Joint cracking: Should I worry?

You have likely heard a crack when getting up, climbing stairs, moving your neck, or simply cracking your knuckles. These sounds are very common and, in most situations, do not necessarily mean there is a problem with the joint.

But then why do joints crack? And when should a crack be a cause for concern?

In this article, we explain what might be behind the different joint sounds and in what situations it is advisable to seek professional evaluation.

Why do joints crack?

The sounds we hear during joint movement can have different origins.

One of the best-known mechanisms is related to so-called joint cavitation. When we manipulate certain joints, as often happens when cracking our knuckles, rapid changes can occur within the synovial fluid (the fluid that lubricates the joints), associated with the formation of a gas cavity that produces the characteristic "crack" sound.

For example, when we pull or bend a finger, the space in the joint increases and the gas is released in the form of a bubble. The cracking sound comes from the rapid bursting of that gas bubble. It usually takes about 20 minutes for the gas to dissolve again before we can crack the same finger again.

However, not all cracks have the same origin.

A "click" or "pop" can also be related to the movement of tendons or ligaments over bone structures. Meanwhile, sounds more similar to crepitus, grinding, or "sand" can occur due to various changes in the joint surfaces or surrounding tissues.

Therefore, hearing a crack does not, by itself, determine whether an injury or joint disease exists.

Is cracking your knuckles bad for you?

This is probably one of the most frequent questions when we talk about joint cracking.

For many years, it was common to hear that cracking knuckles caused osteoarthritis. However, available evidence does not show that the habit of cracking knuckles is a risk factor for hand osteoarthritis.

Thus, the simple fact that a joint cracks does not mean it is being "worn down."

I have joint cracking, but no pain. Should I worry?

In the absence of other symptoms, an isolated crack is often of little concern.

For example, it is possible to hear cracks in the knee during movements such as squatting, climbing stairs, or getting up from a chair without this necessarily meaning that an injury exists.

The most important thing is not just "whether the joint cracks," but rather understanding the context in which that crack happens.

When can cracking be a cause for concern?

A crack deserves closer attention when it is accompanied by other symptoms.

It is advisable to seek an evaluation when the cracks are associated with:

· Pain during or after movement;

· Joint swelling;

· A feeling of locking or that the joint is getting stuck;

· A feeling of instability or that the joint "gives out";

· Decreased range of motion;

· Loss of strength;

· Cracks that appeared after a fall, sprain, or other injury;

· Symptoms that are progressively worsening.

In these cases, the sound may be just part of a broader clinical picture, and it is important to understand the cause of the symptoms.

Do cracks mean joint wear and tear?

Not necessarily.

It is important to distinguish between an isolated joint noise and a set of symptoms associated with a specific condition.

In osteoarthritis, for example, there may be pain, stiffness, limited movement, swelling, and crepitus. Noises can be part of the clinical picture, but they are not, by themselves, sufficient to establish a diagnosis.

Therefore, hearing a "crack" when moving the knee does not automatically mean there is cartilage wear.

How can physical therapy help?

When joint cracks are accompanied by pain or other symptoms, a physical therapy evaluation can help figure out what is happening.

The physical therapist can evaluate, among other aspects:

· Joint mobility;

· Muscle strength;

· Movement control and coordination;

· Joint stability;

· Symptom behavior during different movements;

· History of previous injuries;

· Impact of symptoms on daily activities.

Based on this evaluation, an intervention plan tailored to each person's situation can be defined.

The goal is not necessarily to eliminate the crack. When the noise is not associated with a problem, there is not necessarily a need to "treat" it. The goal is to see if there is any alteration contributing to pain, limitation, or loss of function, and to address what is actually affecting the person.

Musculoskeletal physical therapy can address various conditions affecting joints, muscles, tendons, and ligaments.

In summary: when should I worry about a crack?

An occasional, pain-free crack does not necessarily mean there is a problem.

However, if the crack is accompanied by pain, swelling, locking, instability, loss of strength, or limited movement, it is important to seek proper evaluation.

More important than simply asking "why does my joint crack?" is asking:

"Is the crack associated with any other symptom or change in my function?"

This distinction helps determine whether we are dealing with a normal phenomenon or a situation that deserves to be evaluated.

If you experience joint cracks accompanied by pain or difficulty performing certain movements, an individualized evaluation can help identify the origin of the symptoms and define the best approach.

At Physiokinesis, musculoskeletal physical therapy is aimed at the evaluation and treatment of various problems of the musculoskeletal system, with the goal of improving function and quality of life.

Bibliography

Couch JL, King MG, De Oliveira Silva D, Whittaker JL, Bruder AM, Serighelli F, Kaplan S, Culvenor AG. Noisy knees – knee crepitus prevalence and association with structural pathology: a systematic review and meta-analysis. British Journal of Sports Medicine. 2025;59(2):126–132. doi:10.1136/bjsports-2024-108866.

Saubade M, Karatzios C, Léonard E, Besson C, Gremion G, Gremeaux V. “My joints are cracking, is it serious doctor?” A review about sounds produced by joints. Revue Médicale Suisse. 2017;13(569):1334–1338.

Deweber K, Olszewski M, Ortolano R. Knuckle cracking and hand osteoarthritis. Journal of the American Board of Family Medicine. 2011;24(2):169–174. doi:10.3122/jabfm.2011.02.100156.

Rizvi A, Loukas M, Oskouian RJ, Tubbs RS. Let's get a hand on this: Review of the clinical anatomy of “knuckle cracking”. Clinical Anatomy. 2018;31(6):942–945. doi:10.1002/ca.23243

Lo GH, Strayhorn MT, Driban JB, Price LL, Eaton CB, McAlindon TE. Subjective Crepitus as a Risk Factor for Incident Symptomatic Knee Osteoarthritis: Data From the Osteoarthritis Initiative. Arthritis Care & Research. 2018;70(1):53–60. doi:10.1002/acr.23246.

Castellanos J, Axelrod D. Effect of habitual knuckle cracking on hand function. Annals of the Rheumatic Diseases. 1990;49(5):308–309.

Unger DL. Does knuckle cracking lead to arthritis of the fingers? Arthritis & Rheumatism. 1998;41(5):949–950.

Chan PS, Steinberg DR, Bozentka DJ. Consequences of knuckle cracking: a report of two acute injuries. American Journal of Orthopedics. 1999;28(2):113–114.