Joint cracking: Difference between revisions
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{{short description|Bending person's joints to produce a distinct cracking or popping sound}} | {{short description|Bending a person's joints to produce a distinct cracking or popping sound}} | ||
{{Use dmy dates|date=August 2020}} | {{Use dmy dates|date=August 2020}} | ||
{{Multiple image | {{Multiple image | ||
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'''Joint cracking''' is the manipulation of [[joint]]s to produce a sharp popping sound and a related, subjective sensation. It is sometimes performed by [[Physical therapy|physical therapist]]s, [[chiropractor]]s, and [[osteopath]]s,<ref>Richard Boggs, ''Hammaming in the Sham: A Journey Through the Turkish Baths of Damascus, Aleppo and Beyond'', 2012, {{isbn|1859643256}}, [https://books.google.com/books?id=uoMH_psyizoC&pg=PT161 p. 161]</ref> in pursuit of a variety of outcomes. | '''Joint cracking''' is the manipulation of [[joint]]s to produce a sharp popping sound and a related, subjective sensation. It is sometimes performed by [[Physical therapy|physical therapist]]s, [[chiropractor]]s, and [[osteopath]]s,<ref>Richard Boggs, ''Hammaming in the Sham: A Journey Through the Turkish Baths of Damascus, Aleppo and Beyond'', 2012, {{isbn|1859643256}}, [https://books.google.com/books?id=uoMH_psyizoC&pg=PT161 p. 161]</ref> in pursuit of a variety of outcomes. | ||
The cracking mechanism | The cracking mechanism involves nitrogen gas that is dissolved in synovial fluid. When the pressure inside the joint cavity is quickly reduced due to mechanical expansion, nitrogen gas is released from the solution, leading to the formation of cavitation bubbles. When these nitrogen bubbles collapse, they create a cracking noise. It takes about 20 minutes for the nitrogen to fully dissolve back into the synovial fluid, which allows the joint to produce another set of cavitation bubbles and generate the cracking sound again.<ref name="dvorsky">{{Cite news|url=https://gizmodo.com/now-we-know-why-knuckle-cracking-makes-that-awful-sound-1824154323|title=Simulation May Finally Explain Why Knuckle Cracking Makes That Awful Sound|last=Dvorsky|first=George|work=Gizmodo|access-date=2018-03-30|language=en-US}}</ref> | ||
Voluntary joint cracking is sometimes | Voluntary joint cracking is sometimes viewed as a type of "tic" and has been linked to the spectrum of obsessive-compulsive disorder. Two relevant studies highlight this connection: | ||
* Abouhendy and Jawad (2013) discuss compulsive joint clicking and its relation to the obsessive-compulsive spectrum in their case report published in ''The Primary Care Companion for CNS Disorders''. | |||
* Johnson, Linse, and Novoa (2022) address diagnostic, ethical, and legal considerations in treating individuals with compulsive neck cracking in their article published in ''Cureus''. | |||
These studies provide insights into the complexities of this behavior and its implications for treatment. | |||
==Causes== | ==Causes== | ||
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[[File:Visualization of Joint Cavitation.png|thumb|right|Static images of the hand in the resting phase before cracking (left). The same hand following cracking with the addition of a post-cracking distraction force (right). Note the dark, interarticular void (yellow arrow).]] | [[File:Visualization of Joint Cavitation.png|thumb|right|Static images of the hand in the resting phase before cracking (left). The same hand following cracking with the addition of a post-cracking distraction force (right). Note the dark, interarticular void (yellow arrow).]] | ||
For many decades, the physical mechanism | For many decades, the physical mechanism underlying the cracking sound produced by bending, twisting, or compressing joints remained uncertain. Suggested causes included: | ||
*[[Cavitation]] within the joint—small cavities of partial vacuum form in the [[synovial fluid]] and then rapidly collapse, producing a sharp sound.<ref name="telegraph">{{cite news|url=https://www.telegraph.co.uk/news/science/science-news/11539913/Why-knuckle-cracking-makes-a-popping-sound-and-why-it-might-be-beneficial.html|title=Why knuckle cracking makes a popping sound, and why it might be beneficial|last1=Knapton|first1=Sarah|date=15 April 2015|work=[[The Daily Telegraph]]|access-date=17 December 2016|location=London}}</ref><ref name="guardian">{{cite web|url=https://www.theguardian.com/science/2015/apr/15/cracked-it-scientists-solve-puzzle-of-why-knuckles-crack-when-pulled|title=Cracked it! Scientists solve puzzle of why knuckles pop when pulled|first1=Ian|last1=Sample|date=15 April 2015 |access-date=20 September 2016|work=The Guardian |location=London}}</ref> | *[[Cavitation]] within the joint—small cavities of partial vacuum form in the [[synovial fluid]] and then rapidly collapse, producing a sharp sound.<ref name="telegraph">{{cite news|url=https://www.telegraph.co.uk/news/science/science-news/11539913/Why-knuckle-cracking-makes-a-popping-sound-and-why-it-might-be-beneficial.html|title=Why knuckle cracking makes a popping sound, and why it might be beneficial|last1=Knapton|first1=Sarah|date=15 April 2015|work=[[The Daily Telegraph]]|access-date=17 December 2016|location=London}}</ref><ref name="guardian">{{cite web|url=https://www.theguardian.com/science/2015/apr/15/cracked-it-scientists-solve-puzzle-of-why-knuckles-crack-when-pulled|title=Cracked it! Scientists solve puzzle of why knuckles pop when pulled|first1=Ian|last1=Sample|date=15 April 2015 |access-date=20 September 2016|work=The Guardian |location=London}}</ref> | ||
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There were several hypotheses to explain the cracking of joints. Synovial fluid cavitation has some evidence to support it.<ref>{{cite journal |author=Brodeur R. |title=The audible release associated with joint manipulation |journal=J Manipulative Physiol Ther |volume=18 |issue=3 |pages=155–64 |year=1995 |pmid=7790795}}</ref> 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 [[gas]]es that are dissolved in the synovial fluid (which are naturally found in all bodily fluids) leave the solution, making a [[Bubble (physics)|bubble]], or [[Cavitation|cavity]] ([[tribonucleation]]), which rapidly collapses upon itself, resulting in a "clicking" sound.<ref>{{cite journal|last1=Maigne|first1=Jean-Yves|last2=Vautravers|first2=Philippe|title=Mechanism of action of spinal manipulative therapy|journal=Joint Bone Spine|date=September 2003|volume=70|issue=5|pages=336–341|doi=10.1016/S1297-319X(03)00074-5|pmid=14563460}}</ref> The contents of the resultant gas bubble are thought to be mainly [[carbon dioxide]], [[oxygen]] and [[nitrogen]].<ref>{{cite journal |vauthors=Unsworth A, Dowson D, Wright V |year=1971 |title='Cracking joints'. A bioengineering study of cavitation in the metacarpophalangeal joint. |journal=Ann Rheum Dis |volume=30 |issue=4 |pages=348–58 |doi=10.1136/ard.30.4.348 |pmc=1005793 |pmid=5557778}}[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1005793/pdf/annrheumd00004-0008.pdf]</ref> The effects of this process will remain for a period of time known as the "[[Refractory period (physiology)|refractory period]]", during which the joint cannot be "re-cracked", which lasts about 20 minutes, while the gases are slowly reabsorbed into the [[synovial fluid]]. There is some evidence that [[Ligamentous laxity|ligament laxity]] may be associated with an increased tendency to cavitate.<ref name="Fryer">{{cite journal |author1=Fryer, Gary |author2= Jacob Mudge |author3=McLaughlin, Patrick |name-list-style=amp |year=2002 |title=The Effect of Talocrural Joint Manipulation on Range of Motion at the Ankle |journal=[[Journal of Manipulative and Physiological Therapeutics]] |issue=6 |pages=384–390 |pmid=12183696 |doi=10.1067/mmt.2002.126129 |volume=25|url= http://vuir.vu.edu.au/504/1/Ankle_manipulation_-_revised.pdf |archive-url=https://web.archive.org/web/20170921215401/http://vuir.vu.edu.au/504/1/Ankle_manipulation_-_revised.pdf |archive-date=2017-09-21 |url-status=live }}</ref> | There were several hypotheses to explain the cracking of joints. Synovial fluid cavitation has some evidence to support it.<ref>{{cite journal |author=Brodeur R. |title=The audible release associated with joint manipulation |journal=J Manipulative Physiol Ther |volume=18 |issue=3 |pages=155–64 |year=1995 |pmid=7790795}}</ref> 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 [[gas]]es that are dissolved in the synovial fluid (which are naturally found in all bodily fluids) leave the solution, making a [[Bubble (physics)|bubble]], or [[Cavitation|cavity]] ([[tribonucleation]]), which rapidly collapses upon itself, resulting in a "clicking" sound.<ref>{{cite journal|last1=Maigne|first1=Jean-Yves|last2=Vautravers|first2=Philippe|title=Mechanism of action of spinal manipulative therapy|journal=Joint Bone Spine|date=September 2003|volume=70|issue=5|pages=336–341|doi=10.1016/S1297-319X(03)00074-5|pmid=14563460}}</ref> The contents of the resultant gas bubble are thought to be mainly [[carbon dioxide]], [[oxygen]] and [[nitrogen]].<ref>{{cite journal |vauthors=Unsworth A, Dowson D, Wright V |year=1971 |title='Cracking joints'. A bioengineering study of cavitation in the metacarpophalangeal joint. |journal=Ann Rheum Dis |volume=30 |issue=4 |pages=348–58 |doi=10.1136/ard.30.4.348 |pmc=1005793 |pmid=5557778}}[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1005793/pdf/annrheumd00004-0008.pdf]</ref> The effects of this process will remain for a period of time known as the "[[Refractory period (physiology)|refractory period]]", during which the joint cannot be "re-cracked", which lasts about 20 minutes, while the gases are slowly reabsorbed into the [[synovial fluid]]. There is some evidence that [[Ligamentous laxity|ligament laxity]] may be associated with an increased tendency to cavitate.<ref name="Fryer">{{cite journal |author1=Fryer, Gary |author2= Jacob Mudge |author3=McLaughlin, Patrick |name-list-style=amp |year=2002 |title=The Effect of Talocrural Joint Manipulation on Range of Motion at the Ankle |journal=[[Journal of Manipulative and Physiological Therapeutics]] |issue=6 |pages=384–390 |pmid=12183696 |doi=10.1067/mmt.2002.126129 |volume=25|url= http://vuir.vu.edu.au/504/1/Ankle_manipulation_-_revised.pdf |archive-url=https://web.archive.org/web/20170921215401/http://vuir.vu.edu.au/504/1/Ankle_manipulation_-_revised.pdf |archive-date=2017-09-21 |url-status=live }}</ref> | ||
In 2015, research | In 2015, research indicated that bubbles remained in the fluid after a joint cracked, suggesting that the cracking sound was produced when the bubble within the joint formed, rather than when it collapsed. In 2018, a team in France developed a mathematical simulation to investigate what occurs in a joint just before it cracks. This team concluded that the sound is caused by the collapse of bubbles, while the bubbles observed in the fluid result from a partial collapse. Due to the theoretical nature of this conclusion and the absence of physical experimentation, the scientific community remains unconvinced.<ref name="dvorsky" /><ref>{{cite magazine|url=https://time.com/5220275/knuckles-crack-science-why-reason/|title=Why Does Cracking Your Knuckles Make So Much Noise? Science Finally Has an Answer|magazine=Time|language=en|access-date=2018-03-30}}</ref><ref>{{Cite journal|last1=Chandran Suja|first1=V.|last2=Barakat|first2=A. I.|date=2018-03-29|title=A Mathematical Model for the Sounds Produced by Knuckle Cracking|journal=Scientific Reports|language=En|volume=8|issue=1|page=4600|doi=10.1038/s41598-018-22664-4|pmid=29599511|pmc=5876406|issn=2045-2322|bibcode=2018NatSR...8.4600C}}</ref> | ||
The snapping of tendons or scar tissue over a prominence (as in [[snapping hip syndrome]]) can also generate a loud snapping or popping sound.<ref name="Protopapas">{{cite journal |vauthors=Protopapas M, Cymet T, Protapapas M |title=Joint cracking and popping: understanding noises that accompany articular release. |journal=J Am Osteopath Assoc |volume=102 |issue=5 |pages=283–7 |date=1 May 2002 |pmid=12033758 |url=http://www.jaoa.org/cgi/reprint/102/5/283 |access-date=2 March 2007 |archive-url=https://web.archive.org/web/20070927214025/http://www.jaoa.org/cgi/reprint/102/5/283 |archive-date=27 September 2007 }}</ref> | The snapping of tendons or scar tissue over a prominence (as in [[snapping hip syndrome]]) can also generate a loud snapping or popping sound.<ref name="Protopapas">{{cite journal |vauthors=Protopapas M, Cymet T, Protapapas M |title=Joint cracking and popping: understanding noises that accompany articular release. |journal=J Am Osteopath Assoc |volume=102 |issue=5 |pages=283–7 |date=1 May 2002 |pmid=12033758 |url=http://www.jaoa.org/cgi/reprint/102/5/283 |access-date=2 March 2007 |archive-url=https://web.archive.org/web/20070927214025/http://www.jaoa.org/cgi/reprint/102/5/283 |archive-date=27 September 2007 }}</ref> | ||
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==See also== | ==See also== | ||
*[[Crepitus]]—sounds made by joint | *[[Crepitus]]—sounds made by a joint | ||
==References== | ==References== | ||
Latest revision as of 06:31, 14 December 2025
Template:Short description Template:Use dmy dates Script error: No such module "Multiple image". Joint cracking is the manipulation of joints to produce a sharp popping sound and a related, subjective sensation. It is sometimes performed by physical therapists, chiropractors, and osteopaths,[1] in pursuit of a variety of outcomes.
The cracking mechanism involves nitrogen gas that is dissolved in synovial fluid. When the pressure inside the joint cavity is quickly reduced due to mechanical expansion, nitrogen gas is released from the solution, leading to the formation of cavitation bubbles. When these nitrogen bubbles collapse, they create a cracking noise. It takes about 20 minutes for the nitrogen to fully dissolve back into the synovial fluid, which allows the joint to produce another set of cavitation bubbles and generate the cracking sound again.[2]
Voluntary joint cracking is sometimes viewed as a type of "tic" and has been linked to the spectrum of obsessive-compulsive disorder. Two relevant studies highlight this connection:
- Abouhendy and Jawad (2013) discuss compulsive joint clicking and its relation to the obsessive-compulsive spectrum in their case report published in The Primary Care Companion for CNS Disorders.
- Johnson, Linse, and Novoa (2022) address diagnostic, ethical, and legal considerations in treating individuals with compulsive neck cracking in their article published in Cureus.
These studies provide insights into the complexities of this behavior and its implications for treatment.
Causes
For many decades, the physical mechanism underlying the cracking sound produced by bending, twisting, or compressing joints remained uncertain. Suggested causes included:
- Cavitation within the joint—small cavities of partial vacuum form in the synovial fluid and then rapidly collapse, producing a sharp sound.[3][4]
- Rapid stretching of ligaments.[5]
- Intra-articular (within-joint) adhesions being broken.[5]
- Formation of bubbles of joint air as the joint is expanded.[6]
There were several hypotheses to explain the cracking of joints. Synovial fluid cavitation has some evidence to support it.[7] 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 (tribonucleation), which rapidly collapses upon itself, resulting in a "clicking" sound.[8] The contents of the resultant gas bubble are thought to be mainly carbon dioxide, oxygen and nitrogen.[9] 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 20 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.[10]
In 2015, research indicated that bubbles remained in the fluid after a joint cracked, suggesting that the cracking sound was produced when the bubble within the joint formed, rather than when it collapsed. In 2018, a team in France developed a mathematical simulation to investigate what occurs in a joint just before it cracks. This team concluded that the sound is caused by the collapse of bubbles, while the bubbles observed in the fluid result from a partial collapse. Due to the theoretical nature of this conclusion and the absence of physical experimentation, the scientific community remains unconvinced.[2][11][12] The snapping of tendons or scar tissue over a prominence (as in snapping hip syndrome) can also generate a loud snapping or popping sound.[5]
Relation to arthritis
The common old wives' tale that cracking one's knuckles causes arthritis is without scientific evidence.[13] A study published in 2011 examined the hand radiographs of 215 people (aged 50 to 89). It compared the joints of those who regularly cracked their knuckles to those who did not.[14] The study concluded that knuckle-cracking did not cause hand osteoarthritis, no matter how many years or how often a person cracked their knuckles.[14] 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.[15]
The 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, and for this, he was awarded 2009's Ig Nobel Prize in Medicine.[16]
See also
- Crepitus—sounds made by a joint
References
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- ↑ Richard Boggs, Hammaming in the Sham: A Journey Through the Turkish Baths of Damascus, Aleppo and Beyond, 2012, Template:Isbn, p. 161
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