Does cracking your knuckles cause arthritis?
August 26, 2019
Created by Hannah Nichols
Joints can make a variety of popping, cracking, creaking, grinding, and snapping noises, especially in the knuckles, knees, ankles, back, and neck.
Between 25 and 54 percent of people are thought to crack their knuckles. Reasons include a nervous habit and seeking relief from tension. Men do this more often than women.
Fast facts on knuckle cracking
Here are some key points about knuckle cracking. More detail is in the main article.
The exact reason for the popping and snapping of joints is not known, but there are some theories.
Synovial fluid bubbles and cavitation
Cracking the knuckles can provide a sense of relief and relaxation for those doing it.
One common theory has been that when a finger or joint is extended, the pressure inside the finger is lowered and gases that are present, such as carbon dioxide, are released in the form of a bubble.
The bubble-collapse theory suggests that popping joints creates a vacuum that the gases then fill. Then, when joints are extended through pulling, there is a sudden and dramatic increase in surrounding pressure.
This causes a sudden partial or total collapse of these gas bubbles, and this collapse is heard as the popping sound.
This formation and collapse of bubbles is known as cavitation.
Research has debunked the bubble collapse theory of joint popping, on the basis of visual evidence of what happens in the joint as it cracks.
By collecting real-time footage using magnetic resonance imaging (MRI), one study concluded that joint cracking is related to cavity formation rather than the collapse of gas bubbles.
The scientists studied ten metacarpophalangeal joints by inserting volunteers' fingers into a flexible tube that could be used to apply traction to the joint.
They took images using MRI before and after traction was applied to the point of cracking, at 3.2 frames per second.
The results showed the rapid creation of a cavity in the joint at the point of joint separation, and this produced the sound. The cavity remained visible after the noise.
This suggests that the cracking of the joint itself may be sufficient to cause rapid cavitation and the popping sound.
There may be no need for gas bubbles for the sound to occur.
Tendons snapping over joints
Some doctors propose that the cracking sound made by joints is the result of tendons snapping into place over joints.
Joint cracking is often confused with the snapping sound made by stiff tendons or other bands of soft tissue sliding between muscles or over bony outcrops.
Tendons keep muscles attached to bones, while ligaments connect bones to other bones.
Doctors believe that tendons can make a popping noise when they quickly snap over a joint. Ligaments may make popping noises when they tighten while the joint is moving.
When a joint moves, the tendon changes position relative to the joint. After the tendon changes position, there may be a sudden snap as it returns to its original location.
These noises are often heard in the knee and ankle joints when standing up from a seated position or when walking up or down the stairs.
Shoulder joint pop, crack or click
If the shoulder cracks or clicks painlessly, the soft tissue in the joint is likely to be the cause.
If there is pain with the noise, there may be damage to the surfaces of the joint, possibly due to a tear in the ring of cartilage that acts as a seal around the shoulder joint. This ring of cartilage is known as the labrum.
The labrum may snap over the other structures of the shoulder joint as the arm moves.
Sometimes the clicking may be due to the shoulder slipping in and out of joint. This is known as shoulder instability or subluxation.
Does cracking the knuckles cause arthritis?
Cracking the knuckles is not thought to be linked to arthritis.
The most common joints that people choose to crack are the knuckles.
They tend to do this in one of three ways:
Despite popular beliefs, several studies have concluded that cracking knuckles is unlikely to be linked to arthritis.
Dr Donald Unger researched his own knuckle-cracking, in response to complaints from his family. He cracked the knuckles of his left hand at least twice a day for 50 years, but not those of his right hand.
Unger did not develop arthritis in either hand, and there were no differences between the two hands.
He concluded that knuckle cracking was not linked to arthritis.
The Uniformed Services University of the Health Sciences looked at 215 people, 20 percent of whom popped their knuckles regularly.
Of the knuckle crackers, 18.1 percent had arthritis in their hands, compared with 21.5 percent of participants who did not crack their knuckles.
The study showed that the chances of having arthritis are around the same whether or not you crack your joints.
However, arthritis is not the only concern.
Inflammation and weak grip
In 1990, researchers investigated 300 participants over the age of 45 years, 74 of whom cracked their knuckles, while 226 did not.
Rates of arthritis were similar in both groups, but those who cracked their joints showed a higher rate of inflammation of the hands and a weaker grip.
Cracking knuckles may impact the overall health and strength of hands, including a weaker grip and soft tissue damage.
Why do people do it?
Joint manipulation stimulates a set of nerve endings involved in the sense of motion, called the Golgi tendon organs.
This relaxes the muscles surrounding the joint. Popping joints may make them feel more mobile.
The cracking and popping sounds are mostly normal and do not need treatment.
They are not linked to any long-term, chronic health issues unless they are accompanied by pain and swelling.
As one group of doctors once put it:
"The chief morbid consequence of knuckle cracking would appear to be its annoying effect on the observer."
Robert and Stuart Swezey, 1975. The Western Journal of Medicine
No supplements or exercises appear to prevent these noises.
One way to take care of joint health is to maintain appropriate body weight. This can help reduce pressure on the joints.
Regular, low-impact exercise can help keep joints healthy and minimize the risk of injury, while strengthening muscles to better support the joints and act as a shock absorber.