Popping your knuckles: Not all it’s cracked up to be

Cracking your knuckles or leaning over in your chair to crack the joints in your back may feel good in the moment, but too much of a good thing may be detrimental to your overall joint health.

Scott & White orthopedic surgeon, Russell J. Clark, MD, dispels some myths about “popping” your joints and explains what to do if you are having joint discomfort.

Why do joints crack?

Most joints consist of two bones that contact each other at their cartilage surfaces. The cartilage surfaces are surrounded by a joint capsule consisting of a network of ligaments for stability.

Inside the joint capsule is a liquid, known as synovial fluid. The synovial fluid also contains dissolved gases, including oxygen, nitrogen and carbon dioxide.

“The most common joints that people like to pop are the knuckles of the hands,” Dr. Clark said. “One theory is that the popping sound is thought to be caused by the gases rapidly coming out of the [fluid in the joints], allowing the capsule to stretch a little further.”

Is it okay to “pop” your joints?

It is unlikely that joint-cracking is a significant cause of arthritis or damage, the orthopedic surgeon said.

“Joint cracking is usually painless,” Dr. Clark said. “As long as it does not cause pain, most doctors would agree that you are unlikely to be doing any harm.”

There are some instances where joint cracking could be a sign of a more serious medical condition, but most of the time popping a joint is not something that needs to be addressed.

“But, in general, it is not a good idea to regularly pop your knuckles because it can lead to stretching out the stabilizing ligaments of the joints.”

People who pop their back or neck are doing the same thing to those joints.

“The spine has a series of small joints called facet joints that can be popped by taking them to the end of their range of motion quickly” he said.

The same principle applies to these joints as well—it’s better not to repeatedly crack them for fear of stretching the ligaments.

Can chiropractic adjustments be harmful to joints?

“There have been some reports of some chiropractic treatments being harmful, but these are few and far between,” Dr. Clark said.

Chiropractic treatments can actually be helpful for some musculoskeletal conditions that cause muscle spasms or cramping around the back and neck. But the orthopedic surgeon warns that the treatments may only provide temporary relief.

“I frequently send patients to a chiropractor for evaluation and treatment if their symptoms warrant that type of treatment.”

What should a patient do if they are experiencing joint discomfort after cracking their joints?

“Joint pain should be evaluated by a doctor,” Dr. Clark said. “A family or internal medicine doctor is a great place to start”

These physicians can order an X-ray and decide if conservative treatment or referral to an orthopedic surgeon is most appropriate.

“Many joint issues can be treated with exercise, injections, bracing, and weight loss programs,” he said. “Surgery is generally a last resort for most joint problems.”