You may have cracked your knuckles as a kid and had your mom yell, "Stop!  That'll give you arthritis."  Is this true or an old wives' tale?

Although cracking or popping knuckles is common, the research on it is not.

Let's start with two thoughts.  What causes the popping sound, and what is arthritis anyway?

The cracking or popping sound is caused by release of gas, mainly carbon dioxide, out of solution in the synovial fluid of the joint.^1,2,3  This is similar to the sound of a champagne cork releasing.  The popping produces only a small increase in pressure in the joint, which has been estimated to be only 7% of the pressure needed to damage the cartilage of the joint.⁴  The gas takes out least 30 minutes to build back up.  This is why you cannot immediately pop your knuckles again.  However, other sounds may be re-occurring.  For example, a snapping sound is usually a tendon or ligament sliding over a bone, and a crunching sound is usually damaged cartilage.

Arthritis is one of those words that is casually thrown around by both doctors and patients alike.  Oftentimes, I'll have a patient tell me they have arthritis or a physician told them they have arthritis, and I'll ask what blood tests or x-rays have they had performed.  Usually they'll reply, "none."  Unfortunately, that does patients a disservice because several types of arthritis exist.  The name arthritis means simply “joint inflammation”.  The two main types of arthritis are rheumatoid arthritis (RA) and osteoarthritis (OA).  Rheumatoid arthritis has been theorized to be an autoimmune disorder where the body attacks its own joints and causes joint inflammation including redness, swelling, and deformity.  Often this has to be controlled by some type of medication and/or supplement.  Osteoarthritis is wear and tear upon a joint which may result in joint space narrowing and bone spurs.  Osteoarthritis is also caused degenerative joint disease or degenerative disc disease if found in the spine.  A more proper name might be “osteoarthrosis” as it is seems to not have the inflammation involved with it as once thought.  Psoriatic and gout are other examples of other types of arthritis one might hear.

Drs. Robert L. Swezey and Stuart E. Swezey in 1975 conducted a study of 28 nursing home residents who could recall whether or not they had cracked their knuckles earlier in life.⁵  After studying x-rays of the participants’ hands, the researchers concluded that there was no link between habitual knuckle cracking and arthritis.

In 1990, another study published in the Annals of Rheumatic Disease looked at a group of 300 habitual knuckle crackers.⁶  The researchers found that the participants who cracked their knuckles regularly were no more likely than those who did not to have arthritis.

Dr. Donald L. Unger released an article in 2004 where he reported to have spent fifty years cracking the knuckles of only his left hand twice daily.⁷  After analyzing the difference between his left and right hand, he found no noticeable differences and no arthritis had developed.

According to Sanjiv Naidu, Pennsylvania State University professor of orthopaedics, "Plain old knuckle-cracking should not cause any damage.⁸  It does not strain the ligaments or the tissues, or overextend them enough to cause arthritis," Naidu says.  "It also should not cause joint weakness, on a long-term basis. Anatomically, physiologically, and mechanically, there's no reason it should cause harm."

Elaborates Naidu, "You literally have to disrupt the joint capsule through excessive force – like a ligament injury in a knee, or 'skier's thumb,' for example – to cause chronic, long-term damage.”  The forces generated by knuckle-cracking are relatively small in comparison, Naidu said.

In my opinion, knuckle cracking is not necessarily a bad thing; however, taking the joint in the wrong direction so that it is misaligned can cause a host of problems.  This is similar to spinal or extremity issues.  “Popping” the joint is not going to hurt it if it is taken into a properly aligned position.  However, if it ends up in the wrong position, acute pain might ensue or chronic wear and tear might occur over time.  This is why having your body professionaly aligned is important.

Dr. V.

Reference:
1. Brodeur R. The audible release associated with joint manipulation. J Manipulative Physiol Ther. 1995;18:155-164

2. Brodeur R. What makes the sound when we crack our knuckles? Sci Am. October 26, 2001.

3. Protapapas MG, Cymet TC. Joint cracking and popping: understanding noises that accompany articular release. J Am Osteopath Assoc. 2002;102:306.

4. Watson P, Hamilton A, Mollan R. Habitual joint cracking and radiological damage. Brit Med J. 1989; 299(6715):1566.

5. Swezey RL, Swezey SE. The consequences of habitual knuckle cracking. West J Med. 1975;122:377-379.

6. Castellanos J, Axelrod D. Effect of habitual knuckle cracking on hand function. Ann Rheum Dis. 1990;49:308-309.

7. Unger D. Does knuckle cracking lead to arthritis of the fingers? Arth & Rheum. 2004; 41:5:949-950.

8. Tibbett S. Probing Question: Does cracking knuckles cause permanent damage? Physorg.com. April 13, 2006.

The contents of the this Back to Health Wellness and Chiropractic Site, such as text, graphics, images, and other material contained on the Back to Health Wellness and Chiropractic Site ("Content") are for informational purposes only.  The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.  Never disregard professional medical advice or delay in seeking it because of something you have read on the Back to Health Wellness and Chiropractic Site!  If you think you may have a medical emergency, call your doctor or 911 immediately.  Reliance on any information provided by Back to Health Wellness and Chiropractic, Michael K. Van Antwerp, DC, Back to Health Wellness and Chiropractic employees, others appearing on the Site at the invitation of Back to Health Wellness and Chiropractic, or other visitors to the Site is solely at your own risk.

If you've been in the office for any period of time, you've probably heard me mention omega-3 fatty acids from fish oil. There's a reason why.

They have a huge host of benefits that we are just beginning to understand. If a wonder capsule exists then this is it. From reduction in inflammation in joints AND blood vessels to immune function to brain power, these oils lend a hand.

So big deal. Eat more fish...or flax seed...or both. The problem is we live in landlocked Oklahoma with little access to fresh coldwater ocean fish. The fish obtain the omega-3s from the algae they eat. Lake fish and the amount of frozen ocean fish we eat doesn't cut it. Also, mercury and other contamination in our oceans is unprecedented. You max out your mercury content for the week with one filet of salmon or three cans of albacore tuna. Flax seed oil has omega-3s but not in the longer chain form such as DHA that your brain uses or the EPA that your immune system uses. It's been estimated that flax seed oil conversion in your body to these larger chain oils is very low. Therapeutic dosage on DHA and EPA is often given at 1,200 to 6,000 mg. Try eating that much fish without any mercury or PCB contamination. So what to do? Well, my solution is to suck it up and take my daily mercury-tested, micro-distilled fish oil capsule.

Omega 3 Research 
Studies have shown that Omega-3's can have a very positive effect on the following conditions:
* Reduce the incidence of Cardiovascular disease (heart disease, stroke)
* Reduce triglyceride levels
* Reduce inflammation and symptoms associated with Crohn's Disease
* Reduce inflammation and symptoms associated with rheumatoid arthritis
* Lessen symptoms of kidney diseases
* Lessen the symptoms of Reynaud's disease
* Lessen the symptoms of chronic obstructive pulmonary disease
* Reduce the risk of early delivery in pregnancy
* Reduce the symptoms of childhood asthma
* Possibly reduce the risk of getting Alzheimer's
* Reduce the risk of prostate cancer
* Support normal brain function
* Supports vision development in infants
* Inhibit carcinogenesis and the formation of cancer cells
* Reduce PMS symptoms and breast pain
* Maintain healthy skin
* Boost your immune function

Here is a list of research headlines from just the last couple of months, all of which can be accessed at PubMed.gov:
 
* Erythrocyte fatty acids and risk of proliferative and nonproliferative fibrocystic disease in women in Shanghai, China.

* Omega-3 Fatty Acid Supplementation Effects on Weight and Appetite in Patients with Alzheimer's Disease: The Omega-3 Alzheimer's Disease Study.

* Omega-3 fatty acid rich diet prevents diabetic renal disease.

* Omega-3 Fatty acids, prematurity, and autism.

* Omega-3 Fatty acids and the cardiometabolic syndrome.

* Dietary intakes of omega-6 and omega-3 polyunsaturated fatty acids and the risk of breast cancer.

* Fatty acid facts, Part I. Essential fatty acids as treatment for depression, or food for mood?

* Effects of ethyl-eicosapentaenoic acid omega-3 fatty acid supplementation on hot flashes and quality of life among middle-aged women: a double-blind, placebo-controlled, randomized clinical trial.

* Fish Oil Reduces Heart Rate and Oxygen Consumption During Exercise.

* Dietary n-6 and n-3 polyunsaturated fatty acids: From biochemistry to clinical implications in cardiovascular prevention.

* Neuroprotectin D1-mediated anti-inflammatory and survival signaling in stroke, retinal degenerations and Alzheimer's disease.

* Fish Oil, But Not Flaxseed Oil, Decreases Inflammation and Prevents Pressure Overload-Induced Cardiac Dysfunction.

I'm also excited that a 950 mg, mercury-tested, micro-distilled, enteric-coated, burp-free omega-3 fish oil capsule is available in regular size. No more choking down several capsules. You can get your daily dosage in one capsule or two.

P.S. If you have an aversion to taking in fish, krill or algae-based capsules are available out there.

Here's to improving our health one day at a time!

Dr. V.

The contents of the this Back to Health Wellness and Chiropractic Site, such as text, graphics, images, and other material contained on the Back to Health Wellness and Chiropractic Site ("Content") are for informational purposes only.  The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.  Never disregard professional medical advice or delay in seeking it because of something you have read on the Back to Health Wellness and Chiropractic Site!  If you think you may have a medical emergency, call your doctor or 911 immediately.  Reliance on any information provided by Back to Health Wellness and Chiropractic, Michael K. Van Antwerp, DC, Back to Health Wellness and Chiropractic employees, others appearing on the Site at the invitation of Back to Health Wellness and Chiropractic, or other visitors to the Site is solely at your own risk.