Cracking joints

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Cracking finger joints (knuckles) --Cracking joints is the act of pulling bones apart to release air bubbles in the joints, which does not cause arthritis.
The sound of a knuckle being cracked (pictured: common knucklen joints) happens when joint manipulation in humans produce a sharp cracking or popping sound. This occurs during deliberate knuckle-cracking, and it is possible to crack many other joints, such as those in the back and neck vertebrae, hips, wrists, elbows, shoulders, toes, ankles, knees, jaws, feet, sternum, and the Achilles tendon area. The mechanism that produces the cracking sound was until recently unknown.[1]

According to a folk belief, the popping of joints, especially knuckles, leads to arthritis or other joint problems. However, medical research has so far failed to demonstrate any connection between knuckle cracking and long-term joint problems. It's mainly nitrogen or carbon dioxide bubbles building up between the joints.

Causes[edit]

MRI of a cracking finger joint, visualizing cavitation.

The physical mechanism that causes the cracking sound as a result of bending, twisting, or compressing joints is uncertain. Suggested causes include:

  • Cracking sounds occur when bubbles form in joints as they are pulled apart.[2]
  • Cavitation within the joint—small cavities of partial vacuum form in the synovial fluid and then rapidly collapse, producing a sharp sound.
  • Rapid stretching of ligaments.[3]
  • Intra-articular (within-joint) adhesions being broken.[3]

There were several theories to explain the cracking of joints. Synovial fluid cavitation has some evidence to support it.[4] When a spinal manipulation is performed, the applied force separates the articular surfaces of a fully encapsulated synovial joint, which in turn creates a reduction in pressure within the joint cavity. In this low-pressure environment, some of the gases that are dissolved in the synovial fluid (which are naturally found in all bodily fluids) leave the solution, making a bubble, or cavity, which rapidly collapses upon itself, resulting in a "clicking" sound.[5] The contents of the resultant gas bubble are thought to be mainly carbon dioxide.[6] The effects of this process will remain for a period of time known as the "refractory period," during which the joint cannot be "re-cracked," which lasts about twenty minutes, while the gases are slowly reabsorbed into the synovial fluid. There is some evidence that ligament laxity may be associated with an increased tendency to cavitate.[7]

However, recent evidence demonstrates that the cracking sound is produced when the bubble within the joint is formed, not when it collapses.[2]

The snapping of tendons or scar tissue over a prominence (as in snapping hip syndrome) can also generate a loud snapping or popping sound.[3]

Effects[edit]

Cracking of the joints in the foot is sometimes used for massage

The common claim that cracking one's knuckles causes arthritis appears unsupported. A study published in 2011 examined the hand radiographs of 215 people (aged 50 to 89) and compared the joints of those who regularly cracked their knuckles to those who did not.[8] The study concluded that knuckle-cracking did not cause hand osteoarthritis, no matter how many years or how often a person cracked their knuckles.[8] An earlier study also concluded that there was no increased preponderance of arthritis of the hand of chronic knuckle-crackers; however, habitual knuckle-crackers were more likely to have hand swelling and lowered grip strength.[9] Habitual knuckle-cracking was associated with manual labour, biting of the nails, smoking, and drinking alcohol and was suggested to result in functional hand impairment.[9] This early study has been criticized for not taking into consideration the possibility of confounding factors, such as whether the ability to crack one's knuckles is associated with impaired hand functioning rather than being a cause of it.[10]

Medical doctor Donald Unger cracked the knuckles of his left hand every day for more than sixty years, but he did not crack the knuckles of his right hand. No arthritis or other ailments formed in either hand, earning him the 2009 Ig Nobel Prize in Medicine, a parody of the Nobel Prize.[11]

See also[edit]

References[edit]

  1. ^ Sample, Ian; editor, science (15 April 2015). "Cracked it! Scientists solve puzzle of why knuckles pop when pulled". Retrieved 20 September 2016 – via The Guardian. 
  2. ^ a b Gregory N. Kawchuk; Jerome Fryer; Jacob L. Jaremko; Hongbo Zeng; Lindsay Rowe; Richard Thompson (2015). "Real-Time Visualization of Joint Cavitation". PLoS ONE. 25 (6): 384–390. doi:10.1371/journal.pone.0119470. 
  3. ^ a b c Protopapas M, Cymet T, Protapapas M (1 May 2002). "Joint cracking and popping: understanding noises that accompany articular release.". J Am Osteopath Assoc. 102 (5): 283–7. PMID 12033758. 
  4. ^ Brodeur R. (1995). "The audible release associated with joint manipulation.". J Manipulative Physiol Ther. 18 (3): 155–64. PMID 7790795. 
  5. ^ Maigne, Jean-Yves; Vautravers, Philippe (September 2003). "Mechanism of action of spinal manipulative therapy". Joint Bone Spine. 70 (5): 336–341. doi:10.1016/S1297-319X(03)00074-5. 
  6. ^ Unsworth A, Dowson D, Wright V (1971). "'Cracking joints'. A bioengineering study of cavitation in the metacarpophalangeal joint.". Ann Rheum Dis. 30 (4): 348–58. doi:10.1136/ard.30.4.348. PMC 1005793free to read. PMID 5557778. [1]
  7. ^ Fryer, Gary; Jacob Mudge & McLaughlin, Patrick (2002). "The Effect of Talocrural Joint Manipulation on Range of Motion at the Ankle". Journal of Manipulative and Physiological Therapeutics. 25 (6): 384–390. doi:10.1067/mmt.2002.126129. PMID 12183696. 
  8. ^ a b Deweber K, Olszewski M, Ortolano R (2011). "Knuckle cracking and hand osteoarthritis". J Am Board Fam Med. 24 (2): 169–174. doi:10.3122/jabfm.2011.02.100156. PMID 21383216. 
  9. ^ a b Castellanos J.; Axelrod D. (1990). "Effect of habitual knuckle cracking on hand function". Annals of the Rheumatic Diseases. 49 (5): 49(5):308–9. doi:10.1136/ard.49.5.308. PMC 1004074free to read. PMID 2344210. 
  10. ^ Simkin, Peter (November 1990). "Habitual knuckle cracking and hand function.". Annals of Rheumatic Disease. 49 (11): 957. doi:10.1136/ard.49.11.957-b. 
  11. ^ "2009 Winners of the Ig® Nobel Prize". Retrieved 27 November 2011.