Can knuckle cracking cause arthritis?

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The question:

Is it true that cracking your knuckles can lead to arthritis?

The science:

Knuckle cracking, which stretches the finger joints, is common. People may do it for various reasons – to relieve stress or tension, or simply for the pop. While it may sound destructive, there is no conclusive evidence that it causes serious or lasting harm, including arthritis.

There are no good quality studies that link cracking and degenerative changes in knuckles, or the metacarpophalangeal joints, experts said. “I usually tell my patients there’s no evidence that it’s harmful,” said Michael Pham, a rheumatologist at Mayo Clinic in Arizona.

In a 1998 case report in the journal Arthritis & Rheumatology, a physician named Donald Unger tested the myth perpetuated by his own mother, aunts and mother-in-law. He cracked the knuckles on his left hand twice per day every day, leaving the right hand as his control test. After 50 years, his knuckles showed no signs of arthritis and no differences between his left and right hands.

He quipped that the conclusion “calls into question whether other parental beliefs, e.g., the importance of eating spinach, are also flawed.”

There are many types of arthritis, but the one that has been blamed on knuckle cracking is osteoarthritis, a degenerative disease in which the tissues in the joint wear away, causing pain, swelling and stiffness. While injury or overuse can contribute to this kind of tissue damage, it would require excessive weight-bearing and friction on the joint, which does not occur by increasing the space between the joints by popping the knuckles, said Korsh Jafarnia, an orthopedic hand surgeon at Houston Methodist.

However, there are no rigorous studies that rule out definitively that knuckle cracking is associated with osteoarthritis, said M. Elaine Husni, director of the Arthritis and Musculoskeletal Center at Cleveland Clinic.

What else you should know:

Arthritis may not be a concern, but in rare cases, overzealous knuckle cracking could cause minor injuries such as ligament injuries and joint dislocation, Jafarnia said. In addition, research is mixed on whether the habit can cause other issues. A 1990 study reported that habitual knuckle crackers are more likely to experience hand swelling and lower grip strength, but a 2017 study reported the opposite.

Husni said occasional knuckle cracking is not likely to cause harm, though the effects of habitual knuckle cracking, which she defined as more than about five times per day, is being studied.

Anyone who develops pain or discomfort or experiences an escalation of pain that lasts more than about six weeks, or notices swelling or warmth in a joint should seek medical attention from a primary care physician or rheumatologist, she added.

The bottom line:

There is no conclusive evidence that cracking your knuckles can cause arthritis or other serious or permanent harm.

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