Is cracking my neck and knuckles bad?

14:38Clodagh Toomey:thing it's a more specific thing yeah it's more kind of that creaking grating kind of crunchy noise and sometimes you can feel it as well if you put your hand over your joint when it's making

14:48Katie Edwards:noises you can probably feel those vibrations as well yeah and whenever I'm sure anybody who's ever cracked a knuckle or you know when I've I nodded my head in the car with my mom and my neck cracked and she went oh was that your neck that's arthritis coming that is which was reassuring as I'm sure you can imagine I like that my mom's like that she works she's you know a real positive support throughout life like that. Is that true? Will I get arthritis because I've got a poppy neck?

15:22Clodagh Toomey:So we have no evidence currently to suggest that you would just from cracking and popping joints in that way. I suppose the research that's been done when we describe evidence and you know the quality of evidence of there it's probably on the lower quality side because it's quite hard to conduct these types of investigations. Okay, so we'd be following people over a long period of time. So the types of studies that have been done have been kind of cross-sectional. So looking at one point in time or maybe retrospective where they'd be looking at people maybe with osteoarthritis and asking them, you know, were you a habitual knuckle cracker, you know, for example.

16:01Clodagh Toomey:And so you're relying on people to kind of self-report those. So the studies that have addressed that haven't found any link between joints popping or cracking and development of osteoarthritis. They have looked at other kind of hand function outcomes. So some studies have found like for knuckle cracking reductions in grip strength and other studies weren't able to corroborate that evidence. Some studies have found looser joints with people who knuckle crack a lot, but generally no difference in function. A really interesting study that was conducted. Have you heard of Donald Unger? No. So he was a doctor who was frustrated again, similar to your case, frustrated by his mother telling him he was going to develop arthritis in his hands.

16:54Clodagh Toomey:He was constantly cracking his knuckles. So what he decided to do was to crack the knuckles on his left hand for 50 years, twice a day, and not crack the knuckles in his right hand for 50 years. So he refrained from doing one hand and just did the left. And he wrote this up and published it and everything, investigations done, no arthritis in either hand by the end of 50 years. So that's just one person,

17:25Katie Edwards:but you know it might give you some reassurance. But that's dedication to being annoyed with your mum.

17:32Clodagh Toomey:Absolutely yeah you could say dedication to research but I think dedication to just proving a point to his mum.

17:37Katie Edwards:I know I feel his pain to be honest. So if you're gonna have like any kind of red flags that go along with this so it would be pain and it would be.

17:49Clodagh Toomey:Yes swelling I suppose like if you've noticed that there's reduced function in one hand versus the other, like anything, everything in moderation is okay. But, you know, I suppose if you're forcefully cracking your knuckles all the time, you know, it might not be a great idea. And the studies that have been done, like, as I said, are kind of low quality. So if you don't need to do it, maybe then why would you? And the other thing I suppose is, you know, the psychological benefit that some people feel from it is kind of worth talking about. So that noise that people hear, that audible crack, you know, know, it can be satisfying.

18:22Clodagh Toomey:It can be kind of self-soothing. It can kind of relieve tension. So there's definitely something about that. But there's, you know, there might be other strategies by which you could relieve tension or find ways for kind of meditation or mindfulness that kind of help you in that scenario.

18:39Katie Edwards:And does it do any good? Does it improve joint mobility? Like you were saying about having looser joints. Is that necessarily a bad thing?

18:47Clodagh Toomey:No, not always. It depends, I guess, and we need to make sure that we have enough stability around the joint as well. And that's really for kind of injury prevention and protecting us, I suppose, if we're to kind of take a stumble that we're able to catch ourselves when we fall, you know, that type of thing. So that's important. But, you know, there's definitely evidence there to suggest that we get, you know, increased range of motion, but it is temporary. So, you know, after that 20 minute time period, at a minimum, it's kind of going back to normal again. So there haven't been major studies over a long period of time to say over a long period of time, people have more range of motion if they're cracking their joints.

19:25Clodagh Toomey:So I think, yes, it does provide short term kind of increases in range. And within that, I suppose it can be used therapeutically as kind of tension relief. And it does, you know, it's going to have an effect on your nervous system as well when you're pushing that joint into kind of an extreme range. So it might have an effect on the nerve endings. It might release down muscle tissue if it's quite tight. But again, it's kind of a temporary effect. So you kind of need to keep doing it to get that response.

19:56Katie Edwards:And is it because of the gas? Is it because the gas is causing stiffness? And so when you pop it, it's kind of relieving a bubble of gas?

20:05Clodagh Toomey:Not necessarily, no. The gases aren't really causing stiffness as such, but it might be more due to muscle tension. So there's other ways that we could potentially relieve muscle tension that wouldn't involve cracking the joint or bringing it into a range that it's maybe not suitable for.

20:20Katie Edwards:Clodagh, I've been watching loads of videos of people having the body's manipulated, the joint's manipulated, so they make the most horrific sounding cracks and crunches. And it seems like in the videos that that's miraculous. It has this miraculous effect. So I've seen somebody walking in who could, you know, really could barely stand up straight. And then there's this almighty crack to her neck. And then she's like, oh, I feel great. That's amazing. What is, is that the case? Like, should we not really be doing that? Should we not really be crunching bones to that extent?

21:05Clodagh Toomey:There's not much to suggest that we shouldn't be doing it. I'd probably exercise some caution around the neck for sure. You know, there's a lot of different structures in our spine that we need to protect, including spinal cord and our blood supply. So I suppose making sure that if someone is getting a manipulation that, you know, the therapist is appropriately trained is really important. I suppose coming back to, again, that short-term benefit. And with that kind of psychological audible pop, that does provide that release. So if somebody is coming in and they, you know, they can't move and suddenly they can, it's not really getting to the root problem.

21:45Clodagh Toomey:So it might provide that symptomatic relief, but, you know, most likely that issue is going to come back if it's not addressed from the root problem. So I think that's something to consider in terms of, you know, therapies that are, you know, probably quite costly over the long term, you know, is it the correct way or is it just kind of an adjunct, something they can add on to their treatment to try and get them over that first step and then address the problem, I think is key.

22:13Katie Edwards:And is that just basically the same thing that's happening as when you pop your own joints? It is. Are they just doing the same thing? Yep. Yep. It's the same thing. so what's is is there any evidence for um sort of spinal manipulation for pain relief is is there

22:32Clodagh Toomey:any evidence for that at all yeah there is yeah yeah for sure and again it's kind of along the same lines of relieving tension and maybe you know providing you know psychological benefits as well um over the short term but obviously that must that must carry some risk then

22:48Katie Edwards:if somebody's manipulating a spine?

22:52Clodagh Toomey:Yeah, so the structures there, as you mentioned, the spinal cord. In the neck, we also have the carotid artery, which is the blood that's supplying the brain. So there have been instances of people having a stroke after a manipulation. So that's just something to consider as well. And is it something that really needs to be done to provide the relief or are there other methods that can be used that are just a little bit safer?

23:15Katie Edwards:So is there any evidence that kind of chiropractic cracking then of joints, does that help protect joints or does it help prevent arthritis or does it carry a bit of risk?

23:31Clodagh Toomey:There is neither risk nor kind of protective benefits of chiropractic release, I would say. It's more to target symptoms than, we'll say, provide a fix for somebody. But it doesn't necessarily protect from developing joint conditions or pose a risk to developing osteoarthritis or anything like that.

23:53Katie Edwards:As we get older, do joints just get noisier? Is that just something that happens when you're older? and is like how do you know when it's just getting older and when it's like a kind of degeneration that you need to do something about?

24:09Clodagh Toomey:There's definitely an increase in noisy joints as we age absolutely and that can be for various reasons it can be again the cartilage that we spoke about and over time you know that ages and it's maybe not as healthy as it was when we were younger and therefore it can make some noises as we're moving our joints but also when you think about the surrounding structures of the joints. So the muscles and ligaments maybe aren't as good quality as they were again in our youth. So that might cause extra pulls or pushes from one place to another. That can again cause that increase in noise. But if it's not accompanied again by pain or maybe, you know, reduction in strength, you know, you're still able to absolutely fly up and down the stairs, then great.

24:53Clodagh Toomey:You know, it's not something that should be of concern. And I suppose it's getting that across to people as well and not to worry about it and not to be fearful of noise because a lot of people might decide to reduce their physical activity because they think they're doing damage and they shouldn't do that unless it is accompanied by that that pain it's absolutely safe to continue what you're doing just because your joints are noisy doesn't mean that you should

25:17Katie Edwards:stop are there any supplements that help because i've seen um my brother suggested that i buy a load of collagen supplements and also a load of, what were they now, like cod liver oil to try and improve my joints because they're so noisy. Would that actually do any good? Is there any evidence that it would?

25:38Clodagh Toomey:Not any strong evidence to suggest it would. I think that there's some kind of weaker studies to suggest that it may improve joint health, but not specifically the noise of the joints. I know my husband, you know, takes collagen as well. And he anecdotally says, yeah my joints are less noisy so I think it's worth trialing on yourself um if it's something that you want to trial for a period of time see if it works um if not you know don't spend the money on it but if you feel like it's of benefit then continue um and that's what we'd say for a lot of these supplements where there has been kind of larger studies done on you know how it affects pain and function and people with arthritis um over over large numbers of people we don't see a huge effect but individually people do report that it's of benefit so and they're safe to take

26:25Katie Edwards:so that's the main thing yeah so if people do want to protect the joints long term whether they're crunchy or not what can they do to to kind of protect the function of the joints exercise our joints love movement so like the cartilage in particular um gets a lot of its

26:44Clodagh Toomey:nutrients through movement. So when we compress a joint and release again, that's how we get nutrients in and out of the joint because it doesn't have a huge blood supply into the cartilage. So movement is really important to keep joints healthy. And as I said, everything in moderation, if you build up your activity gradually, it's a really nice protective way to reduce the incidence of things like osteoarthritis. Even if you have osteoarthritis, being active can reduce the progression of the disease. We know that. So exercise and physical activity is really key to maintaining joint health and then things like eating healthy, you know, and there's not one specific diet, there's not one specific supplement, but just maintaining a nice healthy diet following the healthy eating guidelines is what's recommended.

27:30Katie Edwards:What is the single biggest misconception about joint cracking that you would like to retire?

27:41Clodagh Toomey:Joint cracking. I think, yeah, the misconception is that it causes arthritis and really we have no strong evidence to suggest that it does. So myth busted.

27:54Katie Edwards:Oh, I am recording that bit and I'm going to put it on my mum's phone. So every time she gets a text, that's what it's going to say. Thank you very much, Clodagh. That's been really great. Thanks for coming on. Thanks for the chat, Katie.

28:11Clodagh Toomey:Jane Austen's characters jump to life on screen with a new adaptation for each generation. But 250 years after her birth, Austen herself remains an enigma. When she died aged as 41, Jane's sister Cassandra burned most of her letters. What's left gives us tantalising clues about who she really was. I'm Anna Walker, host of Jane Austen's Paper Trail, a new podcast from The Conversation. over six episodes, one for each of her books, will take you on a journey through Austen's life and times with the help of the UK's top experts. From a scandal-filled tea room in Bath

28:47Katie Edwards:She obviously had quite a sharp pen for the cutting remark.

28:52Clodagh Toomey:to a windswept walk along the seashore at Lyme Regis. Austen herself envied the wives of sailors and soldiers because of the freedom, the liberty that you feel at the seaside. listen to jane austen's paper trail wherever you get your podcasts

29:09Katie Edwards:dan that story about that doctor who cracked all his joints on one hand i mean obviously i'm sensing a bit of tension in his relationship with his mother but what what do you think about that

29:20Dan Baumgardt:yeah sounds like someone trying to win an argument i mean it's it's a great story and actually one that you know a really really good self-experiment over 50 years or more i know a little bit about this the doctor in question was an allergist he wasn't a rheumatologist or an orthopedic surgeon, someone who specializes in joints. But interestingly, when his hands were examined later in life, there was absolutely no meaningful difference between them, between the side that he'd cracked his knuckles on consistently to the side that he'd left alone. No increased arthritis, no loss of function, no pain in the cracked hand.

29:52Dan Baumgardt:And actually, this chap went on to win the Ig Nobel Prize. It's a satirical sort of take on the Nobel Prize. And it's sort of awarded for wholly unnecessary, but at the same time really thought-provoking experimental results and findings. But yeah, I think the main thing to note is that this is in one person. So it might have been that he just got lucky. But it is a thought-provoking idea that actually over that long period of time, especially with prolonged joint cracking, if it was going to cause problems, you would have seen them.

30:21Katie Edwards:So Dan, apart from this doctor who is cracking knuckles, you're always good for a case study. So when doctors actually look at joint cracking in clinical settings, what do you see?

30:35Dan Baumgardt:When we look at imaging studies, when we look at MRI scans and ultrasounds, we don't see joint cracking causing any structural harm in healthy joints. What we normally see is gas bubble production, a bit like what Clodo was explaining to us. When we look for a patient who's complaining about joint symptoms, there's a couple of things we ask about. So as well as sort of crepitus and crunching and any sort of noises they've noticed from it, the main things we're actually focusing is have you got any joint pain? Have you got any stiffness associated with it? Because those are sort of like the telltale symptoms that let us know if something's actually wrong with a joint.

31:09Dan Baumgardt:Have you lost any function within your hands as well?

31:12Katie Edwards:So what are the kind of cases where joint cracking is associated with a problem then?

31:18Dan Baumgardt:So you can sometimes see patients who've got arthritis. So particularly that's what we call true crepitus, which Clodagh was talking about as well, where you hear that sort of creaking noise as bits of one bone rub onto another. And normally they're lined with cartilage and they've got all of this membrane and other bits and pieces between them. But when you start feeling them grating it, and sometimes it's not necessarily a noise that you hear, but it's a feeling. It's that feeling of grating, like someone's dragging it along a grater. and that can suggest wear and tear and degeneration within a joint and that might be something like osteoarthritis which is really really common and it's because it's related to degeneration of tissues and wear and tear as we get older we've been on our feet we've been involved in manual labor and other bits and pieces throughout our lives the joints naturally wear down and after a while the joint space decreases and the bones start to rub against each other so noise on its so and then is fine.

32:17Katie Edwards:Like I can continue with my dance career. Oh, most certainly.

32:21Dan Baumgardt:I wouldn't want you to stop there.

32:22Katie Edwards:No, no, I know. I know it's, well, it's a sin, isn't it? To hide talent, let's face it. It most certainly is. So then what have we learned today? So most joint cracking is normal. It's usually not your bones grinding together. It doesn't automatically mean damage. And cracking your knuckles, you can tell your parents, you can tell your grandparents, everybody who's complaining. It is not laying the groundwork for arthritis.

32:50Dan Baumgardt:Noisy joints are just that. They're noisy. The things that matter are the symptoms that we've talked about. So if you notice clicking alongside pain or swelling, redness, loss of movement or joints that feel unstable or they might give way, those are the cues that you need to get checked out with a doctor.

33:08Katie Edwards:And while cracking can feel relieving, that relief is usually temporary. It's not a reset. It's not a detox. It's not a realignment, no matter what you see on the internet.

33:21Dan Baumgardt:Real joint health looks a lot less dramatic. It's about strength. It's about movement, load management, and giving your body time to adapt.

33:28Katie Edwards:And huge thanks to Clodagh Toomey, who helped us to make sense of what's actually going on inside our joints, and especially the alarming sounds that come out of mine.

33:37Dan Baumgardt:So if you enjoyed this episode, hit subscribe, leave us a review and share it with someone who cracks their knuckles so they can continue doing

33:44Katie Edwards:it despite all the cries of you'll get arthritis and if you've seen a health claim online and thought that can't possibly be right then we want to hear from you email us at strangehealth at theconversation.com that's strange health all one word at theconversation all one word.com

34:04Dan Baumgardt:strange health is produced by gem aware editing and mixing is by anu panile and artwork by alice

34:09Katie Edwards:mason and remember if a sound alone meant damage for me every staircase would be a medical emergency

34:16Dan Baumgardt:we don't want that to be the case cheers everyone bye