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HEALTH HEED
 

Will cracking my knuckles harm my fingers?

Most people have cracked their knuckles more often than they're willing to admit. Against the steering wheel of the car, on the arm of an office chair or right on the desk. People crack their knuckles mostly when they're alone, but sometimes they do it in public -- under the table in a restaurant. Does cracking one's knuckles cause permanent damage? Or is it just an old housewives tale that cracking knuckles will cause arthritis or some other ailment.

Plain old knuckle-cracking should not cause any damage. It does not strain the ligaments or the tissues, or overextend them enough to cause arthritis. It also should not cause joint weakness, on a long-term basis. Anatomically, physiologically and mechanically, there's no reason it should cause harm.

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.

What causes the disconcerting sound?
The cracking noise is caused by a gas, mainly carbon dioxide that usually is dissolved in the synovial fluid that encapsulates most joints. If you pull on the joint or distend the joint capsule the walls of the capsule expand and lower the pressure on the fluid inside it. The gas then comes out of solution suddenly and forms bubbles, which makes a popping noise.

The stretching of the capsule also allows a temporary increase in the joint's range of motion. When you move the joint back into position, the fluid comes under normal pressure again, and the bubbles gradually go back into solution. The time it takes to re-dissolve the carbon dioxide into the synovial fluid prevents the knuckle from cracking again for a few minutes.

Arthritis probably not a risk
There has not been much research on the risk of arthritis from this habit. One survey of 300 people identified 74 habitual knuckle-crackers over the age of 45 (so it was assumed they had been doing it for years). Their joints were no more damaged than the joints of people who never cracked their knuckles.
This ties in with the experience of an American doctor who wrote in a medical journal that he had cracked the knuckles of his left hand, but never the right, for 50 years. He thought it would be interesting to compare the degree of arthritis in his right and left hands, and there was no difference.
However, the survey of knuckle-crackers did find that they had somewhat lower grip strength, and their hands were more likely to be slightly swollen. There have also been reports of hand injuries from what their doctors described as ‘the forceful manipulation needed to achieve the audible pop’.

Stopping the habit
If you want to stop cracking your knuckles, try the ‘competing response/habit reversal’ method. It simply means that whenever you feel the urge to crack your knuckles, you do another action instead. For example, you could wear an elastic wristband, and snap it on the inside of your wrist whenever you feel the urge to crack your knuckles. Alternatively, clench your fists tightly with the thumbs inside against the palms of your hands for 1 or 2 minutes; if you are in a situation where this action would be inappropriate, grasp some object instead.

Although the actual process of cracking a knuckle may take only a few milliseconds, the relief that some people feel from it is palpable. The only consequences knuckle-crackers face for their popping and snapping will be comments from friends and funny looks from innocent bystanders.

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