You should know you're a medic - Do people who crack their knuckles get arthritis?
BMJ 2001; 323 doi: https://doi.org/10.1136/sbmj.0112477 (Published 01 December 2001) Cite this as: BMJ 2001;323:0112477
- Edward Wild, fifth year medical student1
- 1University of Cambridge
“My gran used to put the milk in the cup before the tea, and over a period of 40 years all her teeth fell out.” This tragic case, based on a real grandmother, highlights the difficulty we encounter when anecdotal evidence becomes established as folklore. These beliefs are often deeply held and immutable, especially when they come from vaguely plausible foundations. One such conviction, that has frequently caused arguments among my colleagues, is the notion that habitual “cracking” of the knuckles causes arthritis in later life.
Some definitions
Let us, in true medical student style, begin with some definitions. By “knuckles,” we mean of course the metacarpophalangeal and interphalangeal joints. Some disturbing individuals may boast more extensive repertoires of clickable joints, including the toes, knees, and spine, but the principle remains the same.
The “arthritis” that crackers allegedly get must surely be osteoarthritis, a degenerative disease of cartilage with a well established “wear and tear” causation. This link between chronic abnormal joint stress (“microtrauma”) and osteoarthritis provides the basis for the belief that joint cracking causes premature degeneration. The condition can be extremely debilitating. The matter, though apparently trivial, …
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