Over the years I have had many patients expressing concern when they experience noise when moving their joints and question whether further damage is likely to occur if they produce these sounds while exercising or participating in various activities of daily living. Based on this, I am going to explain what crepitus is in a little more detail, outlining the mechanism in which this occurs and when/if you should be concerned.
What is crepitus?
Crepitus describes a crackling, creaking or popping noise or sensation that may occur whilst moving a joint. Most commonly, individuals will note crepitus in their knee joint but can occur in any joint within the body.
What causes the noise?
- Tendon snapping over bony protuberances.
- Connection between the two joint surfaces acts as a vacuum causing gas bubbles within synovial fluid (joint lubricator) to create a popping sensation.
- Normal fluid flowing through slightly rough surfaces may cause a fine grating sensation.
Does the cracking sensation mean that I have Osteoarthritis?
Not necessarily. Interestingly, there has been research to say that individuals with Osteoarthritic (OA) joints often have a reduction, or loss, in vibration suggesting that these individuals may in fact be less likely to produce crepitus when moving their joints.
What is the noise experienced when having joint manipulation (back cracking)?
Many individuals who have had treatment on their back involving manipulation are under the impression that the ‘cracking’ sensation is their spine being ‘realigned’ because it is ‘out of place’. The most likely explanation for this noise is the gas bubble mechanism (discussed above), whereby once a joint is taken to its end range of motion, it causes an increase in pressure resulting in gas bubbles being released. Due to this you will feel better because you have more movement in the joint, not because your back has been ‘realigned.’
When should you be concerned?
A 2017 study determined that there is no research that has been able to support a direct link between a noisy joint and pathology, and therefore in most cases you should not be concerned if you are experiencing crepitus without associated pain or locking.
Should you experience any clunking, deep grinding locking or pain, it is advised that you seek an expert opinion from one of the physiotherapists at Restore to properly assess and manage your condition appropriately.
Bianca graduated from The University of Melbourne with a Doctor of Physiotherapy degree in 2014. Prior to this she completed a degree in Exercise and Sport Science at Deakin University.
Since graduating, Bianca has worked predominantly in the private practice setting treating a variety of Musculoskeletal conditions through manual therapy, dry needling, hydrotherapy and Clinical Pilates. In addition, Bianca has had exposure working as a physiotherapist in a sub-acute hospital, working with local football teams in the VAFA, as well as working part time as an Exercise Physiologist.
As a physiotherapist Bianca draws on knowledge from her background in Physiotherapy and Exercise Science in order to tailor treatment to the individual needs/goals. She believes a holistic approach to treatment is vital to ensure best outcomes are obtained.