What's that noise?
Have you ever wondered what those creaking, clicking or popping noises in your joints are? There is quite often a concern when we hear a noise that doesn’t regularly occur. Especially when it sounds like something is going to snap or pop. Often as a practitioner, when a patient present’s to the clinic, the first thing they say is “I have a clicking noise in my joint and I’m concerned about it”. On further questioning, we often find that there is no pain or issue with function, just a noise. So what exactly is that noise? The first thing a patient commonly suggests is, “its bone on bone” or “my joint is wearing out”. While this may be of concern to the patient, this is quite often not the case. The belief system formed around the noise and its association with wearing the joint out, can lead to changes in the patient’s thoughts towards the joint and how it functions. Whilst all that worrying could be put down to a normal processes known as crepitus.
What is crepitus? There are several theories that are currently doing the rounds, often combined with good and bad information around what crepitus is and its role in joint related pathologies. In most cases, crepitus is a normal function of the joint fluid (synovial) passing through a roughened joint surface. There is no pain associated with this type of noise. In far less common presentations, crepitus can have a pathological nature and be associated with osteoarthritis (OA). The difference being that patients with OA, more commonly complain of reduced mobility and loss of function of that specific joint, not the grinding or clicking noise. More commonly the association with the clicking, is an anxiety based response, formed through generalisations and a misconception around the meaning of the word. There is nothing wrong with that, there is so much jargon and misinterpreted information floating around on the internet, it is hard to filter through and make sense of it all. Enough about the jargon, the common times that the clicks and pops occur are when we first wake up, when we are warming to play sport or exercise and when we have been sitting or standing for extended periods of time. This is all because there will be little gas bubbles forming within the joint, and as the joint goes to move, the joint space closes over forcing the gas bubbles out. This process is absolutely normaland does not lead to arthritis.