Why are my joints noisy?

Our joints, sometimes make a variety of noises and we want to know what these noises are and what they mean. Our brains are constantly evaluating danger vs safety and the more information it has stored the better we are able to weigh these decisions.


Does my cracking joint mean danger?

At the same time when our joints crack, we tend to have a feeling of relief.

Is a cracking joint safe or dangerous?


Gas bubbles or tendons sliding is by far the most common reason we experience cracking joints or audible sounds. These particular noises are not correlated to pain or any decrease in function, they are just present with a variety of movements. The only time we should be concerned is if the associated popping sound is associated with pain or if it occurs in a high velocity-based mechanism of injury, such as cutting or twisting while running with a resultant injury.


Different research demonstrated evidence the cracking joint sound supports the theory of tribonucleation, in which the separation or pulling force creates a negative pressure in the joint allowing dissolved gas to escape forming a bubble. The bubble stays after the point of sound production showing the sounds are not due to the bubble collapsing. Interestingly, the bubble will disappear once the pulling or distraction force is absent but the joint space before and after does not change significantly.


Another reason we may hear noises is not due to cracking joints but moving tissues.

Similar to cracking joints, the sound made when tissue slides and makes noise does not indicate current damage, future damage, or pathology. One explanation for the tissue sliding noise is the stick-slip phenomenon. This refers to the “jerky” motions that happen when two surfaces slide across each other. A big player in this phenomenon is friction, the greater friction between the two objects the greater chance for stick-slip.


Pathological crepitus is the sound that is associated with a pain response. Examples may include a bucket handle tear of the meniscus in which there is painful clicking and catching in the joint during certain ranges of motion. When the noise becomes symptomatic further investigation needs to be done and dynamic or moving diagnostic ultrasound is showing promise as part of a clinical battery.


Creaking sounds, as I mentioned above, usually isn’t a cause for concern if there is no pain. When it comes to the joints, motion is lotion. The more you move the more the synovial fluid in the body moves and lubricates the joints. If you spend most of your days and time sitting your joints are more likely to be prone to creaking and shrieking! Strengthening and stretching the joints will help improve mobility and reduce tightness and, as a result, prevent popping from occurring.


Image: Noises, symptoms and causes via Prehab Guys et al 2022


References

-Claire J. Robertson, Michael Hurley, Fiona Jones, People's beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study, Musculoskeletal Science and Practice,Volume 28, 2017,Pages 59-64,ISSN 2468-7812;

- Real-Time Visualization of Joint Cavitation, Kawchuk GN, Fryer J, Jaremko JL, Zeng H, Rowe L, et al. (2015) Real-Time Visualization of Joint Cavitation. PLOS ONE 10(4): e0119470;

- The mechanism of stick-slip phenomenon during friction process at low temperature

environment AIP Advances 9, 065019 (2019); Shiren La 1,2, Cong Liu 1,2 and Xingyi Zhang

1,2;

-Is Cracking Joints Bad? The Science of Joint Cavitations By Dillon Caswell PT, DPT, SCS, Prehab Guys 2022


By Andrea Cutrupi

August 2022

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