Clicking and Crepitus

One of the most frequently asked questions I get in the clinic from patients is the concerning sounds like clicking, popping, snapping produced my movement. These noises can be concerning to the patient, therefore, leading to think that movement is aggravating and damaging the affected area. As we age, these types of sensations become more prevalent and the majority of times are not indicative of pathology. Crepitus also known as crepitation describes any crunching, popping or grinding sensations experienced under the skin and joints due to the presence of air in the tissue. Patients will generally experience this sensation in the knees but can also occur in the hip, shoulder, spine, and neck. Common causes of crepitus

• Overtime gas can build up in the area forming air particles in synovial fluid within the joint. As a result, creates popping and cracking sounds that usually are pain-free.
• Ligaments or tendons gliding over the joint surface that could sometimes cause pain.
• Noise around the joints can also be from degenerative changes over time, post surgery or patellofemoral instability.

Joint popping and arthritis. Are they related?

People view popping joints as a serious sign of unhealthy joints, some to the point of avoiding strenuous activity. Despite this misconception, research shows that healthy joints can also ‘pop’, and are not always related to health conditions. To date, there is no evidence to suggest they are cause for concern and no evidence that supports popping or cracking leading to arthritis.

When is cracking or popping a concern?

As mentioned, most of the time cracking is harmless. However, any popping or cracking that results in a significant amount of pain or causes immediate swelling after should be assessed. If a joint cracks or pops and you then have limited range of motion in your joint, you should also seek an assessment.

Can some conditions make it worse?

There are some joint conditions that may make cracking more prevalent. People who have hypermobile joints (increased range available in their joints) may experience more frequent audible noises. People who have arthritis may also find they have an increase in popping or cracking.

Treatment

Usually, crepitus doesn’t warrant treatment as most peoples joints will crack occasionally and won’t be painful. However, if you have pain associated with the occurrences treatment may be needed.

If the popping is occurring due to instability, a patient may need a specialised strength program to reduce the popping and cracking of their joints.