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We have all been told stories at some point during our lives like, “don’t pull that silly face, if the wind changes you’ll get stuck like that”. But how many of us have been told by friends or family that cracking your knuckles is bad for your hands and can cause arthritis?
Image by: stakerchiro
This commonplace wives tale is quite an inaccurate miss-conception of what “cracking a joint” really causes or achieves within the human body. Osteopaths and Chiropractors alike utilise the skill of joint manipulation for a variety of reasons within their treatment plans which can result in a patient’s body feeling more mobile, having a larger and less restricted range of movement and in some instances it can completely alleviate a patients pain all together.
What causes the popping noise heard when a joint is ‘cracked’?
Although the research around the area is a bit woolly, recent evidence suggests that the popping noise could be caused by a build-up of carbon dioxide within a joint capsule collapsing. In engineering terms this is known as a ‘cavitation’ which refers to the formation of a vapour cavity within a liquid. The changing in pressures within the liquid of a dynamic environment causes the formation of cavities or ‘voids’ which when subjected to areas of high pressure can collapse causing a popping sound. When related to a joint in a human body, a joint capsule surrounds the area at which the two bones meet. This is filled with synovial joint fluid which helps to lubricate the area. When the joint moves in everyday activities, the pressure changes can cause similar cavities to that in the engineering model but this gas consists of carbon dioxide. If someone was to apply pressure to this joint in a certain way, it can cause this bubble of gas to pop resulting in a clicking or popping sound. Think of popping some bubble wrap!
What are the benefits of popping a joint?
One of the biggest benefits from having a joint manipulated is to increase its range of movement. In an otherwise stiff or immobile area of the body such as the spine, this technique can be applied to greatly improve the amount of movement that the joint can move through. Indirectly, a stiff neck can occur from a lack of movement in the lower spine meaning the neck has to move more and gets tired and achy. If the area of the lower spine can be identified and freed up via a manipulation technique it can take the emphasis off of the neck which can help to reduce pain and improve all round function. Another benefit of joint manipulation is to free up pain sensitive structures within the joints that may have become stuck in between the joining parts of two bones. When the joint is manipulated it essentially helps to ‘gap’ the area releasing and trapped structures that may be causing a patients pain symptoms. This opening of the joint also results in an increased amount of fluid allowed in to the area so more metabolic waste can be transported out of the area and also more bodily fluids carrying essential nutrition can be more readily absorbed giving the area the best chance of healing quickly.
In 2009 a medical doctor named Donald Unger won the lg Nobel Prize in medicine, which is a parody version of the annual Nobel Prize, by confirming there is no harm in such an intervention. He did this by cracking the knuckles on his left hand every day for 60 years but never his right! Can you imagine only cracking one side of your knuckles and never the other for 60 years, what a commitment! After the 60 year period both hands were tested and imaged finding NO arthritis or other ailments in either of his hands!
So in conclusion, there is NO quantifiable or substantiated evidence to suggest that joint ‘cracking’ causes arthritis in the hands or fingers or in the rest of the human body for that matter! There have been no studies to date that have been able to conclude that cracking your knuckles will give you arthritis. However, there is evidence that suggests joint manipulation used by Osteopaths and Chiropractors have some very positive benefits to the human body. Although these types of techniques aren’t appropriate for everyone, it’s nice to know that this old wives tale about such an intervention as this does not in fact cause arthritis but actually has much more positive healing implications to the human body.
Well that’s one wives tale down, I just hope it’s not windy outside………….
Written by Wayne Beck, Osteopath
References
Protopapas, M. Cymet, T. Protapapas, M. (2002). “Joint cracking and popping: understanding noises that accompany articular release”. J Am Osteopath Assoc 102 (5): 283–7
Improbable Research (2015). Winners of the lg Nobel Prize. http://www.improbable.com/ig/winners/#ig2009 online [Access date 02/11/2015]
Unsworth, A. Dowson, D. Wright, V. (1971). ‘Cracking joints’. “A bioengineering study of cavitation in the metacarpophalangeal joint”. Ann Rheum Dis 30 (4): 348–58
Spinal manipulation is a commonly used technique used by osteopaths and chiropractors as part of a treatment. Often when it is done it can result in a ‘pop’ sound. This can be a little intimidating, so what is it?
There are various theories and evidence as to what causes it but it must be pointed out that if it doesn’t ‘pop’ then it does not mean it hasn’t worked!
Synovial Joint
The main theory is that when a joint is manipulated there is a reduction in pressure within the joint or articular capsule. The synovial fluid within that capsule naturally has gases dissolved within it. When this is subjected to reduced pressure, that gas forms a small bubble, or bubbles which form a gas cavity – creating a ‘pop’ sound, as the energy is released. Over the next 20-30 minutes the gas is reabsorbed and the joint fluid goes back to normal.
Ref: Carol Fawkes, Research Officer, National Council for Osteopathic Research Audible sounds associated with spinal manipulation – a brief summary of current evidence.
Our bodies are truly amazing. They cope and adapt to the various stresses and demands we make on them every day and we hardly ever give them the respect and care they need and deserve until – one day they start to hurt or we can’t do something we used to be able to do. Then we feel let down and bewildered as to why? The truth is we need to care for ourselves more than we do and this is how we can care for our joints, those miraculous things that allow us to bend and twist in multiple forms.
There are 206 bones in the human body which makes for a lot of joints. The range of motion of these joints vary depending on the type of joint e.g. ball and socket joint of the hip or hinge joint of the elbow. These joints can be injured by direct trauma such as a fracture; subluxation; sprain; daily increased wear and tear of incorrect movement patterns (which most of us have) or incorrect dietary habits resulting in inflammation and lack of repair. What we are really talking about here is Osteoarthritis. Symptoms are typically joint pain, swelling and stiffness.
Treatment options :
Chiropractic or Osteopathy manipulations of the spine and peripheral joints can decrease joint tenderness and improve function.
Massage around the painful area will improve circulation and reduce pain and swelling.
Exercise – Initially, exercise may increase pain, however, gentle exercise has long-term benefits with positive effects on physical function, fitness and activity levels. Try Pilates, Yoga or swimming.
Dietary Modification – Research has proven time and again that diet can affect the body’s ability to heal and repair itself so it is vital that we eat foods that are beneficial to our health and well-being. Nothing surprising here – surely. So what’s beneficial? It’s the same diet that you always hear me talking about. Reduce protein, simple carbohydrates and saturated fats, alcohol and coffee from your diet and all processed foods. Ultimately – an organic vegetarian diet (produces an alkaline environment in the body) with a good source of omega 3 oils is the way to go. This diet is low in protein (protein produces an acidic environment = pain) but rich in nutrients needed for rebuilding and repair of joints.
The next question for me is – ‘Do we get enough of these nutrients in our diets these days?’ The answer sadly is ‘Probably not.’ The way that our food is now grown results in a product that is lacking in nutritional value (have you noticed food just doesn’t taste like it used to?). Even if we were living in an ideal world where all the crops were grown organically and therefore they were regularly rotated and full of nutrients because they were grown naturally in a richly nutritious soil. When it comes to a arthritic joint – we want to repair the joint surface and we will need more than the RDA (recommended daily allowance) which, for example, is the lowest amount you need to not get scurvy, not the amount you need the heal and repair your body. So supplements and vegetable juicing are the easiest way to pack those nutrients in.
If you would like to know which nutrients you need, you can always make an appointment with me at the clinic. Meanwhile, here are some supplements that are beneficial in either joint health and/or repair:
Omega 3 oils – everyone should be taking these as we are just not getting enough in our diets. Each individual cell in your body has a wall that sounds it. That wall needs to be highly permeable, allowing products to enter it as well as exit. Omega 3 oils increase cell permeability where as poor oils e.g hydrogenated fat, decrease the cells permeability by making the cell wall rigid. Omega 3 oils are essential and sadly lacking in our diets. Be sure to take a good source of this oil that has been filtered from heavy metal contamination if it is from a fish source.
Sources – fish, nuts and seeds, flax, green leafy vegetables.
Omega 6 oils – effective in part due to its conversion to Prostaglandin E1 – anti-inflammatory pathway (as is omega 3).
Source – borage oil, black currant seed oil, evening primrose oil.
Oleic Acid – olive oil. Research link
Glucosamine Sulphate and Chondroitin Sulphate – may both play a role in wound healing by providing the raw materials needed to manufacture molecules called glycosaminoglycans that are found in skin, tendons, ligaments and joints. They are also reported to reduce pain. Glucosamine sulphate has had a lot of research done on it (which is unusual for a nutrient as most research is conduct by pharmaceutical companies, and they can’t patent a nutrient)and most of it is really positive. E.g. research link
Antioxidants – Vitamin C/E – are important against oxidative, free radical damage and also for the creation of collagen which is found in bones, ligaments, blood vessels and tendons; also important in the creation of neurotransmitters (serotonin, nor-adrenaline and dopamine) which control our moods, mental clarity and pain levels. Eat a rainbow of colours in your diet and you’ll be getting some but will you be getting enough?
Sources – peppers (red, orange, yellow, green), carrots, tomatoes, red cabbage, blueberries etc.
Vitamin D – boy – there is so much research being done on this vitamin at the moment and a deficiency in this vitamin is being linked to so many conditions including poor joint health. There is no way we get enough of it in the UK (hardly any sunlight) so take a supplement.
Bromelain – is a protein-digesting enzyme derived from pineapple. Some 200 medical journal articles attest to its effectiveness in treating inflammatory conditions by blocking inflammatory chemicals and digesting excess fibrin, a chemical contributing to osteoarthritis.
Herbs
These beautiful botanical miracles are truly amazing (which is why pharmaceutical companies are very effectively limiting their use in Europe). Get them while you can.
Curcumin – is a herbal extract from turmeric and is as effective as cortisone for anti-inflammatory needs but without the cortisone side-effects.
Ginger – anti-inflammatory and pain reliever.
Devil Claw – anti-inflammatory and pain reliever.
Boswelia – it shrinks inflamed tissue, builds cartilage, increases blood supply and helps to repair blood vessels. I love this herb.
Topical Treatment Options
These are also herbs but made into and highly absorbable gel that can be applied to the skin to reduce pain and swelling. We carry both of these at the clinic.
Horse Chestnut – contains a compound called aescin that acts as an anti-inflammatory. It can be applied to an affected area every couple of hours to reduce swelling.
Arnica – great at reducing pain and inflammation.
I know what you’re thinking – ‘Too much effort. Why not just pop a pill?’
Short-term use of NSAIDs (such as Ibuprofen) can be helpful when used for inflammation that results from traumatic injuries (sprains/strains etc). However, long-term use of these medications can cause a host of unwanted side-effects. The way they work is to block the prostaglandin inflammatory AND anti-inflammatory pathways. Another point that I feel is highly relevant, is that NSAIDs do not actually correct the cause of the pain. In fact they cause intestinal permeability, which leads to more inflammation. A person taking NSAIDs medication is seven times more likely to be hospitalised for gastrointestinal adverse effects which the FDA estimates leads to 200,000 cases of gastric bleeding annually resulting in 10,000 – 20,000 deaths each year.
Why take something that is non-beneficial and possibly detrimental to your health (life expectancy) when there are safe and effective natural options.
Make the effort. You’re worth it!
Written by Anne French
coast clinic 