Joint cracking is the manipulation of

joint A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw ...

s to produce a sound and related "popping" sensation. It is sometimes performed by

physical therapist Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient ...

chiropractor Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudoscie ...

s, osteopaths, and masseurs in Turkish baths pursuing a variety of outcomes. The cracking of joints, especially knuckles, was long believed to lead to

arthritis Arthritis is a term often used to mean any disorder that affects joints. Symptoms generally include joint pain and stiffness. Other symptoms may include redness, warmth, swelling, and decreased range of motion of the affected joints. In som ...

and other joint problems. However, this is not supported by medical research. The cracking mechanism and the resulting sound is caused by dissolved gas (nitrogen gas)

cavitation Cavitation is a phenomenon in which the static pressure of a liquid reduces to below the liquid's vapour pressure, leading to the formation of small vapor-filled cavities in the liquid. When subjected to higher pressure, these cavities, cal ...

bubbles suddenly collapsing inside the joints. This happens when the joint cavity is stretched beyond its normal size. The pressure inside the joint cavity drops and the dissolved gas suddenly comes out of solution and takes gaseous form which makes a distinct popping noise. To be able to crack the same knuckle again requires waiting about 15 minutes before the bubbles dissolve back into the synovial fluid and will be able to form again. It is possible for voluntary joint cracking by an individual to be considered as part of the

obsessive–compulsive disorder Obsessive–compulsive disorder (OCD) is a mental and behavioral disorder in which an individual has intrusive thoughts and/or feels the need to perform certain routines repeatedly to the extent where it induces distress or impairs general ...

s spectrum.

Causes

For many decades, the physical mechanism that causes the cracking sound as a result of bending, twisting, or compressing joints was uncertain. Suggested causes included: *

Cavitation Cavitation is a phenomenon in which the static pressure of a liquid reduces to below the liquid's vapour pressure, leading to the formation of small vapor-filled cavities in the liquid. When subjected to higher pressure, these cavities, cal ...

within the joint—small cavities of partial vacuum form in the

synovial fluid Synovial fluid, also called synovia, elp 1/sup> is a viscous, non-Newtonian fluid found in the cavities of synovial joints. With its egg white–like consistency, the principal role of synovial fluid is to reduce friction between the articular ...

and then rapidly collapse, producing a sharp sound. * Rapid stretching of ligaments. * Intra-articular (within-joint)

adhesions Adhesions are fibrous bands that form between tissues and organs, often as a result of injury during surgery. They may be thought of as internal scar tissue that connects tissues not normally connected. Pathophysiology Adhesions form as a natural ...

being broken. *Formation of bubbles of joint air as the joint is expanded. There were several hypotheses to explain the cracking of joints. Synovial fluid cavitation has some evidence to support it. When a

spinal manipulation Spinal manipulation is an intervention performed on spinal articulations, synovial joints, which is asserted to be therapeutic. These articulations in the spine that are amenable to spinal manipulative therapy include the z-joints, the atlanto ...

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 Gas is one of the four fundamental states of matter (the others being solid, liquid, and plasma). A pure gas may be made up of individual atoms (e.g. a noble gas like neon), elemental molecules made from one type of atom (e.g. oxygen), or ...

es that are dissolved in the synovial fluid (which are naturally found in all bodily fluids) leave the solution, making a

bubble Bubble, Bubbles or The Bubble may refer to: Common uses * Bubble (physics), a globule of one substance in another, usually gas in a liquid ** Soap bubble * Economic bubble, a situation where asset prices are much higher than underlying fundame ...

, or

cavity Cavity may refer to: Biology and healthcare *Body cavity, a fluid-filled space in many animals where organs typically develop **Gastrovascular cavity, the primary organ of digestion and circulation in cnidarians and flatworms *Dental cavity or too ...

(

tribonucleation Tribonucleation is a mechanism that creates small gas bubbles by the action of making and breaking contact between solid surfaces immersed in a liquid containing dissolved gas. These small bubbles may then act as nuclei for the growth of bubbles w ...

), which rapidly collapses upon itself, resulting in a "clicking" sound. The contents of the resultant gas bubble are thought to be mainly

carbon dioxide Carbon dioxide (chemical formula ) is a chemical compound made up of molecules that each have one carbon atom covalently double bonded to two oxygen atoms. It is found in the gas state at room temperature. In the air, carbon dioxide is transpar ...

oxygen Oxygen is the chemical element with the symbol O and atomic number 8. It is a member of the chalcogen group in the periodic table, a highly reactive nonmetal, and an oxidizing agent that readily forms oxides with most elements as wel ...

and

nitrogen Nitrogen is the chemical element with the symbol N and atomic number 7. Nitrogen is a nonmetal and the lightest member of group 15 of the periodic table, often called the pnictogens. It is a common element in the universe, estimated at se ...

. 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

. There is some evidence that ligament laxity may be associated with an increased tendency to cavitate. In 2015, research showed that bubbles remained in the fluid after cracking, suggesting that the cracking sound was produced when the bubble within the joint was formed, not when it collapsed. In 2018, a team in France created a mathematical simulation of what happens in a joint just before it cracks. The team concluded that the sound is caused by bubbles' collapse, and bubbles observed in the fluid are the result of a partial collapse. Due to the theoretical basis and lack of physical experimentation, the scientific community is still not fully convinced of this conclusion. The snapping of tendons or scar tissue over a prominence (as in

snapping hip syndrome Snapping hip syndrome, also referred to as dancer's hip, is a medical condition characterized by a snapping sensation felt when the hip is flexed and extended. This may be accompanied by a snapping or popping noise and pain or discomfort. Pain oft ...

) can also generate a loud snapping or popping sound.

Effects

Relation to arthritis

The common claim that cracking one's knuckles causes

is not supported by scientific evidence. 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. The study concluded that knuckle-cracking did not cause hand osteoarthritis, no matter how many years or how often a person cracked their knuckles. 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. 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 satirical

Ig Nobel Prize The Ig Nobel Prize ( ) is a satiric prize awarded annually since 1991 to celebrate ten unusual or trivial achievements in scientific research. Its aim is to "honor achievements that first make people laugh, and then make them think." The name of ...

in Medicine.

References

{{Reflist Articles containing video clips Habits Joints

Causes

Effects

Relation to arthritis

See also

References