Cracking Crepitus
This cracking sound is medically known as Crepitus. Crepitus is characterized by a crackling, crinkly, or grating feeling or sound under the skin, around the lungs, or in the joints. Crepitus in soft tissues is often due to gas, most often air, that has penetrated and infiltrated an area where it should not normally be. The sounds may be faint or loud enough for people to hear.
Crepitus in the joints is typically related to joint damage, or the formation of tiny bubbles in the fluids surrounding the joint. Crepitus is not so much a condition, but rather a descriptive characteristic that doctors use to pinpoint the source of the problem. The term “crepitus” is derived from the Latin for “rattling” or “creaking.”
CREPITUS OF THE JOINTS
Crepitus may occur in tandem with a joint disorder or entirely on its own. As a symptom, it is not inherently problematic. Cracking your knuckles, for example, is a form of crepitus where a tiny nitrogen bubble in a joint suddenly pop with strenuous movement. It is generally only a problem when the popping is progressive or is accompanied by symptoms of joint damage, injury or infection.
JOINT DAMAGE
Crepitation can occur when the roughened surfaces of two joints rub together, causing the physical grating of cartilage and/or bone. This can occur when the meniscus (the fibrous cartilage between the surfaces of the joints) is gradually worn down or damaged. Repetitive stress can cause cartilage fibers to fray or form tiny crevasses. As the joint moves, these crevasses can “catch” and create popping/cracking sounds, often without causing pain.
If the pain is felt, it’s typically related to advanced joint damage, and/or the compression of nerves between narrowed joint spaces. It is at this stage that the joint may begin show signs of injury. This includes swelling, redness, reduced range of movement, and malformation.
Osteoarthritis (“wear-and-tear arthritis”) is the most common cause of this, although crepitus can occur with other forms of arthritis, including rheumatoid arthritis, psoriatic arthritis, and gout. It can affect any joint of the body but is most common in the knees, hands, feet, lower back, hips, and shoulders.
JOINT INFLAMMATION OR INJURY
Crepitus can occur when a facet of the joint is inflamed or injured. This can happen with conditions such as the following. These types of disorders are usually accompanied by pain and the marked restriction of movement.
Bursitis: This is inflammation of the fluid-filled sacs in the joint space called bursa. This can be caused by an infection, autoimmune disorder, trauma, or a repetitive use injury. Crepitus is often detected when the inflammation starts to subside and portions of the distended sac get trapped during movement, causing a popping sound.
Tenosynovitis: With this, inflammation builds up in the fluid-filled sheath called the synovium, which surrounds a joint tendon. Tiny bubbles can form in the synovial fluid, which pops whenever the joint is moved.
Patellofemoral Pain Syndrome (PFPS): Also, known as runner’s knee, this is caused when the cartilage under the kneecap (patella) is damaged. Crepitus is a common feature of PFPS since fragments of ruptured cartilage scrape together during movement.
Almost any injury of the joint cartilage can cause clicking or popping sounds as the uneven surfaces rub together. Rotator cuff tears and triangular fibrocartilage complex (TFCC) of the wrist are two such examples. Even abnormally shaped cartilage, such as with discoid lateral meniscus (misshapen disc in the knee), can trigger this effect.
JOINT DISORDERS
In some cases, the popping of a joint may be more irritating than problematic. If there is pain, inflammation, or restriction of motion, your doctor may order tests to pinpoint the cause. These may include:
– Imaging tests (ultrasound, X-ray, or a CT) to detect bone or joint injury. Or a MRI to detect soft tissue damage
– Blood tests to check for infection or inflammation
– Antibodies tests to confirm autoimmune disorders such as rheumatoid arthritis
– Arthrocentesis: where fluid is extracted from the joint space for analysis in the lab
Treatment may involve the use of ice and non-steroidal anti-inflammatory drugs to alleviate mild to moderate inflammation and pain. Severe cases may require splinting or intraarticular steroid injections to help further reduce inflammation.
Infectious causes of joint inflammation are most often bacterial and may require a short course of antibiotics.
Severe injuries (such as torn tendons, ligaments, or cartilage) may require surgery. If your mobility or quality of life is significantly impaired, joint replacement surgery may be considered, accompanied by extensive Physiotherapy.
Modifications can be made to your exercise plans to help keep crepitus in check. Such as opting for low-impact activities, and using lighter weights.
HERE AT COMFORT HEALTH
If you can relate to any of the points mentioned above – get an appointment booked today to see one of our practitioners! At Comfort Health we can offer a full body assessment. This assessment will help us determine where you have crepitus, and help with the cracking sound!