint excessively shifting or “giving way” when bearing weight, a movement that is especially pronounced during walking. This condition is estimated to be responsible for 15% to 30% of lower back pain causes.
Spinal Instability (Spondylolisthesis)
A more serious, though less frequent, cause is spinal instability, such as a mild form of spondylolisthesis. This condition involves one vertebra slipping forward out of alignment onto the vertebra below it. This slippage can create instability and noise when walking, as the misaligned joint structures move abnormally. While mild cases may only cause subtle symptoms like hamstring tightness, any structural instability warrants careful medical evaluation.
Self-Care and Determining When to See a Specialist
For clicking that is painless and intermittent, self-care focusing on improving joint stability and muscle balance can be beneficial. Gentle stretching, particularly for the hip flexors and the IT band, can help reduce the tension that causes tendons to snap over bone. Strengthening exercises targeting the core and gluteal muscles are helpful because a strong core provides better support and control for the spine and pelvis during walking.
Maintaining good posture while sitting and standing can also help ensure the joints are moving in their optimal alignment, which may reduce unnecessary friction or snapping. If the clicking persists or is a consistent issue, consulting a physical therapist can lead to a personalized program addressing specific muscle weaknesses or mobility restrictions.
It is important to recognize specific red flags that indicate a need to see a doctor or orthopedist immediately.
- Clicking that is consistently accompanied by sharp or burning pain.
- A sudden loss of mobility.
- Neurological symptoms, such as numbness, tingling, or weakness radiating down the leg, suggesting potential nerve involvement (e.g., sciatica).
- Persistent pain that does not improve with rest or over-the-counter anti-inflammatory medication.